What your nails say about your health

Our nails tell us a great deal about what is happening inside the body. Health professionals will use these signs to determine disease and weaknesses. So now it’s time to take off that nail polish and look at what your nails are trying to tell you.

Dark Lines

A dark longitudinal line that appears beneath the nail should be looked straight away by your doctor. They are sometimes caused by melanoma, the most dangerous type of skin cancer. These lines are common in dark-skinned persons..

Yellow nails

Yellow nails can be a result of a fungal infection. The nail may appear thick, crumbly and grow slowly. In rare cases, yellow nails may be related to severe thyroid disease, diabetes, psoriasis, or lung disease (such as chronic bronchitis). It’s important to be aware of more obvious causes of yellow nails such as smoking, acrylic nails, nail polish and ageing.

Pale nails

Very pale nails with or without a bluish tint can be a sign of anaemia and that your body isn’t getting enough oxygen. It could also indicate other serious illnesses such as congestive heart failure, liver disease and malnutrition.

Lanula

The lanula, or lanulae (pl.), is the crescent-shaped whitish area of the nail at the top. Not everyone has visible lanulae and their absence can indicate lack of hydrochloric acid which results in impaired digestion. 

Changes in the colour of the lunula can be revealing. In patients with Wilson’s disease the area takes on a blue coloration, a phenomenon called azure lunula. Heart failure can turn the lunula red, and tetracycline therapy can turn it yellow. Chronic renal failure can completely obliterate lanula, resulting in half white and half brown nails at the ends.

Vertical ridges

Vertical ridges are typically a normal sign of aging and are not a cause for concern. They may become more prominent as you get older. 

In some cases, nail ridges may be due to nutrient deficiencies, including vitamin B12 and magnesium.

White nails

Nails that are white with darker rims are often a sign of kidney disease or liver trouble, such as hepatitis.

Transverse lines

Beau’s lines appear as transverse linear depressions in the nail plate. They can occur in one or more nails and can be caused by any disease severe enough to disrupt normal nail growth. They can also be a sign of trauma and exposure to cold temperatures in people with Raynaud’s disease.

If there are transverse white bands that don’t extend to the edges these are called Mee’s lines and are classically associated with arsenic poisoning. However, they can be associated with other conditions including Hodgkin’s disease, congestive heart failure, leprosy, malaria, chemotherapy, carbon monoxide poisoning and other systemic insults.

Pairs of transverse white lines that extend all the way across the nail are called Muehrcke’s lines. The lines represent an abnormality of the vascular nail bed and disappear when the nail is pressed down and blood is squeezed from the vessels beneath the nail. Because the lesion is in the nail bed, it does not move with nail growth. These characteristics distinguish Muehrcke’s lines from Mees’ lines. Muehrcke’s lines occur in patients with low protein states (hypoalbumin) and disappear when the protein level normalizes. They also may be present in patients with nephrotic syndrome, liver disease, and malnutrition.

White spots

White spots or markings can be the result of trauma to the nail and will grow out eventually. If trauma is unlikely and there are multiple spots on the nails a naturopath may suggest you supplement with zinc.

Onycholysis

Onycholysis occurs when the nail is lifted off the nail bed—resulting in white discolouration of the affected area. It can be caused by infection from fungus or warts but the most common reason for this separation is trauma. Onycholysis can occur in hyperthyroidism and is known as ‘Plummer’s nails’.

Spoon shaped

Nails that curve upwards at the edges, taking on a spoon-like appearance, may be a sign of iron-deficiency anaemia or iron excess (hemochromatosis). It could also be indicative of lupus, Raynaud’s disease, nail-patella syndrome, trauma and constant exposure of the hands to petroleum-based solvents.

Gnawed nails

Nail biters often have the appearance of gnawed nails. It is a sign of anxiety and has been linked to perfectionism traits and obsessive-compulsive disorder.

Nail pitting

Multiple small dents or pits in the nail is referred to as pitting. It’s a common sign in people with a chronic autoimmune skin disorder called psoriasis. Nail pitting may also indicate connective tissue disorders, inflammatory arthritis, or alopecia, an autoimmune disease that causes hair loss.

Cracked or split nails

Dry, brittle nails that frequently crack or split can be annoying but painful too. They have been linked to thyroid disease but could also be due to fungal infection of the nail, particularly if they are yellow.

Nail fold inflammation

If the area of skin around the nail appears puffy and red, this is known as inflammation of the nail fold. It could be due to infection or a chronic connective tissue disorder such as lupus.

Clubbing

Clubbing is a term used to describe when your fingertips become enlarged – causing your nail to curve downwards.

It can be a sign of low oxygen in your blood, especially in lung disease. It is associated with inflammatory bowel disease, pulmonary malignancy, asbestosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD), cirrhosis, congenital heart disease, endocarditis, atrioventricular malformations and fistulas.

Although most nails signs are completely normal, more concerning signs should be reviewed by your naturopath or GP. Nail findings can provide important clues to what is occuring in the body, so that you can take steps to improve your health.

References

1. https://www.webmd.com/skin-problems-and-treatments/ss/slideshow-nails-and-health
2. Fawcett RS, Linford S, Stulberg DL. Nail abnormalities: clues to systemic disease. Am Fam Physician. 2004 Mar 15;69(6):1417-24 http://www.aafp.org/afp/2004/0315/p1417.html
3. Pacan P, Grzesiak M, Reich A, Szepietowski JC. Onychophagia as a spectrum of obsessive-compulsive disorder. Acta Derm Venereol. 2009;89(3):278-80https://www.ncbi.nlm.nih.gov/pubmed/19479125
4. Hechtman L (2014). Clinical Naturopathic Medicine. Churchill Livingstone, Australia
5. Seshadri D, De D. Nails in nutritional deficiencies. Indian J Dermatol Venereol Leprol. 2012 May-Jun;78(3):237-41 https://www.ncbi.nlm.nih.gov/pubmed/22565422