Nails, a window to your health

I used to think about fingernails only in terms of appearance. Painting them wasn’t for me because I didn’t want to draw attention to my stubby fingers.

Then three recent emails arrived linking nails to a myriad of unhealthy conditions. That my nails break easily may be not just a cosmetic liability. 

“There are hundreds of medical conditions, disorders, and diseases that may cause nail changes,” Mayo Clinic dermatologist Dawn Davis said in a clinic newsletter. “Fingernails are a window to your health.”

My friend Aileen recalls that when her son Jim started to lose his hair at age 4, she was surprised that the specialist examined his fingernails. They had abnormalities pointing to the hair-loss condition called alopecia areata, with which Jim was diagnosed. “Who knew nail health was related to hair loss?,” Aileen wondered at the time. 

Nail changes can show up at any age, but some are especially common as we age, including vertical ridges, brittleness and splitting, slower growth, and discoloration. Fingernails become brittle because aging bodies produce less of the protein found in nails, while toenails get thicker because cell turnover slows down. 

Although many age-related changes are normal, it’s wise to have your doctor check out any change. Northwestern Medicine internist Jeffrey Linder told AARP that he always begins an exam by looking at the patient’s fingernails. “[It] gives you a sense of a person’s general health,” he said, “and occasionally there are clues to conditions or diseases.” 

According to the Mayo Clinic, nail conditions that should not be ignored, and the conditions they suggest, include:

• Depressions or notches (pitting): disorders such as psoriasis, eczema, or alopecia aerata

• Curving around fingertips (clubbing): low oxygen in the blood, lung disease, heart problems, cirrhosis, or gastrointestinal problems

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• Turning up around the edges (spoon nails): anemia or a liver problem

• Whiteness except at the top (Terry’s nails, leukonychia): liver problems, congestive heart failure, or diabetes

• Grooves (Beau’s lines): infections, uncontrolled diabetes, peripheral artery disease, zinc deficiency, or reaction to some medications

• Separation from nail bed (onycholysis): injury, infection, thyroid disease, psoriasis, or reaction to a medication, nail hardeners, or adhesives

• Yellowing: lung disease, lymphedema, or fungal infections

• Ridges: onychorrhexis: nutritional deficiencies, hormonal changes

Examining my nails, I see only the brittleness and vertical ridges associated with aging. But I’ve made a note to ask my doctor to look at my nails during annual checkups. 

Some nail conditions, especially fungal infections and damage from injury, can be prevented. Tips about caring for nails include using oil on cuticles and not trimming them, wearing gloves for household cleaning, and opting for an acetone-free polish remover. Nails should be cut straight across instead of in a curve, and the edges evened out with a glass file instead of an emery board. 

Before I read about nail health, I thought about trying a nail hardener. Continuous use of hardener and polish can cause nails to become even more brittle, however. People who get manicures and pedicures are advised to take a break now and then to allow nails to recover. I decided to leave my nails bare. It will be easier to notice any changes then, too.