Dystrophic Nails Pictures: What Your Nails Are Telling You

Dystrophic nails aren’t just about having nails that look a little different. The term refers to a wide range of nail abnormalities that affect their shape, texture, color, or overall appearance. So, while a simple change in shape might be a minor thing, nail dystrophy involves real changes in the nail matrix (where the nail grows from) or the nail bed itself.

These nail problems are surprisingly common, and they can have a big impact on someone’s life and self-esteem. In fact, half of all nail dystrophies are caused by onychomycosis, which is just a fancy word for a fungal nail infection.

Sometimes, changes to your nails can even point to underlying health issues, like systemic diseases or other skin conditions.

This article will explore all sorts of nail dystrophies, what causes them, how doctors figure out what’s going on, and what treatments are available. We’ll cover everything from congenital issues (things you’re born with) to nail problems linked to other health conditions. We’ll also look at specific nail disorders, like melanonychia (dark streaks in the nails) and onycholysis (when the nail separates from the nail bed).

It’s super important to get a proper diagnosis, which might even involve a nail biopsy in some cases. That’s because some nail changes can be a sign of more serious problems, like nail tumors. Hopefully, with some dystrophic nails pictures and descriptions, you’ll be better informed and ready to talk to your doctor about any nail concerns you might have.

Congenital Nail Dystrophies

Some nail problems are congenital, meaning you’re born with them or they develop shortly after birth. These conditions are often related to genetic syndromes or other birth defects.

Here are some examples of congenital nail dystrophies:

• Pachyonychia Congenita: This rare genetic disorder affects your nails, skin, and other tissues. The nails become thick and deformed, often with a buildup of material under the nail. People with this condition might also have thick skin on their palms and soles, as well as white patches in their mouth.
• Nail-Patella Syndrome: This genetic disorder affects the nails, kneecaps, kidneys, and bones. The nails can be small, split, ridged, or discolored. The half-moon shape at the base of the nail (lunula) might be triangular or missing altogether.

Nail dystrophies that can signal systemic disease

Sometimes, changes in your nails can be a sign of something else going on in your body. Here are some nail conditions that doctors often link to other health problems:

Cardiovascular and pulmonary diseases

• Clubbing: This is when the tips of your fingers get wider and rounder, and your nails curve more than usual. It’s often related to not getting enough oxygen over a long period. When you hold your fingers together, you usually see a diamond-shaped space between your nail beds, but that space disappears with clubbing.
• Yellow Nail Syndrome: This is a rare condition where your nails get thick and yellow. People with this syndrome often have swelling in their limbs (lymphedema) and breathing issues. Their nails grow very slowly and might not have a cuticle. Doctors often see fluid around the lungs and widening of the airways in people with this syndrome.

Renal diseases

• Half-and-Half Nails (Lindsay’s Nails): If the part of your nail closest to your hand is white and the part further away is red, pink, or brown, it could be a sign of kidney disease. This happens in many people with long-term kidney problems. Doctors think it’s because of high levels of waste in the blood.

Endocrine and metabolic disorders

• Terry’s Nails: When most of your nail looks white, except for a narrow pink or red band at the tip, it might be Terry’s nails. This is often linked to liver disease, heart failure, and diabetes. The little half-moon shape at the base of your nail (lunula) is often hard to see.

Nutritional deficiencies

• Koilonychia (Spoon Nails): If your nails are thin, flat, and curve upwards like a spoon, it could be from not getting enough iron. It can also be a sign of a rare condition called Plummer-Vinson syndrome.

Nail dystrophies associated with dermatologic conditions

Nail problems can be a sign of other health conditions, especially conditions that affect the skin.

Psoriasis

Nail psoriasis can cause a variety of changes to your nails:

• Pitting: You may notice small, pinpoint depressions on the surface of your nails. These pits happen because of parakeratosis, a problem in the nail matrix.
• Onycholysis: The nail plate may separate from the nail bed, often with a yellow or white color where the separation is taking place.
• Subungual hyperkeratosis: Scale and debris can build up under the nail plate, making the nail thicker and distorted.
• Oil drop sign: You may see a translucent, reddish-brown spot on the nail bed. This is a sign that strongly suggests nail psoriasis.

Lichen planus

Lichen planus is a condition that can cause dystrophic nails to form. Some of the changes include:

• Longitudinal ridging and fissuring: You may see vertical lines and cracks on the nail surface, along with redness of the lunula (the moon-shaped area at the base of the nail). The nail can get thinner and waste away.
• Pterygium formation: Scarring can happen in the proximal nail fold, causing it to stick to the nail matrix. This can eventually lead to total nail loss.

Alopecia areata

Alopecia areata is an autoimmune condition that causes hair loss, but it can also affect the nails. With alopecia areata, you may see, as shown in 20-nail dystrophy pictures:

• Trachyonychia (rough nails): The nails may look rough, dull, and like sandpaper. This is sometimes called twenty-nail dystrophy and often comes with longitudinal ridging and pitting.

Nail Discolorations

Dystrophic nails can come in a rainbow of colors. Here’s a guide to some of the most common:

• Melanonychia Striata: These are brown or black bands that run lengthwise down your nail. They can be caused by something harmless like a mole in your nail matrix or an injury. But they can also be a sign of melanoma or a side effect of some medications. If you see these, get them checked out ASAP to rule out anything serious.
• Leukonychia: This shows up as white spots, lines, or even a completely white nail. Usually, it’s caused by a minor injury to the nail.
• Green Nail Syndrome: A green tint to the nail, usually from a Pseudomonas aeruginosa infection. It often goes hand-in-hand with the nail separating from the bed (onycholysis) and too much moisture. Keep your nails dry and avoid harsh chemicals if you have this.
• Mees’ Lines: These are white lines that run across the nail. They can be a sign of arsenic poisoning, chemotherapy, or other illnesses.

Specific Nail Dystrophies

There are many different kinds of nail dystrophies.

Median Nail Dystrophy (Median Canaliform Dystrophy)

Median nail dystrophy shows up as a split or groove running lengthwise down the middle of the nail. Sometimes it looks like an upside-down fir tree. This condition can result from repeatedly injuring the nail matrix (the area where your fingernail begins growing.)

If you have median nail dystrophy, your doctor may suggest that you stop any activity that could be causing repeated injuries. They may also prescribe topical tacrolimus.

Onycholysis

Onycholysis is when the nail plate separates from the nail bed. It can be caused by an injury, an infection, psoriasis, or certain medicines. The area where the nail is separating may look white or yellow.

If you have onycholysis, the best thing to do is avoid irritants, keep your nails short and dry, and treat any underlying causes of the separation.

Pincer Nail Deformity

Pincer nail deformity happens when the nail plate curves too much from side to side, causing it to pinch the nail bed. It often affects the big toenails, and may sometimes result in a big toe infection. Wearing shoes can be painful when you have this condition.

Pincer nails can be caused by medications, diseases, or wearing footwear that doesn’t fit well. Sometimes, though, there’s no known cause.

If you have pincer nails, a doctor may recommend surgery, dental correction, or suture treatment.

Trachyonychia

Trachyonychia makes nails look rough, dull, and feel like sandpaper. It’s also known as twenty-nail dystrophy. People with trachyonychia often have ridges and pits running lengthwise down the nail, which are symptoms of 20-nail dystrophy.

Trachyonychia has been linked to alopecia areata, lichen planus, and psoriasis.

In kids, trachyonychia sometimes goes away on its own.

Nail Tumors

Nail issues can signal a number of health problems, and some nail changes are caused by tumors. Like tumors in other parts of your body, nail tumors can be benign or malignant. Identifying them early is essential for treatment success.

Melanoma is one example of a particularly aggressive skin cancer that can affect your nails.

Benign Nail Tumors

• Digital Mucous Cyst: This fluid-filled cyst can distort the nail.
• Glomus Tumor: This benign tumor of the glomus body causes pain and makes you sensitive to temperature changes.
• Onychomatricoma: This benign tumor of the nail matrix causes thickening and longitudinal bands in the nail plate.

Malignant Nail Tumors

• Subungual Melanoma: This melanoma develops from the nail matrix or nail bed.
• Squamous Cell Carcinoma: This common skin cancer can also occur in the nail unit.

How Are Nail Tumors Diagnosed?

A biopsy is the only way to know for sure if you have a nail tumor. If you notice any unusual nail changes that concern you, talk to your doctor right away. They may refer you to a dermatologist or nail specialist for further evaluation.

Frequently Asked Questions

In Summary

Nail dystrophies are a variety of conditions that change the way your nails look and work. They can be caused by things you’re born with, diseases that affect your whole body, skin conditions, infections, and injuries. Getting the right diagnosis is important so you can get the right treatment and to make sure there isn’t a more serious problem, like melanoma, causing the changes in your nails.

If you’re having problems with your nails, your doctor will need to take a close look at your health history and give you a physical exam. They may also need to do some tests. Samples from under your nail or from the nail plate itself can be tested to help figure out what’s going on. Sometimes, a biopsy of the nail plate or matrix is needed, especially if the problem isn’t a fungal infection.

Researchers are continuing to study nail dystrophies to better understand them and find better ways to treat them. For example, new medications that affect the immune system are showing promise for treating nail psoriasis.