Dermatology
4 Common Nail Changes, and What They Say About Your Health (Plus Nail Health Charts)
Your nails are an extension of your skin. Their color, shape, and texture can say a lot about your overall health.
Some nail changes are totally normal and are just signs of day-to-day life or getting older.
Other changes, like a change in nail color or the curve of your nail, can be signs of an underlying health problem.
Crumbly, ridged, or thickened nails can be common with certain skin and joint conditions.
Most people don’t spend much time thinking about their fingernails or toenails. And that’s usually OK. But, like your skin, the health of your nails can say a lot about your overall health. After all, they are an extension of your skin.
This doesn’t mean you need to inspect your nails every day. But it helps to be aware of nail changes that could point to a bigger problem. With that in mind, here are four of the most common types of nail changes — and what they may be telling you about your health.
Healthy nails come in a range of colors, depending on your skin color. They can range from light mauve (purple) in darker skin tones to pale pink in lighter skin tones.
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Changes in nail color can sometimes be a sign of an underlying health problem. The cause can come from an issue with the nail plate (the hard part of your nail), or the nail bed (the tissue underneath). Some medications can also change nail color.
Below are some common nail color changes and what they might mean.
Nail color change | Possible associated health problem |
|---|---|
Black or brown
| Blood under the nail (subungual hematoma) Nicotine staining |
Blue | Low blood oxygen levels (as in breathing problems) Poor blood circulation (like with Raynaud’s phenomenon) Heart problems (including low blood pressure and heart failure) Cold temperatures |
Green | Nail infection (like onychomycosis or pseudomonas) |
Nail infection (like onychomycosis) Lung disease (like recurrent pneumonia or pulmonary fibrosis) Nicotine staining | |
White | Chronic kidney failure |
Red lunula (red half-moon shape at the nail base) |
Just like color, the shape of healthy nails can vary a bit from person to person. We’re not talking about whether your nails are square, oval, or pointed. This is about the shape of the nail from base to tip.
In general, healthy nails have a gentle, even curve from one end to the other.
Here are some changes in nail shape and what they could mean for your overall health.
Change in nail shape | What it looks like | What it may mean |
|---|---|---|
Clubbing | Wide, curved nails that cover enlarged, swollen fingertips | Heart disease |
Spoon nails (koilonychia) | Nails have a spoon-shaped dent in the center | Nutritional deficiency Diabetes |
Ram’s horn (onychogryphosis) | Very thick, curved nail | Age-related changes Psoriasis Nail injury |
Healthy nails generally have a smooth surface. Some people have a few vertical ridges (grooves that run from the base of the nail to the tip). This is especially common as you get older.
Is that nail change normal — or something more? From dark streaks to peeling edges, find out which nail changes are harmless and which could signal something more serious beneath the surface.
What healthy nails should actually look like: Smooth? Pale pink? A little ridged? Learn what’s normal (and what’s not) when it comes to nail color, texture, and growth — no polish needed.
Why nails may change during midlife: During menopause, nails can become brittle, dry, or slow growing. Hormonal changes may be to blame. Here’s how to protect and strengthen them through the transition.
Other changes in nail texture, especially if they happen suddenly, can mean an underlying health problem.
Here are some nail texture changes to look out for.
Change in nail texture | What it looks like | What it may mean |
|---|---|---|
Pitting | Small, pinpoint dents in the nail surface | Alopecia areata Eczema (atopic dermatitis) |
Beau’s lines | Deep horizontal groove in several nails | Recent serious illness Recent stressful life event |
Longitudinal ridging (onychorrhexis) | Multiple longitudinal ridges along the nail | Normal aging Psoriasis Lichen planus |
Rough nails (trachyonychia) | Nails feel like sandpaper | Lichen planus |
Nail strength varies from person to person, and it can change throughout life. You aren’t alone with your frustration if your nails suddenly break, crack, or won’t grow long.
The most common cause of nail splitting is something you’re exposing your hands to. But it can also be related to an underlying health problem.
Here are some common types of nail splitting and what they might mean.
Type of nail splitting | What it looks like | What it might mean |
|---|---|---|
Nail splitting (onychoschizia) | Splitting at the nail tips | Water or detergent damage Picking or biting Everyday wear and tear |
Brittle nails | Nails that chip, flake, or peel easily | Normal aging Frequent handwashing Low iron levels |
Nail plate crumbling | A large portion of the nail plate crumbles and may separate | Psoriasis Nail infection |
Longitudinal splitting | A long vertical spit that runs the length of the nail | Psoriasis Lichen planus Tumors of the nail Nail injury |
Caring for your nails is an important part of keeping them healthy — and it can be quick and easy.
Here are some everyday habits to help keep your nails healthy and strong:
Don’t bite your nails or remove the cuticle.
Keep your nails clean, dry, and trimmed.
File your nails to keep the edges smooth.
Eat a nutritious and balanced diet.
Use gloves when doing wet work, like washing dishes.
Moisturize your nail and the area around them (nail folds).
Because nails grow slowly, changes can take time to appear and heal. Sudden, unexplained, or worsening nail problems should be evaluated by a medical professional.
Here are some nail changes you shouldn’t ignore:
Pain, swelling, or bleeding around the nail
Discoloration, such as black or dark brown streaks that aren’t related to nail injury — these could be a sign of melanoma
Swelling of the fingertip and nail (clubbing), or caving in (spooning) could be a sign of heart, lung, or other medical issues
Persistent splitting, crumbling, or detachment of the nail
Changes that don’t improve with self-care after a few weeks
No single nail change can diagnose liver problems. Some nail changes, like white nails, linear ridges, Terry’s nails, brittle nails, clubbing, or flat nails, may appear with liver disease. But they can also happen with other health issues.
Fungal nail infections (onychomycosis) are also more common in people with chronic liver disease.
Thyroid hormones are key to nail and skin health. An underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism), can cause nail changes, for example:
Thick, dry, and brittle nails with vertical ridges
Soft, shiny nails that crumble easily (more common with hyperthyroidism)
Nails that grow more slowly (in hypothyroidism) or faster (in hyperthyroidism)
Nails that peel, break, or split with little effort
Nails that lift up from the nail bed (called onycholysis), especially in overactive thyroid
Nail changes in thyroid disease happen slowly and affect multiple nails. If you notice these along with other symptoms like fatigue, weight changes, or hair thinning, talk with a medical professional.
It’s not typical for low vitamin B12 to show up in your nails. But rarely, it can lead to a bluish discoloration, or dark streaks across your nails. You may also notice brittle nails, or horizontal grooves across your nails (called Beau’s lines).
No single nail change can diagnose liver problems. Some nail changes, like white nails, linear ridges, Terry’s nails, brittle nails, clubbing, or flat nails, may appear with liver disease. But they can also happen with other health issues.
Fungal nail infections (onychomycosis) are also more common in people with chronic liver disease.
Thyroid hormones are key to nail and skin health. An underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism), can cause nail changes, for example:
Thick, dry, and brittle nails with vertical ridges
Soft, shiny nails that crumble easily (more common with hyperthyroidism)
Nails that grow more slowly (in hypothyroidism) or faster (in hyperthyroidism)
Nails that peel, break, or split with little effort
Nails that lift up from the nail bed (called onycholysis), especially in overactive thyroid
Nail changes in thyroid disease happen slowly and affect multiple nails. If you notice these along with other symptoms like fatigue, weight changes, or hair thinning, talk with a medical professional.
It’s not typical for low vitamin B12 to show up in your nails. But rarely, it can lead to a bluish discoloration, or dark streaks across your nails. You may also notice brittle nails, or horizontal grooves across your nails (called Beau’s lines).
Nails are an extension of your skin. They can tell you a lot about your health. While healthy nails can vary from person to person, they generally have a light pink or purple color and a smooth, rounded surface.
Some nail changes are normal with age and everyday wear. But other nail changes — like changes to color, texture, or shape — can point to an underlying health concern.
Abdullah, L., et al. (2011). Common nail changes and disorders in older people. Canadian Family Physician.
American Academy of Dermatology Association. (n.d.). 12 nail changes a dermatologist should examine.
American Academy of Dermatology Association. (n.d.). Thyroid disease: A checklist of skin, hair, and nail changes.
Bullock, L. (2025). 11 dermatologists’ tips for healthy nails. American Academy of Dermatology Association.
Cheslock, M., et al. (2022). Yellow nail syndrome. StatPearls.
Dawman, L., et al. (2018). Blue nails: Window to micronutrient deficiency. BMJ Case Reports.
DermNet. (n.d.). Beau lines.
Inthasot, S., et al. (2022). Causes of longitudinal nail splitting: A retrospective 56-case series with clinical pathological correlation. Journal of the European Academy of Dermatology and Venereology.
Meged, M. M. A. E. (2019). Patterns of nail changes in chronic liver diseases. Sohag Medical Journal.
Ngan, V. (2016). Hypertrophic osteoarthropathy and digital clubbing. DermNet.
Oakley, A. (1997). Nail terminology. DermNet.
Thomas, L. (2019). Nail discoloration - green, blue, black, white or yellow, why? News Medical.
