What Your Nails Are Telling You

Categorized | Body

Posted on 22 April 2009.

By GABRIELLE LINZER AND MARY KEARL (AOL Health)

Nails — we cover them in polish, or keep them trimmed neat and clean and never give them a second thought, right? Though they may be tiny, everything about your fingernails and toenails — from texture, shape, color and strength — can tell you a lot more than you think. “The nails can be a window to internal disease processes,” says Andrea Cambio, MD, FAAD and spokesperson for the American Academy of Dermatology (AAD). “Always check with a dermatologist — an expert in the diagnosis and treatment of skin, hair and nail conditions — if any nail abnormalities [like the ones below] are noted.”

Texture Changes in Nails

Ridging — when small, raised lines appear vertically or horizontally across the nail — can be a normal part of aging, a result of picking at your nails, or occur because of injury, infection, or skin diseases like psoriasis and lichen planus. Watch out for horizontal lines, because they may be a sign of respiratory disease, malnutrition, arsenic poisoning or even heart attack. Pitting — the appearance of small indentations on the nail surface — can be normal, but Susan Van Houten, R.N., says that, “Deep pitting, especially with yellow or thick nails or separation of the nail from the nail bed, can be caused by a skin disease, such as psoriasis or eczema.” Thick nails that often become “yellow, ridged or brittle” and could even fall off are usually the result of a fungal infection, injury or poor circulation and could point to psoriasis.

Pale Nails

Pale nails or nail beds are often indicators of a lack of proper nutrition and conditions such as anemia or a deficiency of zinc or other vitamins or minerals. Pregnant women are especially at risk for developing anemia and should visit the doctor if their nails appear pale.

White Nails or Nails with White Specks

Little white marks may appear on your nails after minor injuries and will normally disappear on their own within a few days or weeks, according to Van Houten, but an entirely white nail could indicate White Nail Syndrome or leukonychia, which can signal more serious problems. According to the National Library of Medicine, this syndrome can occur with arsenic poisoning, heart disease, renal failure, pneumonia or hypoalbuminemia — a blood condition that may be a symptom of malnutrition.

Brown Nails

A brown tint can occur naturally in people with dark skin, but should be monitored if they change in appearance, as they can also be an indicator of malnutrition, a side effect of certain kinds of medication or worse. Watch out for dark brown, black or purple streaks under your nails — that haven’t been caused by an injury — these could mean melanoma, the most lethal form of skin cancer.

Shape Changes in Nails

Those with chronic lung, liver or thyroid disease may experience clubbing, which is when “ends of the fingers and toes swell, and the nails bulge outward,” Van Houten says. When you experience clubbing, nails undergo various changes, and in addition to wrapping around your fingers or toes, they look “more raised, curved and shiny than usual.” Tube-like nails can be caused by wearing improperly fitting shoes. This issue can often be corrected if you switch your footwear, but if discomfort becomes severe, it may require a doctor’s care. Spoon-shaped nails are common in children, but can also be due to diseases like iron-deficiency anemia — the nails will usually return to their normal appearance when the underlying problem is corrected.

Artificial Nails

Underneath that pretty exterior, bacterial or fungal infections could be growing. Bacterial infections are likely to occur if a new artificial nail is added before a thorough cleaning, and the longer you keep the fake layer on, the more likely a fungal infection will develop, according to Van Houten. If itchiness, redness or swelling occurs on the skin around your manicured nails, this may be a sign of an allergic reaction. Learn more about common problems that arise from wearing artificial nails and how to prevent them.

Nail Biting (Onychophagia)

Along with the ranks of hair-twisting, thumb-sucking, nose-picking and picking at skin, nail biting indicates stress, boredom or inactivity. This stress-relieving habit is prevalent among 50 percent of kids ages 10 to 18, but is dropped by most by adulthood, and only 10 percent of those over 30 still do it. While clearly indicative of a mental health condition, this activity can also have a real impact on your physical health — leaving behind red and sore fingertips, bloody cuticles, and increasing your risk for infection around your nails and in your mouth, according to Van Houten. Long-term nail-biting can even lead to dental problems, gum infections and nail growth abnormalities and deformities.

Bluish Nails

Medication may be the cause of your nail’s bluish tint, but this discoloration could also be a sign that you don’t have enough oxygen in your system. According to Van Houten, blue nails are often “caused by problems that reduce the amount of oxygen in the blood, such as asthma and COPD, severe anemia, cold exposure, exposure to high altitude, peripheral arterial disease or shock.”

Yellow Nails

Frequent use of dark red nail polish or a cigarette habit may be reasons for the new nail hue. But if neither of these applies to you, your new nail color could be a sign of serious illness, like cancer or chronic lung disease.

Weak, Easily Broken Nails

While they could be a part of normal aging, nails that split, peel or become brittle often develop as the result of frequent exposure to water, strong soaps and other chemicals, according to Van Houten, but she notes that using lotion and avoiding excessive contact with these materials may help. But be careful, because according to the American Osteopathic College of Dermatology, too little moisture can lead to dried out nails as well. Brittle nails may also be an indication of nail infection, a symptom of thyroid disease or in rare cases a result of a vitamin deficiency.

Ingrown Nails

Instead of growing above your finger or toe skin, these pesky nails grow directly into your flesh. You may be prone to getting them if you cut your nails too short, have curved or thick nails, sport ill-fitting footwear or suffer an injury such as a stubbed toe, says Caroline Rea, R.N., M.S. Through proper nail trimming and by wearing shoes and socks that fit, these nasty nails can be avoided. Take care — if you do have one and the nail becomes severely ingrown, it may have to be partially or completely removed, and in rare cases, an abscess may develop.

Hangnails

Those pesky slivers of dead or excess skin that seem to sprout between your nail and side of the cuticle could be harmless. Care for them may be as simple as a quick, clean trim with scissors. But biting or pulling at the hangnail could lead to tender, swollen skin and even infection.

Discolored Nails

Discolored nails are normally a surefire sign of a bacterial or fungal infection. According to the American Academy of Dermatology, “A bacterium called pseudomonas causes this discoloration.” Bacterial infections are often contracted when there is an injury on or around the nail bed.

Puffy Skin Around Nails

Red, swollen, tender or pus-filled skin around the nails could mean nail infection resulting from excessive contact with water, biting off a hangnail or pushing back a cuticle.

Separation from the Nail Bed

Is anything more cringe-worthy than a detached nail or toenail? While injury and repeated toe stubbing are major reasons for nail separation, fungal nail infections; skin conditions, like psoriasis; chemicals, such as those found in acetone nail polish removers and some soaps; medications and severe illnesses could also be the cause, according to Van Houten. Sadly, it takes about six months for a fingernail and up to 18 months for a toenail to grow back. Learn about home treatment for a detached nail.