Changes in the appearance of your fingernails can be caused by many different health issues. A lot of these problems are not of major concern, but some may be more serious, and need to be recognised and diagnosed. So, here are some of the nail problems people commonly ask their doctors about, as well as rarer conditions that can occur from time to time.

Ridging of the nails

Horizontal ridges or indentations across the nails, also known as “Beau’s lines”, can occur if the normal growth of the nail has been interrupted for a period of time, due to infection, malnutrition or a significant systemic illness. However, local injury or infection of the nail or nail-bed itself may also be to blame.

Nail infections

• Fungal nail infections are common. Whilst more often seen in the toenails, occasionally the fingernails can be affected. Typical symptoms include white or brownish discolouration of the nails, as well as breaking, crumbling or thickened nails. The diagnosis can be confirmed by sending nail clippings to a lab for analysis. This is important before treatment starts, as sometimes the problem is not actually a fungal infection, but another condition, such as psoriasis. If a fungal nail infection is mild, a topical antifungal varnish may work, but if a lot of the nail is involved or several nails are affected, then oral antifungals may need to be considered. Oral antifungal medications can have bad side effects, so it’s important to discuss the options fully with your doctor.
• Paronychia is a bacterial infection that causes redness and soreness around the nail, and often a small collection of pus is visible under the skin near the cuticle. It may need treatment with oral antibiotics, so medical attention should be sought.

Pitting of the nails

Psoriasis is a skin condition that causes a scaly pink rash on the body and scalp. But sometimes it can also cause “pitting”- tiny pits or hollows in the nails. Pitting of the nails may also happen in psoriatic arthritis, as well as other autoimmune and connective tissue disorders.

Melanoma

Melanoma is a serious form of skin cancer that usually presents as a dark-coloured, irregular or changing mole somewhere on the body. It may itch or bleed. But sometimes Melanoma can develop under a nail. If you notice a dark or unusual spot forming under a fingernail or toenail, you should see your doctor urgently.

Terry’s Nails

Any significant long term illness – such as chronic failure of the kidneys, liver or heart, can lead to changes in the appearance of the nails. They may become white or pale, with pinkish tips- a condition sometimes known as “Terry’s nails”.

Clubbing

In clubbing of the fingers (or toes) there may be widening and increased curvature of the nails, a more pronounced angle between the finger and the nail, a boggy feeling if the nails are pressed, and a bulging appearance to the finger tips. Clubbing of the fingers can occur in a variety of lung, heart and bowel conditions as well as in some blood disorders. It can develop over weeks or years, depending on the underlying cause. As many of the potential causes can be very serious, it’s a symptom that should be assessed promptly by a doctor.

If you are worried about any of the above nail conditions,  you should speak to your doctor.