You may think of seeing a dermatologist when it comes to acne, changing moles or irritated skin, but did you know you can also call on them for concerns related to your fingernails?
“Dermatologists are seen as specialists in skin, but nails and hair also fall under our area of expertise, and we’re equipped to see patients with those concerns,” says UNC Health dermatologist Margaret Coates, MD.
That’s important to remember, because some changes to your nails—either on the fingers or the toes—could indicate a larger issue with your health. Dr. Coates explains some things to watch for.
Pigment and Color Changes on Your Nails
If you’ve just removed nail polish, you may notice some temporary yellow stains, and a stubbed toe can yield a bruise. Chemotherapy and some medications can cause changes to the color of the nail.
But if you notice any of your nails changing color without an apparent cause, you should see a doctor.
“Changes in nail color may be associated with kidney and liver problems, so they can be a clue to underlying disease,” Dr. Coates says.
Color changes could also indicate nutritional deficiencies, heart issues or nail infections.
If you see a new dark streak on one of your nails, running from the nail bed to the tip of the nail, don’t ignore it—it could be a form of skin cancer.
“A dark brown or black band of pigment could be a sign of melanoma,” Dr. Coates says. “It’s particularly worrisome if it’s new, takes up over half of the nail, and is only seen on one nail.”
Pitting of the Nails
Small notches or indentations in your nails, like someone took a tiny ice pick to them, need to be evaluated.
“These changes can be linked to skin conditions such as psoriasis, eczema and alopecia,” Dr. Coates says.
It’s important to show a doctor if nails are showing signs of pitting and changes in color, especially if you already have a diagnosis of psoriasis.
“We know that patients with psoriasis who have affected nails are more likely to have psoriatic arthritis,” a chronic condition that causes inflammation of the skin and joints, Dr. Coates says. “If a person has plaques on the skin and changes with their nails, we’re likely to pursue additional workup for the joints.”
Changes in Nail Growth
If you have a white line or groove that’s perpendicular to your nail bed, it likely indicates a time when the nail stopped growing.
“During times of stress or illness, the body stops prioritizing nail growth,” Dr. Coates says. “That line can indicate past illness.”
It may be that you know what illness caused the pause in nail growth, but if you don’t and continue to notice changes in growth, talk to your doctor.
Nails that dip in the middle, creating a spoon-like shape, might indicate a nutritional deficiency or gastrointestinal issue, while nails that curve over a swollen fingertip could indicate issues with the cardiovascular or gastrointestinal system.
Watch for these Other Nail Changes
Fungal infections of the nails are incredibly common, according to Dr. Coates, and can cause thickening of the nails, separation from the nail bed, discoloration and nail debris (dead nail skin that can be scraped out from under the nail).
“Most cases aren’t harmful, but they can be stubborn,” Dr. Coates says. “For patients with no discomfort or underlying conditions, they may not require treatment.”
And just as your skin changes in your older years, so too might your nails.
“Changes in texture are normal with aging,” Dr. Coates says. “You might see increased brittleness, splits, breaks or more ridges with age. It’s a bit like getting wrinkles on your fingernails.”
Keeping Your Nails Healthy
Trimming fingernails and toenails may be a joyless chore—particularly for parents who have small children—but that regular maintenance is an important part of nail care and helps prevent injury.
Dr. Coates recommends wearing gloves when your hands will be in water for a prolonged period, such as while washing dishes.
“That moisture can affect the skin around the nail, which is already prone to breaking,” she says. “With a cut there, bacteria can get into the body and cause an infection.”
If the skin around your nails is especially irritated or painful, talk to your doctor about potential treatment, and if you bite your nails or cuticles, ask for tips that could help you stop.
Manicures and pedicures are great for stress relief, but take a few precautions to protect your nails.
“Most nail salons are safe, but always make sure that instruments are sterilized and a new emery board is used to prevent infection,” Dr. Coates says. “A gel manicure or acrylic nails can weaken the existing nail, but they don’t affect future growth. If a UV lamp is being used, know that there is a slight increase in the risk of skin cancer, so consider a protective glove with the fingertip cut out or sunscreen for the rest of the finger.”
Choosing a traditional nail polish, rather than a gel, abstaining from picking at polish, and taking occasional breaks from polish can help the strength of your nails.
While there are a variety of supplements with biotin and collagen that promise to make your nails longer or stronger, Dr. Coates says there isn’t enough evidence to support their use.
“Supplements aren’t well-regulated, and high doses of biotin can interfere with accurate testing of your thyroid and heart,” she says. “Instead, eat a varied diet with lots of vegetables and fruits. The same nutrients that are important for your general health are important for your nails.”
If you’re worried about a change to your nails, talk to your doctor. If you need a doctor, find one near you.