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5 Nail Problems That Indicate the State of Your Health

Healthy nails have a smooth appearance and consistent colour. But changes in your nails, such as breakage and ridges, may indicate an underlying medical condition.

Close-up of nails of a person’s index, middle, ring, and baby fingers.

Nail problems can indicate if you have a serious or chronic medical condition. But a change in appearance, colour or physical characteristics doesn’t necessarily mean it’s a sign that something’s wrong.

Thickened nails or nails that break easily, for example, are signs of ageing. A woman’s nails can also become harder, softer than usual, or more brittle during pregnancy.

Traditional Chinese Medicine (TCM) believes that the Liver holds blood and governs the tendons. In addition, the nails are an extension of the tendons and a reflection of your overall health.

Read on to understand the relationship between nail changes and overall health, and the steps you can take to address specific nail problems.

What Do Colour Changes in the Nails Mean? 

Each finger in TCM corresponds with different parts of your body

  • The thumb corresponds with the head, neck, and Lungs 
  • The index finger corresponds with the Lungs and cardiothoracic organs 
  • The middle finger corresponds with the Liver, Spleen, gallbladder and stomach 
  • The ring finger corresponds with the San Jiao (Triple Burner, 三焦), Liver, Kidneys, small and large intestines, and the uterus 
  • The pinky finger corresponds with the small intestine and lower limbs 

Healthy nails are pink and spotless. They’re also symmetrically shaped, smooth, and not twisted out of shape.

According to TCM, if you have nail problems such as changes in the colour of your nails, it may be a sign of health disorders or body constitution syndromes. White nails point towards Blood and Qi (vital life force) Deficiencies. Red nails can be due to Excessive Body Heat, Liver Fire, or cardiovascular disease onset.

Purple nails show a lack of oxygen, Blood Stasis, or peripheral vascular disease. Long-term smokers typically have yellow nails. However, it can also be a symptom of jaundice, liver disease, or senile purpura (forearm bruising) as a result of minor trauma. 

Nails that are greyish-black are likely to have a fungal infection, whereas cherry red nails may indicate carbon monoxide poisoning.

Spoon-shaped Nails (Koilonychia) 

Nails that appear thin and are turned inside with a depression in the centre are referred to as spoon-shaped nails or koilonychia. Iron deficiency anaemia is one of the leading causes of this and it can stem from: 

  • Gastrointestinal blood loss 
  • Cancerous cells, which can spread to other parts of the body or invade and destroy tissues 

Koilonychia may also be a manifestation of: 

  • Inflammatory skin diseases  
  • Hyper- or hypothyroidism 
  • Onychomycosis  
  • Trauma 
  • Alopecia areata 
  • Diabetes mellitus 
  • Plummer-Vinson syndrome  
  • Occupational exposure to petroleum products 
  • Autoimmune, genetic, musculoskeletal, and vascular disorders 

What are the treatment options for koilonychia? 

A person can consume more iron-rich foods or use supplements to correct or prevent the occurrence of anaemia-related koilonychia. Food such as tofu, seafood, red meat, leafy green vegetables, nuts, beans, and seeds can help. 

Treating the reasons behind koilonychia onset will also enable the nails to grow properly. It may take up to 18 months before symptoms of this nail disorder resolve completely.

Nail Psoriasis

Close-up of horizontal grooves across a person’s left discoloured toenail
A horizontal groove across a person’s nails is a symptom of nail problems like psoriasis. 

Grooves that run horizontally across the nails (also called Beau’s lines) are a notable symptom of nail psoriasis. The condition is characterised by discolouration or nail pits.

The skin under the nails may appear red, brown, yellow, or pink. Pits can develop on a person’s nails and comes in various sizes. These can be as small as 0.4 millimetres or big as 2 millimetres in width. 

Nail psoriasis is an autoimmune condition. It involves a rapid production of skin cells and appears with a psoriatic rash on the body. A person may be more vulnerable to the condition if they’re: 

  • Male 
  • Above the age of 40 
  • Have a family history of psoriasis  
  • Diagnosed with psoriatic arthritis 

What are the treatment options for nail psoriasis? 

Natural remedies such as aloe vera, turmeric, capsaicin, and dead sea salt may address nail psoriasis symptoms. A healthcare provider may recommend using a corticosteroid cream, ointment, or nail polish twice daily.

The remedies can only improve the condition after four to six months and if it reaches the nail bed and area where the nail starts to grow. 

Medication such as etanercept, adalimumab, or ustekinumab is used to treat more severe cases of psoriasis. Similarly, methotrexate, cyclosporine, or apremilast may also be used.

Another clinical treatment is phototherapy, which combines a drug called psoralen with ultraviolet A (PUVA) or B (PUVB) to improve the condition. Meanwhile, laser therapy uses pulsed dry lasers to target blood vessels under the nails, reducing the condition’s severity.

Lunula Abnormalities 

The moon-shaped portion of the nail matrix that extends beyond the nail fold is referred to as the lunula. Studies show that lunulae are absent in 62.9% of people diagnosed with chronic kidney disease.

In TCM, fewer lunulae are linked to physical weakness and a Yang (active energy) Deficiency. Overly large lunulae point to an Excess Syndrome, a short temper, and the possibility of a stroke or high blood pressure and blood sugar levels.

Digital Clubbing

Close-up of a person’s right hand with clubbed fingers
Clubbed fingers are associated with various cancers and heart and lung conditions.

Nails that appear detached from the fingers or toes are a prominent symptom of clubbing. The nail tips will curve downward and become wide or rounded.

These symptoms are associated with several types of cancer. They include lymphoma, mesothelioma, gastrointestinal tumours, and liver, lung, and oesophageal cancers. Heart and lung conditions that relate to digital clubbing include:  

  • Congenital heart disease  
  • Bronchiectasis: Scarring of the airways 
  • Empyema: The collection of pus in body cavities 
  • Endocarditis: A bloodstream infection that affects the lining of the heart valves 
  • Sarcoidosis: An inflammatory disease that influences organ structure or functions 
  • Aortic aneurysm: Bulge in the artery’s wall 
  • Cystic fibrosis: A genetic disease that sees a build-up of mucus in the organs 
  • Idiopathic pulmonary fibrosis: Scarred and thickened lung tissue 
  • Lung abscesses: A collection of pus in the lungs surrounded by swollen lung tissue 

Cracked or Broken Nails 

Eu Yan Sang Physician Luke Yau Wai attributes cracked or broken nails to nutritional deficiencies, insufficient blood in the Liver, a Yin (passive energy) Deficiency, or excessive Heat in the body.

A loss of water under the nail bed due to ageing may provoke the onset of vertical nail ridges. Rheumatoid arthritis can also cause its development, albeit to a lesser degree.

Horizontal ridges are a sign of trauma or temporary nail growth disruption. If the symptom persists or recurs, it may indicate diabetes, a zinc deficiency, or vascular disorders.

Is it possible to treat lunula disorders or nail problems directly? 

Pulling out cracked or broken fingernails will encourage the growth of a new fingernail. But the best way to heal nail problems like lunula disorders or clubbed nails is to treat the root causes of these symptoms.

Physician Luke recommends diet therapy as an alternative treatment approach. Examples of these are: 

  • Black bean soup 
  • Waist tonic essence 
  • Luk Mey pills  
  • Bu Qi Jian Zhong pills 
  • Goji berry (gou qi, 枸杞) and Rehmannia (di huang, 地黄) soup  
  • Codonopsis (dang shen, 党参) and jujube (da zao, 大枣) tea 

Understanding the conditions that provoke nail problems will enable a healthcare provider to treat them effectively. Likewise, a TCM practitioner will diagnose your condition based on your symptoms as well as changes in your fingernail appearance and colour. This will allow them to prescribe suitable treatments that remedy the problem while taking into account your body constitution.

References

  1. National Health Service. Nail problems. [online] [Accessed on 12 September 2022]
  2. National Library of Medicine. Spoon Nails. [online] [Accessed on 12 September 2022]
  3. Cleveland Clinic. Koilonychia (Spoon Nails). [online] [Accessed on 12 September 2022]
  4. Cleveland Clinic. Nail Psoriasis. [online] [Accessed on 12 September 2022]
  5. ResearchGate. 2021. Absent lunula: An overlooked finding in chronic kidney disease. [online] [Accessed on 12 September 2022]
  6. Cleveland Clinic. Clubbed Fingers. [online] [Accessed on 12 September 2022]
  7. Celiac Community Foundation of Northern California. 2016. Fingernail Changes in IBS, Gluten Sensitivity and Celiac Disease. [online] [Accessed on 12 September 2022]

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