Nail changes
Ingrid Müller is a chemist and medical journalist. She was editor-in-chief of for twelve years. Since March 2014 she has been working as a freelance journalist and author for, among others, Focus Gesundheit, the health portal ellviva.de, the publishing house living crossmedia and the health channel of rtv.de.
More about the experts All content is checked by medical journalists.Nail changes are common and mostly have harmless causes. The color, structure and shape of the fingernails can change, dots, grooves, discoloration, breaks, cracks or dents form. You can browse through your nails like a book. However, changes in the nails can also indicate a health problem. Examples are diabetes and heart and lung diseases. Read all about the most common nail changes and their causes.
Nail changes: description
Like hair, nails belong to the so-called appendages of the skin. Healthy nails are eye-catching, attractive and can be a real eye-catcher. A flexible and soft texture with a smooth, curved, transparent surface and a light crescent moon at the nail base are the hallmarks of healthy nails. Everyone has a slightly different nail shape that is inherited from the cradle.
This is how nails are built
Basically, nails are solid sheets of keratin that sit on the ends of your fingers and toes. They protect the fingertips and help grip things. They consist of the nail root, the nail bed, NageIwall, nail moon and the nail fold.
In the fine structure, the fingernail is made up of horn cells - about 100 to 150 layers are layered on top of each other. It grows out of the bed of nails in slow motion. It is estimated that a nail travels 0.5 to 1.2 millimeters per week. Anyone who has ever slapped their fingers with a hammer knows that it takes many months before the blue color has disappeared and a new nail has pushed itself out.
Changes to the nails can speak volumes and say a lot about the health of the person who wears them. In the simplest case, yellow fingernails or those that are brittle, brittle and cracked only look neglected and are therefore an aesthetic problem. In the worst case, the nail changes can be caused by serious illnesses.
Nail changes: causes and possible diseases
Longitudinal or transverse grooves, white spots or deformations - there are different types of nail changes. The following causes can be behind it.
Grooves - lengthways or crossways
Fine longitudinal grooves are a normal symptom of age and therefore mostly harmless nail changes. Deep transverse grooves (also known as Beau-Reil transverse furrows) indicate that the nail was not growing properly. Often times, a wrong manicure injures the nail bed. Other triggers for nail changes and impaired nail growth can be severe infections with fever, diseases of the gastrointestinal tract, deficiency situations or poisoning. Examples are thallium or arsenic as well as drugs such as barbiturates, cytostatics or anticoagulants.
Mees stripes are yellowish-whitish transverse grooves that run across the nail. These nail changes can be caused by arsenic or thallium poisoning.
Discoloration
Discolored nails can be caused by changes in the nail plate as well as on it or under it. There are different types of discoloration.
White coloring of the fingernails: White spots on fingernails always appear when you are injured, for example by bumps or during a nail manicure - the cuticle is usually affected.
In the case of leukonychia, the keratinization of the nail matrix cells is disturbed. The most common form is punctate leukonychia - with these nail changes, many white spots are scattered over the nail. The leukonychia vulgaris can be recognized by the white horizontal stripes that run across the nail. The most common reason for both nail changes is manipulation of the cuticle, usually during manicure.
Leukopathies are also characterized by a white coloring of the nails. Causes of these nail changes can be, for example, vascular changes as well as cavities and air inclusions in the nail plate and below it, for example in the case of nail fungus (onychomycosis).
Half-and-half nails: With these nail changes one finds a white coloration of the near (proximal) nail plate half and a reddish brown coloration of the body remote (distal) nail plate half. As a rule, they are an indication of chronic kidney failure (renal insufficiency).
The frosted glass nails (Terry nails) are almost completely discolored whitish and cloudy. These nail changes are often caused by changes in the blood vessels in the nail bed, especially in the case of cirrhosis of the liver, but also in the case of heart failure and diabetes mellitus.
Darkening of the fingernails: Brown nails occur after contact with chemicals (e.g. wood stains, hair dyes, nicotine and tar in smokers) or with Addison's disease. Splinter bleeding causes reddish-brown spots in the nail bed.
Black discoloration of the nails can be caused by injuries (e.g. knocks or knocks on the fingernail). A bruise (hematoma) forms under the nail. In the worst case, however, it can be caused by skin cancer (melanoma). In addition, medication can discolour the nails brown, blue or black. Examples are cancer drugs (cytostatics) or antimalarials. Be sure to ask your doctor.
Changes in the nail in the form of bluish discoloration of the nail bed can indicate cyanosis - a lack of oxygen is the reason that requires medical attention. For example, heart failure or carbon dioxide poisoning can cause cyanosis. In the case of carbon monoxide poisoning, however, the nail bed turns cherry red.
Yellow discoloration: Yellow fingernails can be associated with psoriasis. Sometimes oil nails form - yellowish discolorations that look like drops of oil. Yellow-gray nails indicate a fungal nail disease (onychomycosis).
In the "yellow nail syndrome", yellowish to gray-green discoloration, thickening and hardening of individual or all nails are characteristic. In addition, the nails grow much more slowly. The syndrome is often associated with respiratory diseases (e.g. bronchitis, pneumonia) and lymphedema. You should consult a doctor in these cases.
Deformations
In the case of a watch glass nail, the nail plate bulges outwards. In addition, the nail is enlarged and rounded-convex in shape. The watch glass nail is the result of the end links of the fingers that are blown up in the shape of a drumstick (hence also drumstick fingers). Most often, both indicate lung or heart disease. A visit to the doctor is important here.
With a spoon nail (koilonychia), the nail plate lowers inward while the edge bends upward. The nail is concave like a spoon. The spoon nail most often forms on the thumb. The reason can be an iron deficiency or exposure to chemicals.
Point and funnel-shaped indentations are typical for dimple nails (often also potted nails). The causes can be eczema, circular hair loss (alopecia areata), psoriasis or fungal infections.
Brittle nails
Some people have extremely brittle nails (onychorrhexis). The nail tears, splits lengthways or split from the free edge of the nail. The reason can be frequent contact with detergents and chemicals.
These dry out the skin and nails. Nail polish removers can also remove moisture from the nails and make them brittle. Sometimes malnutrition is to blame (lack of vitamins A, B and iron). Malnutrition, such as anorexia, also plays a role. Brittle nails can also indicate an overactive thyroid or liver disease.
In the Onychoschisis the nail plate usually splits horizontally. Here, too, the reasons are malnutrition and malnutrition (vitamins, iron) and excessive hygiene.
Other nail changes
Sometimes the nail plate also partially separates (onycholysis) from the nail bed - this is a relatively common phenomenon. The nail can become partially detached from prolonged exposure to water, soaps, detergents or too intensive nail cleaning. The total detachment of the nail is less common, here doctors speak of onychomadesis. The causes can be inflammation of the nail bed, nail fungus, psoriasis or trauma. Crumb nails are porous nails that crumble at the edge of the nail. The cause can be psoriasis.
Nail Changes: When Should You See a Doctor?
There is not always a serious cause behind the nail changes. White spots or stripes and longitudinal grooves are usually harmless. Smaller bruises under the nails usually go away on their own, they just take a little time and patience. Changes to the nails caused by incorrect manicures and injuries to the nail bed do not necessarily require medical treatment. However, a visit to an experienced beautician who will show you the right nail care is recommended.
But there are nail changes that make a doctor's visit advisable. These include, for example, the relatively stubborn nail fungus, which must be treated consistently, or certain nail deformations. For example, a watch glass nail can indicate serious heart and lung diseases. Nail discoloration should also be checked by a doctor if the discoloration does not grow out.
Nail changes: what does the doctor do
A skilled doctor can read your nails like a book. The color, structure, strength, texture or shape of the nail are important. At the beginning there is the patient interview (anamese). For example, the doctor will ask you when the nail changes first appeared and whether they occurred suddenly, whether you have any illnesses, are taking medication or handling chemicals. A specialist can already draw certain conclusions from your answers.
If the nail changes are due to illnesses, these must be treated. Examples are psoriasis, respiratory or heart diseases.
Nail changes: you can do that yourself
There are some tips on how to prevent nail changes or how to treat them yourself.
- If you frequently handle chemicals (e.g. hair dyes, varnishes, cleaners), you should protect your nails with gloves.
- It is best to avoid nail polish remover and other aggressive substances that can cause nail changes.
- It is best to file your nails short and grease them sufficiently (greasy nail creams, warm olive oil bath for the fingertips).
- When doing a manicure, do not remove the cuticles completely, just gently push them back.
- Try to reduce mechanical stress on your nails. For example, do not scratch anything solid with your fingernails, otherwise the nail may change.
- Food supplements can help if there is a lack of nutrients (e.g. iron, biotin, vitamins, calcium).
- In the case of nail changes due to lack of fluids, it is important to drink enough!
- If you have a nail fungus: Carry out the drug therapy consistently, otherwise the infection will flare up again and again.
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