Wavy Nails
If the nail surface is wavy, much like the pitted nails I discussed above, this can be an early sign of psoriasis or inflammatory arthritis. Discoloration of the nail is also common, and the skin beneath the nail may appear reddish-brown.
Split Nails
Split or cracked nails are common nail disorders related to the disease. Dry, brittle nails that are cracked or broken have been frequently associated with thyroid disease. Cracked nails with a yellowish color are likely due to a fungal infection.
Low levels of vitamin C, folic acid, and certain proteins in the diet are also known to cause split nails.
Ribbed Nails
Ribs can be horizontal or vertical. Vertical ribs can mean nutritional issues, dehydration, or problems absorbing nutrients. Horizontal veins in the nail are often associated with diabetes, liver disease, or other chronic conditions. Both types of veins can also be caused by nail injuries.
Dark lines under the nail
If you have dark skin, it is quite common to have streaks of the pigment melanin at the base of your nails. However, you should always have this checked by your doctor, as it can sometimes indicate a form of skin cancer called subungual melanoma, the most dangerous type of skin cancer. This usually only affects one nail, and causes the line to change in appearance, becoming wider or darker over time. Pigmentation can also affect the skin around the nail.
Small brown streaks
These are thin, dark lines under the nail that could be tiny vessels bleeding under the nail. These are known as “filiform hemorrhages” and are not a cause for concern if they are due to nail injury. However, if a few nails are affected, it may be a sign that one of the heart valves is infected, a condition called endocarditis. These threadlike hemorrhages can also be associated with several other conditions, such as scleroderma, lupus, psoriasis, and rheumatoid arthritis.
Vertical pearls or ridge formations
These look like vertical ridges or beads, resembling drops of wax from a candle. The pearls appear to flow down the nail like wax and this is associated with endocrine or hormonal problems, such as diabetes mellitus, thyroid disorders, Addison’s disease, vitamin B deficiency, hormonal changes or stress.
However, just like with our skin, these “nail wrinkles” are usually caused by aging. They run from the base of the nail to the tip and usually start on one or two nails. Over time, the ridges can appear on all nails. Gently filing and buffing them can help smooth them out.
Cupped Nails
Cupped nails can be hereditary and may be harmless. However, if they develop suddenly, they can be a sign of an underlying medical condition, and due to low blood oxygen levels, leading to various diseases such as lung or heart disease.
With cupped nails, the natural angle is gone and the nails are level with the tops of the fingers. This can be Hamman-Rich syndrome, an acute interstitial lung disease, (a form of pneumonia) characterized by inflammation of the lung. With advanced interstitial lung disease, clubbing and signs of heart failure may appear. It is also associated with irritable bowel disease, cardiovascular disease, liver disease and AIDS.
Terry’s Nails
This was named after Dr. Richard Terry and occurs when the fingernails or toenails appear white with a characteristic “ground glass” appearance, without a lunula – that crescent-shaped white area of the nail. With this condition, most of the nails are white except for a narrow pink band at the tip. It is described as a brown arc near the ends of the nails.
Terry’s nails can sometimes be attributed to aging. In other cases, they can be a sign of a serious underlying disease. This condition can be due to decreased vascularity and increased connective tissue within the nail, and often occurs in the setting of liver failure, cirrhosis, renal failure, diabetes mellitus, congestive heart failure, hyperthyroidism, and/or malnutrition.
Onychorrhexis
This is the presence of longitudinal ridges or veins on the nail and can simply be a sign of advanced age, but can also be associated with conditions such as rheumatoid arthritis, peripheral vascular disease, lichen planus, and Darier’s disease (broad white and red streaks on the nail). A central vertical ridge or groove (as pictured) may be due to myxoid cysts that appear near the base of the nail, which are associated with osteoarthritis.
Onychorrhexis mainly affects people who suffer from disorders. Malnutrition or poor nutrition can affect the health and growth of the nails and make them brittle, any trauma or injury to the nails can also lead to onychorrhexis. Repeated injury to the nail often leads to this condition. Those who work for long hours with soap and water are also at risk, as are those who use too much nail polish, and those who are subjected to prolonged exposure to cold. Hypothyroidism is a glandular disease that results from a deficiency in the production of thyroid hormone. Reduced thyroid production is due to an underactive thyroid gland. This is one of the main causes of onychorrhexis.
Bulimia is a condition that affects young women who become depressed after overeating and feel guilty for not controlling their diet and weight. Anorexia nervosa is another psychological illness in which the sufferer is obsessed with her weight and has the illusion of being too fat even though she is rather thin.
Diagnosis of onychorrhexis is not complicated, as the condition has been detected mainly by physical observation of the nails. Blood tests and thyroid level examinations may be recommended if the doctor suspects an underlying disease such as hypothyroidism.
Medical treatment of onychorrhexis usually depends on the underlying condition. The treatment is said to vary depending on the nature of the disease underlying the onychorrhexis. Once the causes have been treated, the symptoms of onychorrhexis will also disappear soon.
Home treatment for onychorrhexis involves medications such as hand creams. A cream or lotion made with natural plant oils will keep the hand moisturized and help heal the condition. Regular application of moisturizers to the skin and nails will prevent these symptoms from returning.
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