Could your fingernails indicate something more?

You’ve likely had a health care provider check your blood pressure, pulse and listen to your heart during a recent visit. These common readings can give you an indication of your overall health.

But there’s another health indicator that you may not be familiar with that can be a sign of a variety of issues. And it’s somewhere you might not expect: your fingernails. Changes in nail appearance can be an indicator of a range of conditions.

If you notice a change, don’t panic. Contact your health care provider and describe the change you see. Your provider can give you a recommendation for next steps.

So what symptoms can show up on your fingernails and indicate a serious problem?

They include:

White nails

Your fingernails will naturally have white at the tips. However, if your whole nail is white or noticeably pale, this could be a sign of:

• Liver disease, such as hepatitis
• Low protein stores in the body (hypoalbuminemia)
• Kidney failure
• Congestive heart failure (rare)
• Diabetes (rare)

Pale nails

This can be a sign of a serious illness such as:

• Anemia
• Congestive heart failure
• Liver disease
• Malnutrition

Yellow nails

Nails often turn yellow after nail polish has been used for long periods of time. However, yellow nails can also be a sign of:

• Fungal infection
• Chronic bronchitis
• Lung disease (rare)
• Diabetes (rare)
• Psoriasis (rare)
• Thyroid disease (rare)

Blue nails

If your fingernails have a blue tint, this could be a sign that your body isn’t getting enough oxygen. It could also be a side effect from a drug you are taking, or a sign of:

• Lung issues (such as emphysema)
• Heart problems
• Excessive silver consumption
• Bacterial infection of the nail
• Wilson’s disease (a genetic condition that causes high levels of copper in the body)

Red streaks in the nail

This may be the result of several conditions, including:

• Trauma
• Psoriasis
• Fungal infection
• Heart valve infection
• Blood vessel inflammation (vasculitis)

Dark lines beneath the nail

If you notice dark lines that are about as wide as a pen’s ink cartridge, this could be a sign of melanoma. This is a dangerous type of skin cancer. If you see these lines, it’s important that you see your health care provider immediately.

Some other causes of dark lines beneath the nail are more common and not dangerous. These include moles, trauma and medication-induced changes. It’s also common for people with darker skin types to have noncancerous dark lines under their nails.

Split or cracked nails

If your nails become brittle or if they split repeatedly, this could reveal:

• Thyroid disease
• Psoriasis
• Repeated trauma, especially frequent contact with water (e.g. hand washing, dish washing, bathing, etc.)
• Medication side effects

When the cracking or splitting is accompanied by a yellow color, the cause could be a fungal infection.

Nail clubbing

This happens when the tips of your fingers enlarge a little and the nails curve over the fingertips. This usually happens over a longer period of time, oftentimes years. This could be a sign:

• Lung disease
• Inflammatory bowel disease
• Cardiovascular disease (heart disease)
• Liver disease
• Thyroid disease
• HIV/AIDS

Puffy, red nail fold

The nail fold is the skin at the base of the nail where your nail grows from; it’s often called the cuticle. If your nail fold is puffy, this is due to inflammation. The most common cause of nail fold inflammation is a skin infection from bacteria, viruses or yeast. Less commonly, this can happen because of lupus or other connective tissue disorders.

Ridges on the nails

The direction of the ridges is important to notice. If ridges are parallel to your fingers, it may simply be a reflection of aging or chronic trauma, including repeat wet/dry cycles and contact with water. Ridges may reflect a lack of vitamins or poor nutrition.

If the ridges are across the nail, this could be a sign of:

• Diabetes
• Severe injury
• Past illness or medication exposure

Rippled or pitted nails

Small pinpoint depressions on the surface of the nail often occur after trauma to the surface of the nail. Sometimes they occur in patients with particular types of hair loss and arthritis. They can also be associated with underlying skin disorders, including:

• Psoriasis
• Eczema

Nail lifting

This is when the surface of the nail (called the nail plate) separates from the underlying skin (called the nail bed). There are many causes of this including:

• Medication side effects
• Psoriasis
• Fungal infection
• Trauma
• Pregnancy
• Thyroid disease

Dr. Katherine R. Garrity is a dermatologist at Aurora Health Center in Summit, Wis.