You should be worried about your nails and see a doctor or a dermatologist if you notice significant changes in their color, shape, thickness, or texture, especially if they occur suddenly, persist without a clear cause (like an injury or nail polish use), or are accompanied by other symptoms like pain, swelling, or bleeding.
Ridges or ripples
Vertical ridges in your nails may be age-related and are usually harmless. Horizontal ridges, called Beau's lines, indicate a pause in nail growth that could be related to a health issue. Common causes include high fever, vitamin deficiency, injury, diabetes and peripheral vascular disease.
Like other types of melanoma, subungual melanoma develops in melanocytes, the pigment cells that give skin its color. Unlike most types of skin cancer, subungual melanoma isn't related to sun exposure. Nail melanoma often shows up as a narrow brown or black streak or band on the nail.
But some nail color changes can be a sign of an underlying medical problem: Yellow or green patches could be a nail fungal infection. A brown or black line could be melanoma (so it should be checked out right away).
While there are some harmless causes of nails changing color, some are a warning sign of diseases, infections, anemia, and even poisoning. Watch out for unexplained changes to blue, white/pale, greenish-black, yellow, or red, which can affect either the whole nail or just parts of it. A dark streak.
Heart failure nails often show nail clubbing, where fingertips enlarge and nails curve downward like an upside-down spoon due to poor oxygen flow, feeling soft and warm, but can also present as blueish tints (cyanosis) or splinter hemorrhages (tiny red lines under nails) from heart infections (endocarditis). Other signs can include Terry's nails (mostly white with a pink tip) or Mees lines (horizontal white bands). These changes signal serious underlying issues, requiring prompt medical evaluation.
iron deficiency anaemia. an underactive thyroid or overactive thyroid. diabetes.
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.
Persistent brittle, thickened, pitted, or discolored nails may signal infection, psoriasis, or other disease; see a dermatologist for diagnosis. Dark nail streaks or unusual color changes can be serious, including melanoma; get prompt evaluation.
Nail changes in vitamin B12 deficiency present as hyperpigmentation of nails like bluish discoloration of nails, blue-black pigmentation with dark longitudinal streaks, and longitudinal and reticulate darkened streaks.
The 5 key signs of melanoma, often remembered by the ABCDEs, are Asymmetry (uneven halves), Border irregularity (jagged edges), uneven Color (multiple shades), Diameter larger than a pencil eraser (about 6mm), and Evolving (changing in size, shape, color, or symptoms like itching/bleeding). Also watch for a sore that doesn't heal, new dark streaks under nails, or unusual sensations like itching or pain in a mole.
Equipment used for Nail Biopsy
For numbing your skin during the biopsy, a local anesthetic called 1% lidocaine solution is often used. This prevents you from feeling pain during the procedure.
White Nails
If the nails are mostly white with darker rims, this can indicate liver problems, such as hepatitis. In this image, you can see the fingers are also jaundiced, another sign of liver trouble.
Tips to treat the 5 most common nail disorders: brittle nails, onycholysis, paronychia, psoriasis, onychomycosis.
Bacterial infections (paronychia)
You'll notice symptoms appear quickly: intense redness, swelling, and pain concentrate around the nail edges and cuticle area. The infected skin feels warm to touch and may develop a pus-filled pocket that looks white or yellow.
Symptoms of acute liver failure may include:
Here's a comprehensive guide to ten nail diseases and disorders that deserve a closer look.
Beau's lines on all of your nails can mean that an illness or stress caused them. Multiple Beau's lines on each nail may mean that an illness or trauma happened more than once. Thicker Beau's lines may be a sign that an illness or trauma lasted a longer time.
Medium to dark vertical lines on your nails could indicate a Vitamin D and B12 deficiency. Short white lines or spots might point to zinc deficiency. Brittle nails that easily break could mean you're low in calcium and biotin. Yellow nails could signal a fungal infection.
A magnesium deficiency can result in weak, flaky nails that are prone to breakage.