The 3 Most Common Nail Abnormalities and What to Do About Them

Close up of fingernails The 3 Most Common Nail Abnormalities and What to Do About Them

If you’ve noticed a change to your nail shape, color, or texture, you might be wondering what it means for your health. Any change can mean something is wrong, and our nails are an often overlooked sign of a number of skin conditions. If you know what you’re looking for, they can tell you a lot about what’s going on.

What Are Nails Made Of?

Finger and toe nails are made of a protein called keratin, which also makes up hair and skin. Essentially, nails form from the base of the nail, called the cuticle. Keratin grows outward and in layers, so nails are basically laminated, thin sheets of protein. While nails don’t have much use for humans in modern society, many mammals rely on them for grabbing onto various objects, like tree limbs. One common misconception is that nails are composed of dead skin cells. This isn’t exactly true, though the proteins in nails are not living once they become visible. Since keratin composes skin, hair and nails, the “dead skin” myth has been propagated about hair as well. Finger and toenails are composed of a very pure, unpigmented form of keratin, which further sets them apart from hair and skin. When your nails develop abnormalities, odds are you’ll notice. Here are the three most common nail abnormalities.

Pitting Nails

Pitting is a pretty self-explanatory abnormality that is characterized by multiple indentations in the nail. Nails with pitting look like a small ice pick took tiny chunks out of them. There are a number of skin conditions that can cause pitting in your nails. Psoriasis of the nails causes pitting, and can be harder to treat than psoriasis of the skin. Since nails grow slowly, it takes time for your dermatologist to gauge the results of your treatment.

Nail pitting can also be the result of alopecia areata. Alopecia areata is a skin condition in which body hair is lost in a patch or patches. It’s commonly believed that alopecia areata is the result of the body’s immune system attacking the hair follicles by mistake. As a result, if it occurs in the skin it can inhibit or disrupt the keratin produced for the nail. If nearby hair on the knuckles or arm is lost, this is a good indication that alopecia areata is causing the pitting.

Lifting Nails

If your nails seem to have loosened and start lifting off the skin, there are a number of health conditions you should be on the lookout for. If you don’t notice that the nail feels loose and can almost lift, but there is discoloring (a lightness that looks like the end of your nail, but is located in the middle or toward the bottom of the nail) it might still be lifting. This condition is called onycholysis and can also be caused by psoriasis.

The other most common cause of a nail lifting from the skin is a fungal infection or trauma. Trauma often doesn’t require any treatment, unless the nail becomes infected. That being said, a fungal infection requires your dermatologist’s attention. Fungus affects toenails more often than fingers, as it extends from other common fungal infections of the foot, like athlete’s foot.

Discolored Nails

There are a variety of reasons your nail might have changed color in patches or completely, and almost all of them need medical attention. While trauma can cause nails to become black, red or yellow, other serious health conditions can lead to the same discoloration. Melanoma, a deadly form of skin cancer, can cause nails to develop a black streak or spot. Since this is similar to how a bruised nail might look, some people ignore it. If melanoma is not treated early, it can be fatal.

Psoriasis, which can cause a variety of nail abnormalities, can also cause discoloration of the nail. White discoloration and black or red spots (burst blood vessels) are the most common manifestations of nail psoriasis. Sometimes nails can have a yellowish appearance due to psoriasis. Additionally, nails may turn yellow if an infection is present. Sometimes, painting your nails red without a clear base coat can make nails look yellow.

Treating Nail Abnormalities

Since practically every nail abnormality has a variety of different causes, getting to the root of your condition is key. Sometimes, treating the underlying skin condition is all the treatment your nail needs. Other times, like with psoriasis, the nail treatment is different than if it were on the skin. A common psoriasis treatment is a strong, topical corticosteroid. This needs to be applied to the base of the nail and the abnormal area itself. Tazarotene is another commonly prescribed topical drug used to treat pitting, lifting and discoloration. With psoriasis of the nail, infection can sometimes occur. Treating the infection it causes is crucial to restoring the health of the nail.

The drugs mentioned above are also able to treat pitting, lifting and discoloration caused by other conditions. Other treatments for alopecia areata like minoxidil don’t address the causes of nail abnormalities, so corticosteroids are the best bet. Certain laser therapies have proven successful in reducing or eliminating pitting and discoloration caused by a number of skin conditions including alopecia and psoriasis.

Treating melanoma is given a great deal of care, as it is a severe form of cancer. Regardless of where melanoma is located, it needs to be removed. Melanoma treatment is specialized for small, sensitive areas and the success rate of early melanoma intervention is very high.

Regardless of circumstance, any nail changes should be examined by a dermatologist. If you are experiencing nail abnormalities, call the experts at Northeast Dermatology Associates today.

Request an Appointment