If You Notice This on Your Fingernails, Get a Blood Test

Did you know that your fingernails are composed of dead skin cells? While that might…

Did you know that your fingernails are composed of dead skin cells? While that might sound gross, it’s really nothing to be squeamish about: Your nail beds simply push old cells out to make way for new, healthy cells. What’s more, your fingernails can provide important insights into your health. In particular, one symptom you may notice on your nails could signal one of several autoimmune conditions. If you notice it, you may want to consider getting a blood test to identify the underlying cause. Read on to find out what to look out for, and how to care for your nails after treating the root problem.

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Pitted fingermails
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If you notice dents, holes, or depressions in your fingernails, this is a sign of pitted nails—one of seven “fingernail problems not to ignore,” flagged by the Mayo Clinic. Their experts note that nail pitting is often caused by autoimmune disorders. These commonly include psoriasis, inflammatory arthritis, and connective tissue disorders such as Reiter’s syndrome and alopecia areata.

Experts say nail pitting is especially common in cases of psoriatic arthritis. In fact, according to the informational site Creaky Joints, nearly 90 percent of people with this condition experience such changes in the nails. “Both fingernails and toenails can be affected, and it can affect one nail or all 20 nails,” Mona Gohara, MD, associate clinical professor of dermatology at Yale School of Medicine, told the site.

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young woman with curly hair looks at her fingernails with a concerned expression on her face
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According to Very Well Health, you may notice several other nail-related symptoms if you experience pitted nails. These can include nail discoloration which can appear in a shade of white, yellow, or brown, nails that crumble, nails that separate from the nail bed, blood underneath the nails, changes in the nail’s shape or deformation of the nail.

If your doctor is unable to diagnose your condition based on the presence of one or more of these symptoms, they may opt for a skin biopsy, which can help identify an infection or abnormality. Given the wide range of possible autoimmune conditions related to this particular symptom, it’s important to mention your full range of symptoms, even if they seem unrelated. In addition to nail changes, these may include hair loss, skin changes, joint pain, and more.

Half-and-half nails fingernail health
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The connection between your fingernails and an autoimmune condition may not seem immediately clear, but experts say nail pitting occurs as a result of inflammation. Specifically, this takes place in the nail matrix, the part of your fingernails and toenails that generates growth and pushes out the dead cells that become your nails.

Over time, the marks on your nails may actually serve as a record of your condition’s progress. If the depressions on your nails are followed by a stretch of smooth, healthy nail, it may mean that your inflammation has ceased for some length of time.

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Unrecognizable woman looking at her nails, while removing her nail polish.
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The most important thing to remember about nail pitting is that it’s not only a cosmetic issue, but a potential sign of a deeper problem. As such, you should always work with your doctor to address the underlying cause before focusing on aesthetic improvements.

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Experts say there are several ways to improve the look of your nails over time, and most suggest going “au natural” as one of the best methods. This means keeping your fingernails short and clean and avoiding manicures, which can be traumatic for your recovering nails. Resist biting or picking at your nails, both of which can cause infection, and avoid cutting or pushing back your cuticles. Wear protective gloves during gardening, dishwashing, or any other activity that could damage your nails or expose them to harsh substances.

While other interventions may help to varying degrees—phototherapy or certain supplements, for example—your doctor may simply recommend treating the underlying cause and waiting for healthier nail regrowth. If the underlying condition causes flareups, you may experience pitting and healthy growth intermittently.

Your doctor can help you identify the underlying cause for your pitted nails, and discuss the full range of possible interventions.

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