Nail Changes

Nail Changes

Nails reflect our overall health, which is why proper nail care is so important. If your nails change, swell, or cause pain, see your dermatologist because these can be signs of serious nail problems. If you have diabetes or poor circulation, it’s especially important to seek treatment for any nail problems.

Have you noticed a change to any of your nails lately? A change in color, texture, or shape can be harmless, but it can also be a sign of disease. If you notice any of the following changes to a fingernail or toenail, it’s time to see a board-certified dermatologist.  Here are 12 nail changes a dermatologist should examine:

Dark Streak (Acral lentiginous melanoma)

If a fingernail or toenail has a new or changing dark streak, it’s time to see a dermatologist for a skin cancer check. That dark streak could be melanoma, the most serious type of skin cancer. Not every dark streak is a melanoma, but it’s always good to have a dermatologist examine one. Caught early and treated, that may be the only treatment you need. Allowed to grow, treatment becomes more difficult.

Nail Lifting Up (Onycholysis)

If a nail starts to lift up so that it’s no longer completely attached, you’ll likely see white discoloration, as shown here. When a nail lifts up, the cause is often:

  • A fungal infection
  • Psoriasis
  • Injury from an aggressive manicure
  • Injury form cleaning under your nails with a sharp object

A dermatologist should examine any nail that’s lifting up. You may need treatment to clear an infection. A dermatologist can also give you some tips that may help the new nail grow out normally.

Redness & Swelling Around a Nail (Paronychia)

If you have redness and swelling around a nail, you may have an infection. When diagnosed early, you can often treat an infection with soaks and antibiotics. If an open sore forms, you’ll need more extensive treatment.

Greenish-Black Color (Paronychia)

When bacteria cause a nail infection, the nail can turn greenish black as shown here.  Without treatment, a nail infection tends to worsen. Treatment can get rid of your pain and tenderness and help clear the infection.

Pitted Nails (Pitting)

If you have dents in your nails that look like they were made by an icepick, this could be a sign that you have a disease that affects your entire body.

People who have pits in their nails may have:

  • Psoriasis
  • Atopic dermatitis
  • Alopecia areata

Seeing a board-certified dermatologist for a diagnosis is important. Dermatologists are the specialists who diagnose and treat these diseases. Treatment can help you feel more comfortable and prevent the disease from worsening.

Yellow Nails (Yellow nail syndrome)

Wearing red nail polish without a base coat or smoking can turn your nails yellow. If your nails turn yellow, thicken, and seem to stop growing, it could be a sign of something going on inside your body.

Lung disease and rheumatoid arthritis can cause yellow nails. You may also have a serious nail infection, which requires treatment.


Deep Grooves/Gaps (Beau lines)

:Lines that run the length of a nail are common and usually nothing to worry about. If you see deep grooves that run the width of your nail like the ones shown in this picture, it means that something slowed (or stopped) your nails from growing for a while.

When something causes your nail(s) to completely stop growing for a while, you may see a gap. If this happens, you’ll have a place on your nail(s) that’s missing nail. The medical name for this condition is onychomadesis (on-ah-coe-ma-dee-sis).

A fever, injury, chemotherapy, or major stress can cause your nails to grow slowly or stop growing.

If you cannot think of what could may have caused your nails to grow slowly or stop growing, see your dermatologist or primary care doctor. Once you find and get rid of the cause, nails often start growing normally.

Ram's Horn Nails (Onychogryphosis)

This happens when the nails thicken and overgrow. Some people get Ram’s horns because the condition runs in the family.

If you have a disease, such as psoriasis, ichthyosis, or circulation problems, you may also develop Ram’s horn nails.

Cutting and treating these nails requires help from a podiatrist or dermatologist.

Thin, Spoon-Shaped Nails (Koilonychia)

If you have thin fingernails that dip down in the middle and look like spoons, you may not be getting enough iron. People develop an iron deficiency for many reasons, including:

  • Lack of proper nutrition
  • A health problem with their stomach or intestines
  • Sensitivity to gluten (celiac disease)
  • High altitude

Getting a proper diagnosis and treatment can help you feel better.


Washboard Nails (Onychotillomania)

If you have grooves and ridges in the center of your thumb that look like the ones shown in this picture, you may have developed a habit of picking at (or pushing back) the cuticles on your thumbnails. Many people are unaware that they do this.

A dermatologist may be able to help you break the habit, allowing healthy nails to grow out.

Curved Nails (Clubbing)

: The curving can begin so gradually that many people are unaware it's happening. As the nails continue to curve downward, fingertips often swell and the nails start to feel spongy when pressed on.

If you notice your fingernails start to curve, it’s time to see a board-certified dermatologist. Curved nails can be a harmless trait, which runs in the family. Curved nails can also be a sign that you have a disease in the:

  • Lungs
  • Heart
  • Liver
  • Stomach or intestine

Color Change

A disease inside your body can cause your nails to change color. Certain color changes can be a warning sign of a specific disease, as the following table shows.  Keep in mind, seeing a change to your nails or the half-moons doesn’t always mean that you have a disease.

Color Disease or Health Problem
Blue nails Not enough oxygen in your bloodstream
White nails Liver disease, diabetes
Pale nails Anemia
Half pink, half white nails Kidney disease
Yellow nails Lung disease, nail infection
Dusky red half-moons Could be lupus, heart disease, alopecia areata, arthritis, dermatomyositis
Blue half-moons Could be sign of poisoning

Cited from the American Academy of Dermatology

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