Deep ridges in fingernails, especially vertical ones (onychorrhexis), often signal normal aging, dehydration, or nutrient deficiencies (iron, zinc, protein) but can indicate issues like thyroid problems, eczema, or rheumatoid arthritis, while deep horizontal ridges (Beau's lines) suggest more significant systemic illness, severe infection, trauma, or medications like chemotherapy. While vertical ridges are usually harmless, deep horizontal ones warrant a doctor's visit to check for underlying conditions, especially if accompanied by color/texture changes.
Sometimes, vertical ridges on nails are a sign of vitamin deficiency or other nutrient deficiency. You may notice them if you have an eating disorder or if you're low in nutrients such as iron, folic acid (vitamin B9) or protein.
Certain nutritional deficiencies can cause changes to your nails. Zinc deficiency can cause Beau's lines and white spots on your nails. Iron deficiency can cause vertical nail ridges and koilonychia (spoon nails). Spoon nails have a depression in the middle, like the center of your nail was scooped out.
Skin and autoimmune disorders (like psoriasis and psoriatic arthritis), nutritional deficiencies, trauma to the nail, and vitamin deficiencies can affect nail health and cause dents.
Liver disease can cause several nail changes, most notably Terry's nails, where nails appear mostly white with a narrow pink band at the tip (like a "ground glass" look). Other signs include clubbing (nails curve downwards, thickening at the tips), yellowish discoloration, and sometimes nail separation (onycholysis) or ridges.
Symptoms of acute liver failure may include:
If your fingernails change color or you develop horizontal nail ridges, consult your health care provider. These changes could indicate an underlying health condition.
Diabetic nails may look thickened, yellowish, brittle, or have an unusual shape. This is often due to reduced blood flow to the extremities and nerve damage, also known as peripheral neuropathy, which affects the feet.
Horizontal ridges can be caused by trauma to the nail and may be deep or discolored. They can also indicate malnutrition, psoriasis or a thyroid problem.
Common Nail Signs That Point to Vitamin Deficiencies
Vertical Ridges – While these can be a normal part of aging, they may also suggest magnesium or iron deficiency. White Spots – Often caused by zinc deficiency, though minor trauma can also lead to these spots.
Nail problems can sometimes be a symptom of a more serious or long-term condition, such as:
Nail pitting is small, pin-poke dents in the nail plate of your fingernails or toenails. It's usually a sign of psoriasis, but other conditions cause it, too. If you notice nail pitting, talk to your healthcare provider so they can help find and treat the cause. Treatment includes medications and prescription creams.
Koilonychia is an abnormal shape of the fingernail. The nail has raised ridges and is thin and curved inward. This disorder is associated with iron deficiency anemia.
Ridged Nails
While nail ridges can be normal in some people, they can also be a sign of some medical conditions, such as kidney disease. Beau's lines are a common type of ridged nail that can occur in people with kidney disease. They appear as horizontal dents in your nail.
Liver failure nails often appear as Terry's Nails, characterized by an opaque white or "ground glass" look across most of the nail, with only a thin, brownish or pinkish band at the very tip and the half-moon (lunula) often disappearing, though other changes like ridges or yellowness (jaundice) can also occur, indicating systemic issues.
Five early signs of diabetes include frequent urination, increased thirst and hunger, fatigue, blurry vision, and slow-healing sores or frequent infections, stemming from high blood sugar levels that affect the body's ability to use glucose for energy, leading to these common symptoms.
Nail pitting is when small round depressions or notches appear in the nails. It's common in people who have skin disorders such as psoriasis and eczema. Nail pitting also may be related to alopecia areata — an autoimmune disease that causes hair loss.
Discolored nails that look yellow or greenish. Thick, dry cuticles that are ragged and tear easily. Redness around the nail (called periungual erythema) Fungal infections — people with autoimmune disorders like Sjögren's are at higher risk for infections.
If you notice nail changes like yellowing, lifting, ridges, or curving, talk to your doctor. Some of these changes may be related to RA or other autoimmune conditions. In rare cases, they could be a sign of lung or heart problems. Your doctor can help figure out what's causing the changes and what to do next.
Longitudinal ridges
Often referred to as "nail wrinkles", they usually appear with age or, for some, around the time of menopause. They suggest the body is producing less keratin and that hormone levels may be unbalanced. Longitudinal ridges can also point to vitamin or mineral deficiencies.
If there are symptoms of liver disease, they may include: Yellowing of the skin and the whites of the eyes, called jaundice. Yellowing of the skin might be harder to see on Black or brown skin. Belly pain and swelling.
Fetor hepaticus is a distinct smell on the breath of someone with liver disease. It happens when your liver can't filter certain toxic substances from your blood anymore. These substances build up in your blood and come out in your breath. You may also detect the same smell in your pee or sweat.
Dark urine.
Urine that is dark orange, amber, cola-coloured or brown can be a sign of liver disease.