Charles Langston:What do nails have to say about your health? Experts answer your FAQs.

If your nails are Charles Langstonbrittle, thin and easily breakable, you may be wondering if it’s time to pay a visit to your dermatologist. 

While changes to the color, texture and shape of your nails aren’t always a cause for concern, occasionally, these changes could be a sign of an underlying condition. 

What do nails actually have to say about your health? From getting a glimpse into what healthy nails look like, to understanding what potential illnesses may be impacting your nails, here’s what dermatologists need you to know.

What do healthy nails look like?

“Healthy nails should be smooth and without any ridges, bumps or dents,” says Dr. Soraya Azzawi, MD, FAAD, a board-certified dermatologist and health sciences clinical instructor at UCLA. The surface of the nail should be free of any grooves, with the texture staying fairly consistent, she says.

A key sign of good nail health is nail resiliency. Healthy nails should be flexible, but they should not be easily breakable, Azzawi notes. 

Healthy nails should be relatively pink in color, adds Azzawi. “There should not be yellowness to the nail, dark colors within the nail, or whiteness in the nail,” she explains.  

Also, the cuticular seal of the nails should be intact, and the nail plate should adhere to the nail bed, says Dr. Thomas Stringer, a dermatologist with MedStar Health.

What do nails have to say about your health?

“Fingernails, along with the skin and the hair, are all pretty good indicators of overall health,” says Azzawi. 

There are certainly instances in which changes to the color, texture and shape of your nails are completely fine. However, some nail changes “are more closely associated with either an acute systemic illness or chronic systemic illnesses of some kind,” says Stringer. 

Beau’s lines are transverse grooves in the nail, says Azzawi. They result from a recent temporary disturbance in the body, such as an acute trauma or viral illness, she says.

Clubbed nails occur when there is increased curvature in the nails. This condition has been linked to a variety of pulmonary, cardiovascular and thyroid diseases, Azzawi says.

Lindsay’s nails and Terry’s nails are conditions that result in changes to the color of the nail, Stringer adds. Lindsay’s nails cause the color of the nail bed to look half white and half red or brown, whereas Terry’s nails cause the nail bed to look mostly white or washed-out, per Cleveland Clinic. Both conditions “are very closely associated with things like liver problems or heart problems,” Stringer says.

There are a few reasons why nails could be thin, brittle, and rough on the surface. Brittle nails are sometimes a symptom of metabolic conditions, such as thyroid disease and iron deficiency anemia. With that being said, not all brittle nails are the result of a chronic illnesses. “Age is probably the most common sort of underlying condition for why nails might be brittle,” says Stringer. Brittle nails can also result from fungal diseases, he says. Hormonal changes in the body are another contributing factor, says Azzawi.

Nail crumbling, and the lifting of the nail, could be signs of nail psoriasis. Nail psoriasis is a condition in itself, but it is also an independent risk factor for psoriatic arthritis. So, if someone is exhibiting the symptoms of nail psoriasis, “I also screen avidly for psoriatic arthritis in those patients, because they're at higher risk,” Stringer explains. 

Long, dark brown or red lines that follow the vertical grooves of the nail plate may indicate splinter hemorrhages, which often occur from simple trauma. However, these lines could also result from nail psoriasis or longitudinal melanonychia (effectively a mole of the nail), Stringer says. In extreme cases, these lines may turn out to be a squamous cell carcinoma, Azzawi adds.

White spots on the nail usually reflect a disturbance in the nail plate, such as a small trauma, although they can also be a symptom of nail psoriasis or liver conditions, Stringer says.

When to see a doctor for nail changes

Not every single change to the nail should raise red flags. However, if there is a “rapid change that you can't really explain, and it seems to be coming from the nail itself,” seek medical attention, Stringer says. In particular, if there are any visible growths around the nail, or the nail brittleness has become very pronounced, it’s time to seek evaluation from a physician or dermatologist, he says.

Additionally, Azzawi recommends seeking medical attention if you are experiencing the following: 

• Swelling or pain around the nails (which may indicate infection)
• Failure of the nails to fully grow out
• Bleeding around the nails
• Lifting of the nail from the nail bed
• Changes in the shape or texture of the nail (such as curled nails or increased curvature) 

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