Changes in Your Fingernails/Toenails
Can Signal Larger Health Problems
Important information about nail health from the American Academy of Dermatology:
Our nails often reflect our general state of health. Changes in the nail, such as discoloration or thickening, can signal health problems, including liver and kidney disease, heart and lung conditions, anemia, and diabetes. Symptoms that could signal nail problems include changes in color, shape and/or thickness, swelling of the skin around the nails, bleeding or discharge, and pain. See your dermatologist for the successful diagnosis and treatment of nail problems, and to find out if they are indicating a greater issue with your overall health.
Nail growth
- Fingernails grow faster than toenails — especially on one’s dominant hand.
- On average, fingernails grow 3.5 mm per month, while toenails grow about 1.6 mm per month.1
- Nail growth rates depend on age, health status, time of year, activity level and heredity.
- Women’s nails grow more slowly than men’s, except possibly during pregnancy.
- Nails grow more rapidly in summer than in winter.
- Nail growth is affected by disease, nutrition, medications, trauma, chronic illness, fever and the aging process.
Nail problems
- Nail problems make up about 10 percent of all dermatologic conditions.2
- Nail problems usually increase throughout life and affect a high number of senior citizens.3
- Fungal infections cause about half of all nail disorders.4 They are more common in toenails because the toes are confined in a warm, moist, weight-bearing environment.
- Melanoma, the deadliest form of skin cancer, can grow under the nail in rare cases. Such melanomas may be mistaken for injuries, so a dermatologist should be consulted if a dark-colored streak appears within the nail plate, if the nail discoloration does not gradually improve or if the size of the streak increases over time.5
- Other common nail problems include:
- White spots after an injury to the nail.
- Vertical lines, known as splinter hemorrhages, under the nails caused by nail injury or certain drugs and diseases.
- Bacterial infections, most often due to injury, poor skin hygiene, nail biting, finger sucking or frequent exposure to water.
- Ingrown toenails, caused by improper nail trimming, poor stance, digestive problems or tight shoes.
- Do not try to self-treat ingrown toenails, especially if they are infected. See a dermatologist.
- Nail problems are more common in those with diabetes or poor circulation. At the first sign of a problem, see a dermatologist.
Tips for keeping nails healthy
- Keep nails clean and dry to prevent bacteria from collecting under the nail.
- Cut your fingernails and toenails straight across and rounded slightly in the center. This will keep your nails strong and help you avoid ingrown toenails.
- When toenails are thick and difficult to cut, soak feet in warm salt water (one teaspoon of salt per pint of water) for five to 10 minutes, and then apply urea or lactic acid cream. This softens the nails, making them easier to trim.
- Wear proper-fitting shoes and alternate shoes on a regular basis. Tight shoes can cause ingrown toenails.
- Do not bite your fingernails; this can transfer infectious organisms between your fingers and mouth. Nail biting also can damage the skin around your fingers, allowing infections to enter.
- Apply a cream to moisturize your nails, especially after removing nail polish, since most polish removers contain chemicals that dry the nails.
- If you want to wear a bright red or orange polish, prevent discoloration by applying an extra layer of base coat. If your nails become yellowed and discolored from the polish, they should return to their normal color over several weeks if the same polish is not reapplied.
Nail salon safety
- While most nail salons follow strict sanitation guidelines, consumers should check to make sure that the salon, the manicure stations, the footbaths and the tools are clean, and that the technicians wash their hands between clients.6
- Consumers who get frequent manicures and pedicures should bring their own tools to the salon.
- Don’t let a nail technician cut or push back your cuticle. It may allow an infection to develop.
- Do not wear artificial nails to cover up nail problems, as this may make those problems worse. Artificial nails are not recommended for people who are prone to fungal infections or have brittle nails. For people with healthy nails, artificial nails can be fine as long as they are not worn continuously.
- Don’t shave your lower legs for at least 24 hours before you get a pedicure. If you nick yourself while shaving, a pedicure could put you at risk for an infection.
- If you experience itching, burning or any type of allergic reaction to a nail cosmetic, see a dermatologist.
1Yaemsiri S, Hou N, Slining MM, He K. Growth rate of human fingernails and toenails in healthy American young adults. J Eur Acad Dermatol Venereol. 2010 Apr;24(4):420-3.
2Cashman MW, Sloan SB. Nutrition and nail disease. Clin Dermatol. 2010 Jul-Aug;28(4):420-5.
3Abdullah L, Abbas O. Common nail changes and disorders in older people: Diagnosis and management. Can Fam Physician. 2011 Feb;57(2):173-81.
4Ghannoum MA, Hajjeh RA, Scher R, Konnikov N, Gupta AK, Summerbell R, Sullivan S, Daniel R, Krusinski P, Fleckman P, Rich P, Odom R, Aly R, Pariser D, Zaiac M, Rebell G, Lesher J, Gerlach B, Ponce-De-Leon GF, Ghannoum A, Warner J, Isham N, Elewski B. A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000 Oct;43(4):641-8.
5Kottschade LA, Grotz TE, Dronca RS, Salomao DR, Pulido JS, Wasif N, et al. Rare presentations of primary melanoma and special populations: a systematic review. Am J Clin Oncol. 2014 Dec;37(6):635-41
6Stout JE, Gadkowski LB, Rath S, Alspaugh JA, Miller MB, Cox GM. Pedicure-associated rapidly growing mycobacterial infection: an endemic disease. Clin Infect Dis. 2011 Oct;53(8):787-92.
