Our physical appearance can serve as a window into our internal health, and one’s nails are no exception.
Nail health can be an indicator of health overall. Here are a few common symptoms and what they may mean.
Weak, brittle or peeling nails: there can be numerous causes to this problem. Sometimes it is as simple as dryness or moisture loss because of over-washing or chronically damp, wet nails. In other cases, hypothyroidism (an under-active thyroid) nutrient deficiency may be the culprit behind weak nails. Nutrients involved may be minerals like calcium or iron, fatty acids, or B vitamins. Blood work can be done to differentiate the causes. I notice in my clinical practice, not eating enough protein may also impact nail strength.
Blue nails: this can indicate there is not enough oxygen in the bloodstream or that there are issues with circulation. Blue hued nails may also indicate a sluggish thyroid, especially if the hands are chronically cold.
Black spots or streaks: a dark red or black spot may be a sign of bruising underneath the nail bed (likely from trauma to the nail), while a black streak may be a sign of melanoma, the most serious type of skin cancer. Not every dark line is melanoma, but always see a medical doctor as soon as possible to differentiate causes and be treated accordingly. Early detection is key in cancer treatment and outcomes.
Clubbed nails: this occurs when, over time, the fingertips become enlarged for various reasons causing the nails to curve around the fingertip — giving a clubbed appearance. This can be due to low blood oxygen levels and can be related to lung disease, or other issues like cardiovascular or inflammatory bowel disease.
Dark colouration: a green or black colour to the nail may indicate a bacterial infection.
Lifting or nail separation: if the nail bed appears to be lifting at the corners, it can be a sign of fungal infection, thyroid disease or psoriasis, especially when accompanied by white discolouration.
Pale nails: pale nails may indicate anaemia which can be confirmed through blood work.
Pitted nails: small dents or pits in the nails could be a sign of more systemic illness like psoriasis or alopecia.
Horizontal ridges: also known as Beau’s lines, these may indicate a moment of stress to the nail itself or body overall that have caused the nail to stop or slow growth in that moment. For example, if you have had trauma to the nail, fever, or have undergone an intensive medical treatment like chemotherapy, these lines will be created and will mark that moment in time. These lines will grow out slowly. These may also represent other underlying causes.
Vertical ridges: these can occur with age and may not be a sign of an underlying health condition, especially if they do not present with other nail symptoms, like changes to colour.
Spoon-shaped nails: nails that are thin and dip in the centre angling upward on the sides could indicate iron deficiency. Iron deficiency can be caused by lack of consumption of foods rich in iron (like red meat), or digestive issues that do not allow for enough iron absorption (like celiac disease).
White spots: if they are small and underneath the nail bed (also referred to as leukonychia), they may indicate trauma to the nail or iron deficiency anaemia. If the white spots are larger and cause the nail to have a thicker appearance and are causing the nail to lift, this is likely a fungal infection.
Yellow nails: smoking or wearing polish (particularly red in colour) long-term can turn the nail yellow. If the nails are also slow to grow or have stopped growing and are beginning to thicken, this could indicate a deeper issue like infection, lung disease or rheumatoid arthritis.
Not all physical symptoms have an underlying meaning however, if you are experiencing a new or worsening nail symptom or are concerned, always seek the advice of your medical doctor or dermatologist. As with any physical symptom, it is important to rule out any underlying causes and treat accordingly.