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Nail changes – causes, help, prevention

by Josephine Andrews
Published: Last Updated on 143 views

Nail changes occur frequently and usually have harmless causes. The color, structure and shape of the fingernails can change, small dots, grooves, discolouration, breaks, cracks or dents form. You can browse through the nails like in a book. Nail changes can also indicate a health problem. Examples are diabetes and heart and lung diseases. Read all about the most common nail changes and their causes.

Nail changes: description

Like hair , nails belong to the so-called appendages of the skin . Healthy nails are eye-catching, attractive and can be a real eye-catcher. A flexible and soft texture with a smooth, curved, transparent surface and a light crescent at the base of the nail are the hallmarks of healthy nails. Everyone has a slightly different nail shape that is innate in them.

This is how nails are made

Nails are basically solid sheets of keratin that sit on the ends of fingers and toes. They protect the fingertips and help to grip things. They consist of the nail root, nail bed, nail wall, nail moon and nail fold.

In the fine structure, the fingernail is made up of horny cells – about 100 to 150 layers are stacked on top of each other. It grows out of the nail bed in slow motion. It is estimated that a nail moves 0.5 to 1.2 millimeters per week. Anyone who has ever hit their finger with a hammer knows that it takes many months for the blue discoloration to disappear and for a new nail to emerge.

Nail changes can speak volumes and say a lot about the health of their wearer. In the simplest case, yellow fingernails or those that are brittle, brittle and torn appear unkempt and are therefore an aesthetic problem. In the worst case, serious diseases are behind the nail changes.

Nail changes: causes and possible diseases

Longitudinal or transverse grooves, white spots or deformations – there are different types of nail changes. The following reasons can be behind it.

Grooves – lengthwise or crosswise

Fine longitudinal grooves are a normal sign of aging and are therefore mostly harmless nail changes. Deep transverse grooves (also known as Beau-Reil transverse grooves) indicate that nail growth was disrupted. Often a wrong manicure hurts the nail bed. Other triggers for nail changes and disturbed nail growth can be severe infections with fever , diseases of the gastrointestinal tract, deficiency situations or poisoning. Examples are thallium or arsenic as well as drugs such as barbiturates, cytostatics or anticoagulants.
Mees stripes are yellowish-whitish transverse grooves that run across the nail. These nail changes can be caused by poisoning with arsenic or thallium.


Discolored nails can be caused by changes in the nail plate, as well as on or under it. There are different types of discoloration.

Whitening of the fingernails: White spots on fingernails always appear when you hurt yourself, for example by impact or nail manicure – usually the cuticle is affected.

In leukonychia , the keratinization of the nail matrix cells is disturbed. The most common form is leukonychia punctata – these nail changes have many white spots scattered over the nail. Leukonychia vulgaris can be recognized by the white transverse stripes that run across the nail. The most common reason for both nail changes is manipulation of the cuticle, usually during a manicure.

Leukopathies are also characterized by whitening of the nails. Causes of these nail changes can be, for example, vascular changes as well as cavities and air pockets in the nail plate and underneath, for example in nail fungus (onychomycosis).

Half-and-half nails: With these nail changes, one finds a white discoloration of the near (proximal) half of the nail plate and a red-brown coloring of the far (distal) half of the nail plate. As a rule, they are an indication of chronic kidney weakness (renal insufficiency).

The frosted glass nails (terry nails) are almost completely whitish and cloudy. The cause of these nail changes are often vascular changes in the nail bed, especially in oneLiver cirrhosis , but also in heart failure and diabetes mellitus.

Darkening of the fingernails: Brown nails occur after contact with chemicals (eg wood stains, hair dye, nicotine and tar in smokers) or in Addison’s disease. Splinter hemorrhages cause reddish-brown dots in the nail bed.

Black nail discoloration can result from injuries (e.g. hit or hit on the fingernail). A bruise (hematoma) forms under the nail. In the worst case, however, it can also be caused by skin cancer (melanoma). Drugs can also turn nails brown, blue, or black. Examples are cancer drugs (cytostatics) or antimalarial drugs. Be sure to ask your doctor.

Nail changes in the form of bluish discoloration of the nail bedcan indicate cyanosis – a lack of oxygen is the reason that needs medical attention. For example, heart failure or carbon dioxide poisoning can cause cyanosis. In the case of carbon monoxide poisoning, on the other hand, the nail bed turns cherry red.

Yellow discoloration: Yellow fingernails can occur in connection with psoriasis. Sometimes oil nails form – yellowish discolorations that look like drops of oil. Yellow-grey nails indicate a nail fungus disease (onychomycosis).

Yellowish to gray-green discoloration, thickening and hardening of some or all nails are characteristic of the “ yellow nail syndrome ”. In addition, the nails grow much slower. The syndrome is often associated with respiratory diseases (eg bronchitis, pneumonia) and lymphedema. You should consult a doctor in these cases.


In the case of a watch glass nail, the nail plate curves outwards. In addition, the nail is enlarged and rounded-convex in shape. The watch glass nail is the result of the ends of the fingers, which are swollen like drumsticks (hence the term drumstick fingers). Most commonly, both indicate lung or heart disease. A visit to the doctor is important here.

In a spoon nail ( koilonychia ), the nail plate sags inward while the rim curves upward. The nail is concave in shape like a spoon. Most commonly, the spoon nail forms on the thumb. The reason may be iron deficiency or exposure to chemicals.

For dimpled nails(often also pitted nails) point and funnel-shaped indentations are typical. The causes can be eczema, patchy hair loss (alopezia areata), psoriasis (psoriasis) or fungal infections.

Brittle nails

Some people have extremely brittle nails (onychorrhexis). The nail cracks, splits lengthwise, or splits from the free edge of the nail. The reason may be frequent contact with detergents and chemicals.

These dry out the skin and nails. Nail polish remover can also remove moisture from the nails and make them brittle. Sometimes malnutrition is to blame (lack of vitamins A , B, and iron). Malnutrition, such as in anorexia, also plays a role. Brittle nails can also indicate an overactive thyroid or liver disease.

In onychoschisis , the nail plate usually splits horizontally. Here, too, the reasons are malnutrition and malnutrition (vitamins, iron) and excessive hygiene.

Other nail changes

Sometimes the nail plate also partially detaches (onycholysis) from the nail bed – this is a relatively common phenomenon. The nail can partially lift off as a result of prolonged exposure to water, soaps, detergents or excessive nail cleaning. The total detachment of the nail is less common, here physicians speak of onychomadesis. The causes can be nail bed inflammation, nail fungus, psoriasis or trauma. Crumb nails are porous nails that crumble at the edge of the nail. The cause can be psoriasis.

Nail Changes: When Should You See a Doctor?

There is not always a serious cause behind the nail changes. White dots or stripes as well as longitudinal grooves are usually harmless. Minor bruises under the nails usually go away on their own, it just takes a little time and patience. Nail changes caused by incorrect manicure and injuries to the nail bed do not necessarily have to be treated by a doctor. However, we recommend a visit to an experienced beautician who will show you the right nail care.

But there are nail changes that make a doctor’s visit advisable. These include, for example, the relatively stubborn nail fungus, which must be treated consistently, or certain nail deformities. A watch crystal nail, for example, can indicate serious heart andindicate lungs . Nail discoloration should also be checked out by a doctor if the discoloration does not grow out.

Nail changes: what does the doctor do

An experienced doctor can read your nails like a book. The color, structure, strength, texture or shape of the nail are important. At the beginning there is a discussion with the patient (anamesis). The doctor will ask you, for example, when the nail changes first appeared and whether they appeared suddenly, whether you suffer from illnesses, take medication or handle chemicals. A specialist can draw certain conclusions from your answers.

If the nail changes are due to diseases, they must be treated. Examples are psoriasis, respiratory or heart diseases.

Nail changes: you can do this yourself

There are some tips on how to prevent nail changes or treat them yourself.

  • If you frequently handle chemicals (e.g. hair dyes, varnishes, cleaning agents), you should protect your nails with gloves.
  • It is best to avoid nail polish remover and other aggressive substances that can cause nail changes.
  • It is best to file your nails short and grease them sufficiently (greasy nail cream, warm olive oil bath for the fingertips).
  • Do not completely remove the cuticles during the manicure, just gently push them back.
  • Try to reduce mechanical stress on your nails. For example, do not scratch anything solid with your fingernails, otherwise nail changes may occur.
  • Dietary supplements can help with a nutrient deficiency (e.g. iron, biotin , vitamins, calcium).
  • In the case of nail changes due to lack of liquid, the following applies: drink enough!
  • If you have nail fungus: Carry out the drug therapy consistently, otherwise the infection will flare up again and again.

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