We've Got Healthy Nails Nailed Down

We've Got Healthy Nails Nailed Down

Your hands are among the most expressive parts of your body and provide a rich source of information about how you feel, what you are thinking, and your emotions as you speak. You shake hands, hold hands and use gentle touches to provide reassurance. Your hands hug, cradle and create. Strong, healthy nails on your hands (and feet) not only boost your confidence, they can speak volumes about your general health. Our dermatologists and expert providers are experienced at diagnosing nail conditions, and at treating underlying problems at their source.

Interestingly, changes in the health of your nails, nailbeds, and cuticles may be indicators that other health problems are present and warrant further study.

Nail Infections

If you have a nail infection, you should consult with one of our dermatology professionals, as the condition can become serious. People who have diabetes or a weakened immune system are at increased risk of developing non-healing sores and need to seek prompt treatment of any infection.

Misshapen or Brittle Nails

Injury to the base of the nail or the nail bed may cause a permanent nail deformity. If you haven’t had an injury and see one of the following distortions to your nail shape, talk to your dermatologist.

See Nail Infections for additional information about causes of misshapen nails.

Nail Pitting

Dents in your nails that look like they were made by a little icepick could be a sign of psoriasis, atopic dermatitis, alopecia areata (an autoimmune disease that also can cause hair loss), and other disorders. It’s important to identify the cause of nail pitting to ensure the right treatment and to help prevent a condition from advancing.

Nail Clubbing

Usually occurring over the course of years, the tips of the fingers enlarge and the nails curve around the fingertips. Nail clubbing can be a result of low blood oxygen or a sign of various types of disease. Check with us at the first sign of nail clubbing.

Spoon Nails

Spoon nails are soft, curved upward and “scooped,” like spoons. Spoon nails can signal that you may not be getting enough iron, which can be the result of lack of proper nutrition, a stomach or intestinal problem or celiac disease. Spoon nails might help alert you to heart disease or hypothyroidism. We can diagnose spoon nails and consult with your other trusted medical professionals to help you receive the care you need for any underlying condition.

Terry's Nails

If most of your nails appear white except for a narrow pink band at the tips, you may be experiencing Terry’s Nails. While sometimes attributed to aging, Terry's Nails may be a sign of diabetes, or of an underlying illness of the liver, heart or kidney. Our dermatologists can help determine the cause.

Vertical Nail Ridges

Vertical nail ridges, which are fairly common, extend from the cuticle to the tip of your nail. They often become more numerous or prominent with age and are not usually associated with a physical health condition.

Ram’s Horn Nails

This happens when the nails thicken and overgrow. Some of the reasons people get Ram’s Horn Nails include psoriasis or circulation problems, or it can also be a condition that runs in the family. You’ll want to seek our assistance for proper cutting and treatment of these types of nails.

Beau's Lines

Beau's Lines are indentations that run horizontally across the nails. These indentations can appear when nail growth is slowed or stopped because of injury or severe illness. Uncontrolled diabetes or peripheral vascular disease, as well as illnesses producing a high fever, such as scarlet fever, measles, mumps and pneumonia can cause Beau’s Lines. Eczema around the nail, zinc deficiency, chemotherapy for cancer, or improper nutrition can also result in Beau's Lines. With such diverse possibilities, medical evaluation is needed when you see this condition. Once the cause is addressed, nails often begin growing normally again.

Nail Separation or Lifting Up

When the fingernails become loose and partially separate from the nail bed, the separated part of the nail becomes opaque with a white, yellow or greenish tinge. The cause can be from an injury or infection (such as from an aggressive manicure or from using a sharp object to clean under your fingernails), from a drug or consumer product interaction (nail hardeners or adhesives can cause injury, as can drug reactions, especially to antibiotics), or from thyroid disease and psoriasis. If your nails are lifting up, we can suggest treatment to help them grow out normally, again.

Brittle Nails

Women are more prone than men to have splitting, brittle, soft or thin nails. Brittle nails often occur as a normal result of aging, but they can also be caused by certain diseases and external conditions. Rarely, internal disease or vitamin deficiencies are the reason for this nail condition. Long-term exposure to moisture or nail polish can cause nails to peel and become brittle. If your fingernails split, but your toenails are strong, we can help you explore if an external factor as the cause.

Nail discolorations, lines & white spots

See Nail Infections for more information about nail discolorations.

Yellow Nail Syndrome

Did you know that wearing red nail polish without a base coat, or smoking can turn your nails yellow? With Yellow Nail Syndrome, however, nails also thicken, and new growth slows. Yellow Nail Syndrome can be a sign of respiratory disease, such as chronic bronchitis, lung disease, rheumatoid arthritis, and can also be related to swelling of the hands (lymphedema), and is cause for further examination.

Dark Streak

A new or changing dark streak in a fingernail or toenail is your sign it’s time to see us for a total-body skin cancer check. That dark streak could be melanoma, the most serious type of skin cancer. A key indicator of one type of melanoma is called a "Hutchinson's sign" and looks like a dark streak that extends from the tip of the nail down to the nail bed and into the cuticle. Not every dark streak is a melanoma, but it’s better to check it out. Early detection is important for prompt and proper treatment.

Redness and Swelling Around a Nail

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 may need more extensive treatment and should contact us. (See more information in Nail Infections section.)

Greenish-black Color

When bacteria causes a nail infection, the nail can turn greenish black. Without treatment, a nail infection tends to worsen. Treatment offered by your dermatologist can get rid of any discomfort and help clear the infection.

Green Nail Syndrome

Green Nail Syndrome is a bacterial infection of the nails that leads to a greenish discoloration. The green discoloration varies from blue-green to dark green and blue-grey. The discoloration is underneath the nail, so it can’t be washed away. The condition is usually confined to one or two nails and can involve fingernails or toenails. While the nail is usually not painful, the skin around the nail, including the cuticle, may be swollen, tender or red.

Splinter Hemorrhages

Splinter hemorrhages are small areas of bleeding (hemorrhage) under the fingernails or toenails. Splinter hemorrhages look like thin, red or reddish-brown lines under the nails, running in the direction of nail growth. They look like what their name implies – a splinter under the fingernail. Trauma to the nail from sports or housework, for example, is the most common cause. Hemorrhages can also be caused by environmental factors, skin disorders, systemic diseases, other health conditions and medication use. Your dermatologist is an expert at diagnosing these marks.

Nail Growths

The skin around and under nails is also a common place to develop a growth. It is important to know that a growth under the nail can present as only as discoloration or misshaping of the nail plate. It is therefore critical sometimes to surgically remove the nail plate to examine and possibly biopsy the skin underneath when a discoloration or change in shape of the nail occurs (especially when it is present in just one nail). Some common growths in this location include:

Common Warts

Warts are a benign growth caused by human papilloma virus (HPV) infection. While they are generally harmless, they are infectious, can be painful, and rarely can progress into Squamous Cell Carcinoma (also known as Squamous Cell Cancer or SCC). Warts around and under the nail can sometimes be difficult to eradicate and often times require more than just the simplest treatments.

Squamous Cell Cancer

Squamous Cell Skin Cancer can arise from a wart but most commonly is a consequence of chronic exposure to UV from the sun. Generally this type of skin cancer is readily treatable, but when neglected can sometimes invade bone and necessitate amputation of a finger or toe.


Melanoma is a potentially dangerous skin cancer that usually (but not always) shows up as a dark spot or discoloration in or around the nail (see above). Unfortunately, melanomas in this location are often misdiagnosed as an infection or a collection of blood. A new dark spot in or around the nail is therefore worthy of prompt evaluation by a trained professional.

Nail Psoriasis

Nail Psoriasis

If you have psoriasis, it’s important to check your fingernails and toenails for signs of nail psoriasis. Common signs include:

  • tiny dents in your nails (called “nail pits”)
  • white, yellow, or brown discoloration
  • crumbling nails
  • nail separating from your finger or toe
  • buildup beneath your nail
  • blood under your nail

If you notice any of these signs or any other problems with a nail, tell us. Without treatment, nail psoriasis may worsen and become severe, but treatment can help clear nail psoriasis and reduce discomfort.

Nail changes can also be a sign of psoriatic arthritis, so you’ll want to see your dermatologist to discover the cause. Treating psoriatic arthritis can prevent it from getting worse.

Ingrown Toenails

Ingrown Toenails

An ingrown toenail occurs when a side or corner of the nail curls down and digs into the skin of your toe. It happens most often to the big toenail, but can happen to any toenail. It is fairly common and can be caused when a nail is not trimmed properly, a corner tears from a nail or it is trimmed on an angle, or from shoes that are too tight or too short. Symptoms include redness, swelling and pain on your toe around the nail.

While an ingrown toenail is not a serious health risk in healthy individuals, we should be consulted if the pain from an ingrown nail is severe or spreading. Also, if you have diabetes or another condition that causes poor blood flow to your feet, you’re at greater risk of having complications from ingrown nails and should seek the advice promptly.

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