Nail Health Chart: Common Problems And How To Treat Them

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Medical News TodaySubscribeCommon conditions of the nails with illustrated chart

Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — Written by Anna Smith Haghighi on April 29, 2021

Common nail problems
Keeping nails healthy
When to see a doctor
Summary

There are many common nail conditions people experience, some of which a person can treat at home. For more severe conditions, a person should talk with a doctor, as they may require surgery.

A person who has healthy nails will notice the following features:

uniform size and shape
smooth and shiny appearance
pink nail bed, which is the skin beneath the nail
white lunula, which is the small half-moon shape at the base of the nail
white nail-free margin, which is the part of the nail that grows past the fingertip

This article goes into detail about common nail problems, their treatments, and how to keep nails healthy.

List of common nail problems

Common nail problems and their symptoms include the following:

1. Nail psoriasis

According to the National Psoriasis Foundation, approximately 50% of people with psoriasis will also have nail psoriasis. Nail psoriasis can affect a person’s fingernails or toenails.

Symptoms of nail psoriasis include:

nail pitting, where tiny dents appear in the nail
white, yellow, or brown discoloration
crumbling nails
separation of the nail from the finger or toe
blood beneath the nail
nail thickening
a buildup of debris beneath the nail
nail ridges
pain or tenderness

Treatments

A dermatologist can treat nail psoriasis by:

applying potent corticosteroids to the nail
applying calcipotriol, a cream used to treat psoriasis
applying tazarotene, a gel used to treat psoriasis

Nail psoriasis can be challenging to treat and may require more than one type of treatment. If stronger treatments are necessary, a dermatologist may try:

injecting corticosteroids into or near the nail
performing laser treatment
performing PUVA, a therapy that involves exposing nails to UVA rays after soaking them in psoralen
using medication to treat both skin and nail psoriasis

2. Onychoschizia

Onychoschizia is the medical term for nails that are brittle, splitting, soft, or thin. Onychoschizia is a common nail problem and is more likely to occur in females than in males.

Onychoschizia can occur due to:

repeated wetting and drying of nails
low humidity
frequent use of nail polish and nail polish remover
extended contact with detergent or cleaning products
aging
deficiencies of iron, zinc, or selenium

Treatments

A person can treat onychoschizia by:

wearing rubber gloves when washing up or using cleaning products
using less nail polish and nail polish remover
taking the vitamin biotin
using moisturizer

3. Onychogryphosis

Onychogryphosis, also called ram’s horn nails, describes when a person’s nail becomes thick and overgrown. Onychogryphosis commonly occurs on the big toe of older adults.

Causes of onychogryphosis include:

genetics
trauma
peripheral circulation disorders
wearing improper footwear
foot abnormalities
skin conditions such as psoriasis or ichthyosis

Symptoms of onychogryphosis include:

thickened nails
yellow or brown discoloration
nails that curve abnormally
pain

Treatments

A person who has onychogryphosis will need to see a dermatologist or podiatrist to cut their nails. Wearing suitable footwear can also help with onychogryphosis.

However, onychogryphosis can reoccur, so nail removal is the only method to treat it permanently.

4. Ingrown toenails

Ingrown toenails occur when the nail starts to grow into the skin of the toe.

Causes of ingrown toenails include:

cutting toenails too short or at angles
wearing shoes that are too small
experiencing nail trauma
having a family history of ingrown toenails
having fungal infections

A person with ingrown toenails may experience the following on their toe:

pain and tenderness
swelling
redness
infection

Treatments

Treatments for ingrown toenails include:

soaking the foot in warm water
cutting toenail straight across
gently massaging the nail
wearing comfortable shoes
taking prescribed antibiotics
having surgery to remove part of the nail

5. Fungal infections

A fungal nail infection occurs when fungus enters a person’s nail, usually via a small crack. Fungal nail infections are more likely to occur on toenails than the fingernails.

Causes of fungal nail infections include:

nail injury
diabetes
a weak immune system
circulation problems
athlete’s foot

Symptoms of fungal nail infections include:

yellow, white, or brown nail
cracked or fragile nail
thickened nail

Treatments

Doctors can treat fungal nail infections with antifungal pills or by surgically removing the nail.

6. Onycholysis

Onycholysis is when a person’s nail starts to separate from their skin. There can be many causes of onycholysis, including:

fungal infection
psoriasis
nail injury from aggressive manicure
iron deficiency
overactive thyroid
prolonged immersion in water

Onycholysis can cause white discoloration where the nail has lifted from the skin. If infection occurs, the nail may have green or yellow patches.

Treatments

A person can treat onycholysis by:

removing the unattached nail
keeping nails out of water
using gloves when cleaning
taking medication to treat any infection
using a prescribed drying agent, such as 3% thymol, after washing hands

7. Paronychia

Paronychia is an infection at the base of the nail. There are two forms of paronychia:

Acute paronychia

Acute paronychia occurs due to infection of the nail fold, the skin at the base of the nail.

Symptoms of acute paronychia include:

redness and swelling of the skin at the base of the nail
pain
pus from the cuticle
fever
pain in the armpit glands

Chronic paronychia

Repeated contact with irritants can cause chronic paronychia. People who constantly have wet hands are more likely to have chronic paronychia. Chronic paronychia often starts on one nail and spreads to others.

Symptoms of chronic paronychia include:

redness and tenderness at the base of the nail
white, yellow, or green pus discharge from the cuticle
distorted, ridged nails
yellow or green nails
brittle nails

Treatments

A person can treat acute paronychia by:

using soaks
applying antibiotic creams
taking antibiotic tablets
lancing any abscesses

Treatment for chronic paronychia includes:

keeping hands clean and dry
using gloves when cleaning or working with chemicals
applying topical creams or lotions
taking antifungal drugs

8. Punctate leukonychia

When small white spots appear on the nails, it’s called punctate leukonychia. Trauma to the nail, such as knocks or nail-biting, can cause punctate leukonychia.

Treatments

Punctate leukonychia will eventually disappear as the nail grows out.

9. Subungual hematoma

A subungual hematoma is a bruise that appears underneath the nail. Injuring the nail, such as by stubbing a toe or wearing shoes that are too tight, can cause subungual hematomas.

A person with a subungual hematoma may notice:

pain and tenderness in the nail
lifting of the nail
spots of purple, red, brown, or black on the nail

Treatments

A person can treat a subungual hematoma by:

applying ice wrapped in a cloth or towel to the nail
compressing the finger or toe with a bandage
resting
elevating the injured digit
taking pain medication

A subungual hematoma should disappear as the nail grows out, which can take 6⁠–9 months.

A person should seek medical attention if their subungual hematoma:

keeps bleeding continuously
is incredibly painful
occurs alongside severe damage to the base of the nail

A doctor may X-ray the nail to check for injury to the bone beneath it.

The doctor may also lance the subungual hematoma if it is causing pressure to build on the nail.

Tips to look after nails and keep them healthy

There are many ways a person can keep their nails healthy. To maintain healthy nails, the American Academy of Dermatology (AAD) recommends:

keeping nails clean and dry
cutting nails straight across
using an emery board to remove any snags on the nail
not biting nails
not using nails to open cans or as a tool
cutting nails regularly
wearing footwear that fits properly
wearing flip-flops at public pools and showers
never pulling at hangnails

When to see a doctor

A person who notices any unusual changes to their nails should talk with a doctor. The doctor can recommend what treatment a person may need for their nail issue.

A person who has received treatment for a nail condition but has no improvement should also talk with their doctor.

Summary

There are many conditions that can affect a person’s nails. Treatment for nail conditions will depend on the cause.

A person who is concerned about changes to their nails should speak with their doctor.

Uncategorized

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

12 nail changes a dermatologist should examine. (n.d.).https://www.aad.org/public/everyday-care/nail-care-secrets/basics/nail-changes-dermatologist-should-examine
Brittle splitting nails. (n.d.).https://www.aocd.org/page/BrittleSplittingNail?
Chang, P., et al. (2015). Onychogryphosis: A report of ten cases.https://pubmed.ncbi.nlm.nih.gov/26790505/
Fungal nail infections. (2020).https://www.cdc.gov/fungal/nail-infections.html
Hands, feet & nails. (2020).https://www.psoriasis.org/hands-feet-nails/
Ingrown toenail. (n.d.).https://www.foothealthfacts.org/conditions/ingrown-toenail
Ko, D., et al. (2018). Onychogryphosis: case report and review of the literature.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219229/
Nail hygiene. (2016).https://www.cdc.gov/healthywater/hygiene/hand/nail_hygiene.html
Onycholysis. (n.d.).https://www.aocd.org/page/Onycholysis
Paronychia nail infection. (n.d.).https://www.aocd.org/page/ParonychiaNailInfe
Sparavigna, A., et al. (2019). Efficacy and tolerability of a biomineral formulation for treatment of onychoschizia: A randomized trial.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525000/
Reinecke, J. K., et al. (2020). Nail health in women.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105659/
Subungual hematoma. (n.d.).https://www.aocd.org/page/SubungualHematoma?
Tips for healthy nails. (n.d.).https://www.aad.org/public/everyday-care/nail-care-secrets/basics/healthy-nail-tips
What is nail psoriasis, and how can I treat it?https://www.aad.org/public/diseases/psoriasis/treatment/genitals/nails
White nail. (2016).https://dermnetnz.org/topics/white-nail/

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Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — Written by Anna Smith Haghighi on April 29, 2021

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List of common nail problems

1. Nail psoriasis

Treatments

2. Onychoschizia

Treatments

3. Onychogryphosis

Treatments

4. Ingrown toenails

Treatments

5. Fungal infections

Treatments

6. Onycholysis

Treatments

7. Paronychia

Acute paronychia

Chronic paronychia

Treatments

8. Punctate leukonychia

Treatments

9. Subungual hematoma

Treatments

Tips to look after nails and keep them healthy

When to see a doctor

Summary

How we reviewed this article:

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