Dents on fingernails

09.10.2019
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Ridges in Fingernails: Symptoms, Causes, and Treatments

Your fingernails can reveal a lot about the state of your health. Conditions ranging from stress to kidney and thyroid disease can cause changes in your nails. One common change is the appearance of vertical or horizontal ridges. Most of the time, ridges in fingernails are harmless.

Fingernails are made by living skin cells in your fingers. So a skin condition such as eczema may lead to fingernail ridges. Skin dryness can also cause these ridges. If your body is low in protein, calcium, zinc, or vitamin A, a deficiency can sometimes be revealed by ridges in your fingernails.

Vertical ridges

Vertical ridges are furrows that run from the tip of your fingernail down to the cuticle. They are sometimes called longitudinal striations or bands.

Slight vertical ridges in fingernails often develop in older adults, possibly due to a slowing of cell turnover. This is when new skin cells produced below the surface of your skin rise up to take the place of dead cells that are discarded from the surface.

If you experience other symptoms like color or texture changes in your nails, it may be caused by a medical condition. In trachyonychia, or 20-nail dystrophy, the ridges may be accompanied by a change in color to your nails, or your nails may become rough or brittle.

Iron deficiency anemia can also trigger vertical ridges and changes to your nails that make them concave, or spoon-shaped.

Horizontal ridges

Deep horizontal ridges, called Beaus lines, are often symptoms of a serious condition. They may actually stop nail growth until the underlying condition is treated. Acute kidney disease may also be present if Beaus lines appear. In addition, when Beaus lines develop on all 20 nails, it could be a symptom of:

Chemotherapy may also cause Beaus lines.

Trauma to your nails can cause red or brown spots to form underneath your nails. However, if you notice dark brown, black, or red color changes under your nails and you havent experienced nail trauma, this can be a symptom of a more serious condition, such as endocarditis or melanoma.

Sudden changes in your nails should be examined by your doctor. If you damaged your nail in an injury, you may wait to see how the nail and your finger heal for a few weeks before deciding whether to see a doctor.

However, you should see your doctor as soon as possible if the injury resulted in:

  • a clean or ragged cut through your nail
  • a crushed nail
  • a nail being torn off
  • bleeding under your nail

During your appointment, your doctor will examine your nails and ask about any other symptoms youre experiencing.

Your doctor may order urine and blood tests if they suspect kidney disease, diabetes, or nutritional deficiencies.

If it appears the ridges are the result of a skin condition, a dermatologist can start you on a treatment plan.

If the cause of your fingernail ridges is unclear, your dermatologist may take some fingernail clippings to have them analyzed in a lab for signs of infection.

Because fingernail ridges are usually signs of other health problems, treatment is focused on the underlying cause of the changes to your nails. For example, if youve developed Beaus lines because of diabetes, successfully controlling your blood sugar may reduce these horizontal fingernail ridges.

Treatment for skin conditions such as eczema may include moisturizers for your hands or topical ointments to reduce eczema symptoms. If low levels of minerals or vitamins are to blame, you may be advised to alter your diet or take supplements to boost your levels.

Buffing your fingernails with an emery board may help smooth ridges. Ask your dermatologist for advice on treating your nails. Youll want to be careful not to press too hard to avoid further damage.

Most of the time, ridges in fingernails are normal signs of aging. However, its important to pay attention to fingernail ridges and other nail changes. These might be the first signs of a serious medical problem.

Ridges in the fingernails are often normal signs of aging. Slight vertical ridges commonly develop in older adults. In some cases, they may be a sign of health problems like vitamin deficiencies or diabetes. Deep horizontal ridges, called Beaus lines, may indicate a serious condition.


dents on fingernails
Dents in Nails- Fingernails, Nail Bed, Thumbnails Causes, Meaning & Treatment

Well, it is a known fact that there are certain nail changes that refer specifically to various disorders that could be dermatological or systemic. This prompts the examination of the nails regularly to ensure that notice of any changes in color, surface and shape of the nails are reported and corrected if possible before it functional incapacitation. Information in this material is meant to address dents in nails as a looming nail pathology.

Dents in Nails Meaning, Horizontal, Small & Pictures

Jump to:

  • Dents in Nails Meaning, Horizontal, Small & Pictures
  • What Causes Dents in Fingernails, Thumbnails & Nail Bed
  • Dents in Nails after Acrylics
  • How to Prevent & get rid of Dented Nails

General meaning of dents in nails

You probably only view nails from an aesthetic perspective but these structures are really specialized structures that have more than just that to its functions.

They in addition, aid in the increase in sensory perception in the pulp. They also come in handy in the ability of one to pick objects in a fine manner.

Fingernails and Toenails-dents-pitting
Fingernails and Toenails

The nails, just like your tongue could act as a window to your systemic functions and abnormalities.

Dents is non-specific and may refer to pitting or the formation of ridges. The term however denotes that the pathology referred to herein occurs on the surface of the nail and not under the nail, on the nail bed. Medically, this abnormality is commonly, the beaus lines which are deep groves that run across the nail surface in a band-like fashion.

It basically extends across the paronychium which is the soft tissue lateral to the nail plate. While its pathophysiology may not be very vivid, it is thought to be caused by a halt in the growth of nail in the germinal matrix below the skin fold proximal to the nail plate, the eponychium.

Beaus lines could occur as a result of nutritional deficiencies, trauma to the eponychium and systemic infections including pneumonia, mumps and syphilis or conditions with endocrinological basis such as hypothyroidism. As in most diseases, idiopathic or that arising from an unknown etiology and genetic predisposition is probable.

Onychochizia, caused by genetic conditions such as polycythemia Vera and chondrodysplasia punctate leads to formation of dents that run horizontally towards the tip of the nail (Baran R et al, 2005)[1]. Beaus lines progress with increase in depth within 2 weeks of inhibited nail growth and leads to onychomadesis.

Beaus lines are themselves triggers to complications such as:

Onychomadesis: an idiopathic freeze of growth of the nail due to dysfunction of the nail matrix that leads to shedding. Unlike onycholysis, this condition leads to shedding beginning from the proximal part of the nail plate, below which you find the germinal matrix.Onychochizia: horizontal splitting towards the tip of the nail.Trachyonychia: commonly known as nail pitting resulting from a defect in the deposition of keratin in the germinal matrix due to excess of parakeratotic cells[2].

Various online platforms fail to distinguish various terms that could wrongfully be used to refer to ridges or pits on the nails. Here are some of them:

Muehrckes lines

These are vertical lines that occur as a normal process of aging in which case they are harmless. Also known as leukonychia striae, they are surface manifestations of nail bed pathologies.

They result in lines that resemble ridges but which are non-palpable indicating metabolic diseases, hypoalbuminuria (patients albumin Gregoriou S et al, 2008[3], it could also occur in glomerulonephritis and liver disease.

Mees lines

These are white ridges that resemble beaus lines but non-continuous. Also known as true leukonychia characterised by multiple, white lines that transverse the width of the nail or parallel to the moon white (lunula). Mostly due to arsenic intoxication, cardiac failure, Hodgkins disease among others.

Note that the dents or grooves are subtle for months without your noticing until they have grown outwards to make them visible enough. The dents may be accompanied by color changes and there could be an overlap between the complications stated before with beaus lines.

Specific meaning when theyre

Horizontal

These are beaus lines and often indicate a serious condition. They are indentations or dents that run across the nail plate from one side to another unlike the longitudinal striae. It normally occurs as an aging sign when the ridges become deeper but may be due to acute kidney disease and in the 20-nail dystrophy.

The latter is basically a condition that results in development of beaus lines on all the 20 nails and a known sign of conditions such as syphilis, diabetes, hypothyroidism and mumps.

Note that horizontal lines could also be accompanied by color change especially after trauma in which the nail bed or the hyponychium is compromised or in more serious systemic conditions such as endocarditis and melanoma. Though the former is best diagnosed with the presence of splinters on the nail bed.

Vertical

These are dents that run along your nail plate, longitudinally from the distal to the proximal parts. They resemble bands and can also be referred to as longitudinal striations. The occurrence of this is generally due to aging and may be considered harmless.

This is due to the reduced rate of cell turn over by the germinal matrix responsible for the deposition of keratin and subsequent nail formation. However, there are conditions that result in vertical indentations which could harm you.

This life-threatening conditions will manifest as a concurrent coloration and changes in the texture. Such conditions include trachyonychia in which the nails turn dark and surface rough making the nails brittle (onychoschizia). It can also point out to dystrophy of the nails.

Longitudinal striations or indentations (onychorrhexis) may be due to a minor trauma or systemic connotations including nail-patella syndrome, graft versus host disease, rheumatoid arthritis and collagen vascular diseases. Iron deficiency anemia (IDA) could also be a reason for vertical ridges and may lead to clubbed nails (convex-shaped nails) or koilonychia (spoon shaped/concave)

Small

Interestingly, the distal limit (tip-wards) of the furrow of the dent may aid in the determination of the onset. Sudden attack of a condition results in a furrow with a less steep gradient than that which attacks chronically or protractedly. Therefore, the grooves appear small.

Big

Likewise, as with small dents, this form when there is chronic or slow progressive underlying condition. The dent grows wider with a steep gradient distally that is appreciably palpable.

In reference to the harmless, sign of ageing type of dents on nails, the older you get, the bigger the dents become. This is well attributed to the further decrease in the rate of nail turnover and growth therefore.

Pictures

grooves dents in nails pictures
dents on nails

What Causes Dents in Fingernails, Thumbnails & Nail Bed

General causes of the dents

Thyroid

Thyroid hormone has been shown to cause adverse effects on cutaneous tissues the nails and hair of those who are affected. In fact, Hale and Ebling performed a demonstration with rat specimen investigating the effect of T4 on the telogen phase of hair growth. This effect is synonymous to that which occurs with nails. In thyroxin toxic nails in thyrotoxicosis, the nails might undergo physical changes in the shape resulting in a concave contour. This is further complicated by Plummers nails consequential of tipward onycholysis.

Vitamin Deficiency

If your body is low in vitamins, then ridges could form. B vitamins are important in cell growth and in fact vitamin B 12 is known for its benefits in nail growth. Ridges form when you have this in low amounts. Vitamin C too. This may be a result of low dietary vitamins or a malabsorption of vitamins.

Iron deficiency

Insufficient iron in circulation could lead to iron-deficiency anemia that is mostly characterised by koilonychia in which case the nail plate curves upwards and forms a spoon shape. Hemochromatosis in which iron is highly absorbed may lead to this too. In this condition, the nails may become brittle and may signify iron deficiency.

Infections

Fungal infections could lead to brittle nails and nails with ridges. In fact fungal infections are implicated as causes of nail abnormalities and should therefore be considered and explored (National Health Society).

Chemotherapy

Nail blemishes could occur as a result of chemotherapy. For instance, breast cancer therapy, according to BreastCancer.org, may lead to drying, bruising, clubbing and formation of dents. Culprit chemotherapeutic agents include doxorubicin and docetaxel among others.

Hypocalcemia

Calcium is involved in the formation nails and therefore a deficiency in your body could make it brittle and even form dents and ridges.

Particular causes in

Finger nails-thumbnails & other fingers

When dents appear on particular fingers, it could be due to:

Fungal infection on that particular fingerSlow development to 20 finger nails diseasePoor nutrition that is low in vitamins, iron, calcium and zincHypothyroidism also makes the thumb nails dent.

Nail Bed

The nail bed is essential for the growth of the nail and without it the nail becomes non-adherent and can be deformed.

At times the nail bed is intact but avulsed from the germinal matrix. The germinal matrix is responsible for the growth of the nail. Eponychial loss due to trauma, excision or amputation of the tips of fingers may cause this.

Sometimes a cicatricial build up beneath the matrix may make the nail assume the shape of the underlying matrix hence formation of ridges (Ravindra Bharathi and Babu Bajantri)[4].

Dents in Nails after Acrylics

Acrylics lead to dents on finger nails due to improper fixing and/or removal. Anyone knows that if acrylics are not removed appropriately they could completely ravage your nails and make them lose their aesthetic look.

Some people even bite them to pull them off. To remove them soak the nails first, get a soft buffer and then smooth the surface. This, if not done, may lead to ridges and dents on nails.

How to Prevent & get rid of Dented Nails

Good thing is that you can prevent the occurrence of dents and ridges on your nails. You can do the following:

Make sure that you supplement your diet or have enough to supply the recommended daily amounts of vitamins, iron, calcium and zinc.Treatment of the underlying condition. At times waiting too long to treat an infection could lead to complications. For instance, if you notice that you are itching on your fingers, then it is important that you seek medical attention fast to ensure that any fungal infection is treated.Manage hypothyroidism. Though there have been cases of not recuperating from dented nails even after taking antithyroid drugs, it is good that you prevent the involvement of more finger nails.Moisturize your nails to protect your eponychial skin. This will also maintain the integrity of the cuticles which protect your germinal matrix. When your germinal matrix is interfered with, then a deformity could occur.

Sources

[1] Baran R, Dawber RP, Haneke E, Tosti A, Bristow I.Martin Dunitz.3rd ed. 2005. Nail configuration abnormalities. A Text Atlas of Nail Disorders: Techniques in Investigation and Diagnosis; pp. 1824.

[2] Nail pitting and onycholysis.Jadhav VM, Mahajan PM, Mhaske CB; Indian J Dermatol Venereol Leprol. 2009 Nov-Dec; 75(6):631-3.

[3] Gregoriou S, Argyriou G, Larios G, Rigopoulos D. Nail disorders and systemic disease: What the nails tell us.J FAM Pract.2008;57:50914.

[4] Bharathi, R. R., & Bajantri, B. (2011). Nail bed injuries and deformities of nail.Indian journal of plastic surgery: official publication of the Association of Plastic Surgeons of India,44(2), 197.



What Do Dents in Fingernails Mean?

Many of us do not take nail health issues, such as ridges, discolored nails, and changes in the shape of the nails. But these can be early indications of undiagnosed medical conditions like circulatory problems, iron deficiency, and thyroid diseases as well. Proper nail care is also essential. So, the next time you notice dents in your fingernails, do not ignore it. It is always better if you listen to what your nails are trying to tell you!

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