Nail Ridges, Clubbing and Spooning
Causes of Changes in the Shape of Fingernails and Toenails
Jun 11, 2009
Nails are made from keratin, one of the strongest substances in the body, but their growth and appearance are surprisingly vulnerable to disruption for various reasons.
Transverse Ridges
A transverse ridge is a raised line running across the width of a nail. It is often self-inflicted by careless manicure, when rough use of manicure tools damages the cuticle or causes it to separate from the nail altogether.
Irritants such as dishwashing liquid may then get under the nail fold (the skin at the base of the nail), and the resulting inflammation can interfere with nail growth, leading to a ridge. If bacteria enter the gap, infection of the nail fold may occur.
Transverse ridges caused by damage to the cuticle grow out over time as the nail grows. The simplest way to avoid them is to take care when doing a home manicure; in particular, be gentle when pushing back the cuticles.
Beau’s Lines
Beau’s lines are transverse grooves that are characteristically visible at the same place on all or most of the nails. They arise when nail growth is temporarily halted by an illness, injury, malnourishment, or exposure to cold temperatures in a person with Raynaud’s disease (a vascular disorder that affects blood flow to the extremities). Psoriasis or diabetes may also cause Beau’s lines.
Knowing the rate at which the nails grow, the approximate date when the original problem occurred can be estimated from the distance between the Beau’s line and the base of the nail.
Longitudinal Ridges
Longitudinal ridges are raised lines running along the length of the nail. Like transverse ridges and grooves, they are a sign of disrupted nail growth. Mild ridging is a normal part of the ageing process. More severe longitudinal ridges are most commonly seen in people with lichen planus (an autoimmune condition affecting the skin). They may also be associated with rheumatoid arthritis, impaired peripheral circulation and kidney disorders.
Clubbing of the Nails
Nail clubbing occurs when the nail beds become soft, thickened and spongy, leading to thickening of the ends of the fingers. It is a classic sign of certain lung diseases, including tuberculosis, lung cancer and mesothelioma, and may be seen in heart disease, gastrointestinal disorders, liver disease or hyperthyroidism. It can also occur in healthy people, with no apparent cause.
Spooning of the Nails
As the name suggests, ‘spoon-shaped’ nails (koilonychia) are concave in shape rather than rounded. They are most commonly seen in people with iron deficiency anaemia. Those with Raynaud’s disease, systemic lupus erythematosus (often called simply ‘lupus’) or haemochromatosis (a condition in which iron accumulates in the body) may also have nail spooning.
Nails May Provide Important Clues to Illness
The appearance of the fingernails and toenails can reveal a lot about a person’s health. If you have any concerns, never hesitate to see your doctor for advice.
Reference
American Family Physician. Nail Abnormalities: Clues to Systemic Disease. Accessed 11-06-09
Disclaimer
The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
