Nail Problems

What are the 8 common nail disorders

1. Nail pitting

Nail pitting usually showcases itself as either shallow or deep holes in your nails. This can occur on both your fingernails and your toenails.

Most often, nail pitting is connected with nail psoriasis, but sometimes there are other causes of this condition.

If nail pitting is due to nail psoriasis, you may also notice the following symptoms:

• Changes to the normal shape of the nail
• A thickening of the nail
• Changes in the colour of the nail
• The nail coming away from the nail bed

In the most severe cases, nail psoriasis can cause the nail to crumble completely.

Nail pitting is most common in people aged 40 and over and is also more prevalent in those who have psoriatic arthritis.

If you do not have nail psoriasis, other possible causes of nail pitting sometimes include:

• A connective tissue disorder such as Reiter’s syndrome.
• An autoimmune disease such as alopecia or sarcoidosis.
• Incontinentia pigmenti, which is a genetic disorder that affects the hair, skin, nails, and teeth.
• Atopic or contact dermatitis.

2. Nail clubbing

Nail clubbing is one of the nail problems that often go unnoticed and undiagnosed. This is because the symptoms develop very slowly over time.

You can recognize nail clubbing by a downward curve to the nail, which feels soft when pressed. The tips of the nails are often swollen and may also be red in colour. The easiest way to describe the appearance of this condition is that the nails will look like upside-down spoons.

Nail clubbing can be a sign of a more serious condition, and you may also experience shortness of breath and/or coughing.

Nail clubbing is sometimes a symptom of lung cancer, although other lung conditions, congenital heart disease, endocrine problems, and gastrointestinal conditions can also cause this nail problem.

3. Beau’s lines

Beau’s lines are horizontal ridges that develop across the nails. You can develop more than one line on a single nail, or you can experience Beau’s lines on multiple nails.

There are several causes for Beau’s lines, including a nail infection, an injury, or as a result of certain illnesses.

• Acute kidney failure
• Mumps
• Thyroid disease
• Syphilis
• As a side effect of chemotherapy
• Melanoma
• Diabetes

You may also experience Beau’s lines if you have a zinc deficiency.

4. Nail separation

Nail separation, known in medical terms as onycholysis, is when your nail separates from the skin underneath it. One of the more common nail problems, onycholysis, has several possible causes, including injury to the nail, a fungal infection, or an allergy.

If you have onycholysis, you are likely to experience the below symptoms:

• The nail peeling upward from the nail bed
• Discoloration of the nail – yellow, green, purple, white, or grey depending on the cause

You shouldn’t feel any pain or discomfort. If your nail separation has occurred as the result of an injury, then no treatment is needed. You will simply have to wait for a new nail to grow through. If your nail separation is accompanied by other symptoms such as a yellowing and thickening of the nail, an unpleasant odour and/or a hardening of the skin surrounding the nail, you may have a fungal nail infection.

5. Discoloured nails

Another one of the more common nail problems is that your nails suddenly change colour, which can be a sign of an infection, an injury, or an underlying health condition.

Nail discolouration can affect both the fingernails and the toenails and typically involves the nail turning yellow, white, or green.

In more than 50% of cases, a discolouration of the nails is caused by a fungal infection. This is especially the case when the nail turns yellow or green. Alongside this, you may also notice that the nail has thickened, become curved, and/or started to separate from the nail bed.

If your nail appears red or purple in colour, this is most likely the result of an injury or trauma. In most cases, no treatment is needed, and you must simply wait for the injury to heal and the nail to regrow.

Chronic medical conditions such as diabetes, liver disease, and heart conditions can also cause discolouration of the nails.

Other causes of nail discoloration may include:

• A bacterial infection
• Candidiasis
• Malnutrition
• Yellow nail syndrome
• Staining from nail varnish or related products

6. Nail spooning

Nail spooning, known as koilonychia, is when the fingernails have raised ridges and scoop outwards much like a spoon.

In severe cases, the nail is so curved that it could hold a drop of water in it.

There are many possible causes of nail spooning, but the most common one is an iron deficiency.

You can identify spoon nails by the centre of the nail, which looks as though it has been spooned out. You may also notice that your nail becomes thin, cracked and the outer part of the nail may become separated from the nail bed.

Typically, spoon nails occur on the fingernails, but they can also develop on the toenails.

If your spoon nails are caused by an iron deficiency known as anaemia, you may also have the below symptoms:

• Fatigue
• Pale skin
• Feelings of weakness and lethargy
• Shortness of breath

Other possible causes of spoon nails include trauma, chemotherapy, frequent exposure to detergents or solvents, and an inability to absorb nutrients into the body. Spoon nails can also be hereditary.

You should be able to diagnose spoon nails yourself by their distinctive appearance, or you can visit your doctor for a professional diagnosis.

7. Nail streaks

Nail streaks, known as melanonychia, are a common nail condition that can affect both the fingernails and the toenails.

Typically, melanonychia displays itself as brown or black lines on your nails. It can be present on one nail or several.

If you are dark-skinned, these streaks may be a natural occurrence. However, they can also be a sign of a more serious condition, so they should always be investigated further.

The most common symptoms of melanonychia to look out for include:

• A black or brown vertical stripe down the length of the nail
• A black or brown horizontal stripe across the nail
• A deformity of the nail

There are many potential causes of melanonychia, including pregnancy, race, trauma, an infection, psoriasis, and, in rare cases, skin cancer.

Although the likelihood of nail streaks being a sign of cancer is low, you should always ask for an examination by your doctor to rule this out.

8. Yellow nail syndrome

Yellow nail syndrome is a rare condition that can affect both the fingernails and the toenails. This condition typically manifests itself as a gradual yellowing and thickening of the nails.

Sometimes, other symptoms you may experience include:

• The loss of the cuticle
• Curving of the nails
• Nails that stop growing
• Nails that separate from the nail bed
• Nail loss

Most people with yellow nail syndrome also experience problems with their lymphatic system. This can cause swelling in the lower parts of the body as well as respiratory problems.

Yellow nail syndrome can occur in people of all ages but is more common in those over 50.