What the shape of your nails says about your health

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Did you know that the appearance of your nails, including their colour, texture, and shape, can provide valuable insights into your overall health? In this third article of our nail health series, we will explore the various shapes of nails and what they may indicate about your health. Although a change in nail shape does not necessarily imply a medical problem, it could be a warning sign, and therefore, it is recommended to seek medical advice if you observe any such changes.

Here are some common nail shape problems and their possible causes:

 

Issue Common Cause
Koilonychia (Thin, spoon-shaped nails) If your fingernails are thin and dip down in the middle – i.e. they look like spoons – it’s commonly caused by iron deficiency or softening due to a particular occupation. (Other occupational causes include mild nail-plate thickening and discoloration.) It could be unrelated to any condition (idiopathic) or linked to a variety of conditions including old age, coronary disease, thyroid disorders, and injury. It occurs commonly in babies and tends to disappear as they grow older. If you see a chalky substance under the thin, spoon-shaped nail, it’s suggestive of psoriasis.
Clubbing/ Curved nails When you first notice curving, see a dermatologist. Curving starts gradually, and many people are unaware that it’s happening. The nails will continue to curve downward, fingertips often swell, and the nails start to feel spongy when pressed on. It can be harmless if it runs in the family, but it can also be a sign of disease in the lungs, heart, liver, or stomach. It often affects all 20 fingernails.
Nail lining (Onycholysis) When a nail lifts, this can be due to:
  1. A fungal infection
  2. Psoriasis
  3. Injury from an aggressive manicure
  4. Injury from cleaning under your nails with a sharp object
It’s often accompanied by white discoloration. If you have any redness and swelling around a nail, it may also indicate an infection, and it’s important to get treatment as soon as possible.
Pincer nail This is a painful, toenail disorder where the lateral edges of the nail slowly curve towards each other, constricting the nailbed and underlying dermis.
Parrot beak nail This is when the nail plate bends over the fingertip, resembling the beak of a parrot. This is typically seen in severe acrosclerosis1.
Macronychia and micronychia This is when the nails are larger (macronychia) or smaller (micronychia) than normal. Macronychia may occur due to local gigantism, whereas micronychia occurs in Iso-Kikuchi2 and Zimmermann-Laband3 syndrome.

Footnotes

1 A combination of Raynaud’s disease and scleroderma of the distal parts of the limbs, especially the digits, and of the neck and face, particularly the nose. 2 Iso-Kikuchi syndrome is characterized by various nail dysplasias including micronychia. 3 Zimmermann-Laband syndrome is a rare disorder characterized by micronychia, gingival hypertrophy, bulbous, soft nose, and thick, floppy ears.

 

References

  1. American Academy of Dermatology Association. (n.d.). 12 Nail changes a dermatologist should examine. American Academy of Dermatology Association [Online]. Accessed on 31 January 2023. Available from https://www.aad.org/public/everyday-care/nail-care-secrets/basics/nail-changes-dermatologist-should-examine
  2. Huang, C., Huang, R., Yu, M., Guo, W., Zhao, Y., Li, R., & Zhu, Z. (2020). Pincer Nail Deformity: Clinical Characteristics, Causes, and Managements. BioMed Research International, 2020, 2939850. Available from https://doi.org/10.1155/2020/2939850
  3. Richert, B. & Baran, R. (n.d.). Congenital micronychia – Nail and Distal Digit. Visual Dx [Online]. Accessed on 12 June 2023. Available from https://www.visualdx.com/visualdx/diagnosis/congenital+micronychia?diagnosisId=53519&moduleId=19

Disclaimer

These articles are for information purposes only. It cannot replace the diagnosis of a healthcare provider. Pharma Dynamics gives no warranty as to the accuracy of the information contained in such articles and shall not, under any circumstances, be liable for any consequences which may be suffered as a result of a user’s reliance thereon.

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