What Your Nails Say About Your Health
Nail color and texture can reflect a wide range of medical conditions.
Reviewed By Brunilda Nazario
Take a good look at your fingernails and you may notice subtle variations in the texture or color - a touch of white here, a rosy tinge there, perhaps some rippling or bumps in the surface. These imperfections may not look like much to you, but to the trained eye they can provide valuable clues about your overall health.
"Just like the eyes are the window to the soul, so are the nails," says Tamara Lior, MD, a dermatologist with Cleveland Clinic Florida. Lior says she once convinced a patient to have his lungs checked after noticing a bluish tint to his nails, a sign that he wasn't getting enough oxygen. Sure enough, he had fluid in his lungs.
Warning signs for many other conditions, from hepatitis to heart disease, may also appear in the nails, according to Joshua Fox, MD, director of Advanced Dermatology and a spokesman for the American Academy of Dermatology. "Changes in the nails can be a sign of a local disease like a fungus infection or a sign of a systemic disease like lupus or anemia," Fox tells WebMD.
He says he sometimes tries to guess if a person has anemia by looking at his or her nails. He explains that pale, whitish nail beds may indicate a low red blood cell count consistent with anemia.
An iron deficiency can cause the nail bed to be thin and concave and have raised ridges.
While most of Fox's patients don't come in to report nail problems, he often checks their nails anyway. "The nails offer many little clues to what's going on inside you. Lupus patients get quirky, angular blood vessels in their nail folds. Psoriasis starts in the nails up to 10% of the time" and causes splitting and pitting of the nail bed.
Heart disease can turn the nail beds red. Obsessive-compulsive disorder can show up in the nails through persistent nail-biting or picking, Fox says.
Even common disorders like thyroid disease can cause abnormities in the nail beds, producing dry, brittle nails that crack and split easily.
He lists the following 10 examples of nail changes that could indicate a serious medical condition.
'Rarely the First Clue'
But can a doctor truly detect undiagnosed heart disease or kidney problems by looking at your nails? American College of Physicians spokeswoman Christine Laine, MD, MPH, says it's not likely. She doesn't dispute the connection between nails and disease, but she cautions, "Nail changes are rarely the first clue of serious illness. In most instances, patients will manifest other signs or symptoms of disease before nail changes become evident. For example, it would be unusual that nail clubbing was the first thing a patient with emphysema noticed. Breathing difficulty probably would have been present already."
In addition, Laine, who is the senior deputy editor of the Annals of Internal Medicine, notes that certain illnesses may cause nail changes in some patients but not in others. "For example, not all people with liver disease develop white nails," Laine tells WebMD. The reverse is true as well - not everyone with white nails has liver disease. "In the absence of other signs or symptoms of disease, I would be reluctant to launch a complex, expensive work-up for systemic disease solely because of nail findings."