Causes Of Nail Ridges 

  • Hadiza Bello Doctor of Medicine - MD, All Saints University, Saint Vincent, UK
  • Sara-Jane Duffus MSc Applied Medical Science, University of Glasgow
  • Ellen Rogers MSc in Advanced Biological Sciences, University of Exeter

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Introduction

Your nails, both on your fingers and toes, are not only present for cosmetic purposes but can serve as indicators of your overall health. The look and feel of your nails can provide valuable information about your body. Ridges in your nails may not just be simple imperfections but clues to underlying health issues. We will delve into the causes of nail ridges and the types of nail ridges and explore what they can reveal about your well-being.

The anatomy of nails

To understand the causes of nail ridges, we need to understand the anatomy of nails. Your nails protect your fingertips and assist in sensation detection and temperature regulation. The nail has many other functions besides these, and any abnormalities may result in both functional and cosmetic issues. 

Human nails and nail beds are made up of several structures. The nails themselves are made up of a protein called keratin, which is also found in your hair and skin. This protein forms several layers of the hard, protective nail, with the most outermost layer being the nail plate you can see.1 The nail bed lies underneath the nail plate, and the tissue at the base of the nail is known as the matrix. The matrix is the main area where a new nail is formed.

Vertical ridges

Vertical ridges, also known as longitudinal ridges or Onychorrhexis, are ridges that form from the base of the nail to the tip. These ridges are common and can be part of the nail’s natural ageing process. However, several other reasons can cause them to form, including:

  • Ageing: ageing is associated with a decrease in the rate of cell turnover in the nail matrix. This leads to thinner nail plates and increases the likelihood of the formation of vertical ridges. This is common and often referred to as "senile nails".
  • Nutritional deficiencies: vertical ridges can point to a nutritional deficiency. For example, essential nutrients like iron, zinc, and biotin all play roles in the formation of nails, so deficiencies in any of these nutrients may lead to nail abnormalities.2 Eating a well-balanced diet with these essential elements is crucial to maintaining healthy nails.
  • Lifestyle: lifestyle factors, like your occupation and daily habits, play a role in nail health. People in occupations that require using their hands or frequent hand washing might be at risk of developing nail ridges. Smokers have also been known to have brittle nails that are prone to ridging.
  • Trauma or injury: injury to the nail can result in ridges forming as the nail might have been weakened. This is often temporary and will grow out with the injured nail. 
  • Medication: some medications may have the side effect of causing brittle nails, which can lead to nail ridges
  • Medical conditions: certain medical conditions, such as psoriasis, eczema and Brittle nail syndrome, can manifest as vertical ridges in the nails. If you suspect an underlying health issue, consult a healthcare professional for an accurate diagnosis.

Horizontal ridges

Horizontal ridges, also known as Beau's lines, are deep lines that run across the width of the nail. They are a more severe disruption in the nail growth process and are a sign of acute disease. Some of the factors that may contribute to the development of horizontal ridges are:

  • Severe infection or fever: severe illness or high fever can interrupt the nail growth process, causing Beau's lines to appear. Once the underlying illness is treated, the nails typically return to normal.
  • Injury: sudden trauma to the nail or nail bed can result in horizontal ridges. This is often a temporary condition, as the nail regrows and the ridges grow out.
  • Malnutrition: severe malnutrition, particularly a deficiency in proteins, can lead to the formation of horizontal ridges in the nails.
  • Chemotherapy: some chemotherapy drugs can impact nail health, causing horizontal ridges as one of their side effects. These ridges may appear and remain during treatment.
  • Metabolic conditions: certain metabolic disorders, like uncontrolled diabetes, can lead to the development of Beau's lines in the nails. Proper management of the underlying condition is crucial in resolving this issue.
  • Chronic stress: Chronic emotional or physical stress can affect the body's overall health, including the nails. Stress-induced changes in the body's metabolism may manifest as horizontal ridges.
  • Allergic reactions: Allergic reactions, especially those that affect the nail bed, can result in horizontal ridges. Identifying and avoiding the allergen is essential to prevent further issues.

Treatment and prevention of nail ridges

Treatment of nail bed abnormalities involves addressing the underlying cause. If these abnormalities are caused by ageing or trauma, there may be little or no need for specific treatment. However, for more concerning cases, here are some strategies:

  • Supplements: nutritional deficiencies can be remedied by improving your diet and using supplements. You should speak with your healthcare provider to determine which supplements are appropriate for you, but biotin, iron, and zinc are common supplements recommended for improving nail health.
  • Hydration: staying hydrated can help prevent ridges due to dehydration.
  • Protect your nails: be mindful of what your hands are exposed to. Having a good nail care routine and taking care to avoid harsh chemicals can help protect your nails. wear gloves when cleaning, and keep your hands and nails moisturised.
  • Avoid trauma: avoid opening things with your nails and use gloves when doing tasks that could injure your nails to prevent injury to your nails and nail bed.
  • Maintain a healthy lifestyle: adopting and maintaining healthy choices like a balanced diet, smoking cessation, and extreme manicure practices can help prevent nail ridges from forming.
  • Medical attention: if you suspect or suffer from an underlying health condition, consult your healthcare provider. They can help provide a diagnosis and recommend appropriate treatment.

Summary

Our nails serve other purposes beyond cosmetics: they help to protect your fingertips from the outside world, play a part in picking up sensations, and help maintain the temperature in your fingers. Nails are made up of a substance called keratin, which is also a component of our hair and skin. Abnormalities in our nails play a role in pointing out other underlying issues with our health. 

Nail ridges are some of the abnormalities that often point to poor health. There are different types of nail ridges: Horizontal ridges or Beau's lines, which are deep lines running across the width of a nail. They are often an indication of stress, injury, or severe infection. Vertical ridges or Onychorrhexis form from the base of the nail to the tip and are often caused by nutrient deficiencies, ageing, or diseases like Brittle nail syndrome. Most cases of nail ridges are reversible and will resolve when the underlying cause is treated. A healthy lifestyle with a balanced diet and good nail care goes a long way in preventing nail ridges. It is also important to seek the help of a healthcare professional to help with any underlying health conditions.

FAQs

Are nail ridges permanent?

Nail ridges are often temporary and resolve once the underlying cause is treated. As such, ridged nails usually grow out and are replaced with new (and normal) nails. 

What can I do to maintain healthy nails and prevent ridges?

Practising good nail care, protecting your hands and nails from trauma, and generally maintaining a healthy lifestyle with a balanced diet that includes essential nutrients will help protect your nails from damage. Practising good nail care can also help promote strong nails.

When should I seek medical attention for nail ridges?

If you suspect an underlying health condition is causing your nail ridges, or if they persist despite your efforts to address them, it's advisable to consult a healthcare professional for a diagnosis and appropriate treatment.

Can I use over-the-counter treatments?

Over-the-counter treatments may be suitable for some nail issues, but they may not be a long-term solution. It is important to determine the cause of your ridges and treat the underlying cause first. 

Are nail ridges the only indicators of overall health?

Nail ridges can provide valuable insights into your health. However, they are not the only indicators. The texture, colour, and shape of your nails can also give an insight into your health.

Are there any home remedies for treating nail ridges?

Some home remedies, like keeping your nails well-moisturised and protecting them from damage, can help improve the appearance of ridges. However, it is best to seek the advice of your healthcare provider for underlying health issues. 

References

  1. Medscape. Nail anatomy: overview, gross anatomy, nail growth [Internet]. 2023 Apr 7 [cited 2023 Oct 30]; Available from: https://emedicine.medscape.com/article/1948841-overview
  2. Scheinfeld N, Dahdah MJ, Scher R. Vitamins and minerals: their role in nail health and disease. J Drugs Dermatol. 2007 Aug;6:782–7.

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Hadiza Bello

Doctor of Medicine - MD, All Saints University, Saint Vincent

Hadiza is a Medical Doctor who has worked in a clinical setting for five years, gaining valuable experience in diagnosing and treating a wide range of conditions.
She is currently pursuing an MSc in Infectious Diseases at the University of Kent
She is constantly exploring options to get involved in global health initiatives and is passionate about making healthcare more accessible and equitable for all.

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