Understanding Nail Abnormalities: Causes and Concerns

Our nails serve important protective and functional purposes, but various conditions can affect their appearance and health. Understanding these changes can help identify when professional care is needed.

What Are Nails?

• Composed of keratin, the same protein found in hair and hooves

• Develop early in fetal growth: fingernails at 10 weeks, toenails at 14 weeks

• Structure includes the visible nail plate, growing nail matrix, and underlying nail bed

• Change in thickness and flexibility with age

Purpose of Nails

• Protect finger and toe digits

• Aid in precise movements

• Assist with gripping small objects

• Enable scratching and scraping actions

Common Nail Abnormalities

Color Changes

• White or yellow discoloration: Often indicates fungal infections or nail separation

• Red or black coloration: Usually due to blood under nail from trauma

• Green coloration: May signal bacterial infection, typically Pseudomonas aeruginosa

• Dark spots: Should be evaluated to rule out skin cancer if not trauma-related

Structural Changes

• Lines and ridges: Often normal, may increase during pregnancy

• Horizontal ridges (Beau's lines): Can result from illness or chemotherapy

• Pitted nails: May indicate psoriasis or other skin conditions

• Thickened, brittle nails: Common with aging (senile nails)

Infection and Inflammation

• Fungal infections can cause:

  • Surface discoloration

  • Nail separation (onycholysis)

  • Thickening and flaking

• Paronychia: Infection of skin around nail causing swelling and redness

Physical Trauma

• Chronic trauma from ill-fitting shoes

• Sports-related injuries

• Repetitive impact from running or kicking

• Can cause permanent nail and matrix damage