Recognizing nail diseases from pictures

Recognizing nail diseases from pictures

The condition of the nails on fingers and toes says a lot about our health. Because deformed toenails, blue fingernails, grooves, white spots, watch crystal nails, brittle nails and many other changes in the fingernails and toenails are often indications of diseases. For example, circulatory disorders, metabolic diseases such as  diabetes  mellitus or deficiency symptoms such as iron deficiency anemia can show up in changes in the nails. Bacterial infections or  nail fungus can also  lead to changes in the toenails and fingernails.

If you notice your nails changing or looking different than usual, seek medical advice quickly. In the case of nail fungus in particular, early diagnosis and prompt treatment are important to stop the fungus from spreading. In this series of photos, we show you pictures of various nail changes and explain the possible causes behind them!

Frequent nail changes

In addition to nail fungus, there are other nail diseases and changes that occur frequently. These include:

  • chipped and brittle nails
  • Nails that are peeling off
  • dark discoloration
  • a dented nail surface
  • deformed nails, for example watch glass nails and claw nails
  • yellowing of the nails
  • Longitudinal and transverse grooves
  • thickening of the nail plate
  • white dots or spots on the nails
  • ingrown nails
  • inflamed cuticles

The following pictures show you which diseases can be behind the changes in fingernails and toenails and how you can recognize nail diseases.

Brittle nails

Nails – especially fingernails – dry out if, for example, you wash your hands frequently, use nail polish remover or use harsh cleaning agents. The loss of moisture causes the nails to become brittle, chip or crack.

A lack of vitamin A or B vitamins and a lack of  biotin , calcium and  iron  can also lead to brittle nails. They can also be caused by a thyroid disease.

What to do with brittle nails?

Frequent hand washing with  soap  is one of the main reasons for brittle fingernails. Not only do the hands dry out, the fingernails are also attacked. Regular creaming helps here – not only for the skin, but also for the nails and the nail bed. To better protect your nails while brushing, you can use gloves. This also applies to washing dishes by hand.

If your nails on your hands and feet have become brittle from varnish and nail polish remover, it is best not to use them until your nails have recovered.

In the case of a vitamin or mineral deficiency, the targeted supply of the missing  vital substances  via dietary supplements can stop brittle nails. Get medical advice if you are unsure whether you have such a deficiency. The same applies to suspected thyroid disease.

White spots and discoloration on the nails

In the case of white discoloration of the nails, two cases must be distinguished: On the one hand, so-called frosted glass nails can be congenital – the nails are cloudy white and the nail moon at the bottom of the nail bed cannot be seen. Conversely, if clouding occurs later in life and the nails previously appeared normal, chronic  liver disease , such as  cirrhosis , could be behind the white nails.

White spots, dots, lines or grooves, on the other hand, may indicate nail fungus. This is especially true for toenails, as they are more likely to be affected by fungus than fingernails. A harmless explanation, on the other hand, could be improper nail care, as a result of which the nail plate or nail root is damaged. However, it is just a misconception that white spots on the fingernails are caused by a lack of calcium.

White or blue fingernails and tips

In most cases, blue fingernails and fingertips indicate circulatory disorders. The blue colouration, also known as cyanosis, occurs when there is not enough oxygen in the blood. This can be caused by cold,  heart failure  or lung diseases. It is advisable to have blue fingernails examined by a doctor.

On the other hand, if the fingertips or fingernails turn white,  Raynard syndrome can be  the reason. This is a functional circulatory disorder – the small arteries in the fingers and toes contract more than normal when it is cold, and the blood flow to the body parts is no longer regulated. Blue fingernails can also occur here.

Black or blue nails

In most cases, a dark, blue to black discoloration is caused by bruising under the nail from an injury to the finger or toe. Even if you have no memory of such an injury, crushing the nail may have caused the bruise to form under the finger or toenail, making the nails appear dark blue to black. Usually you just have to be patient and the discoloration will slowly grow out.

However, if the black discoloration of the nail persists over a longer period of time, the cause may be melanoma. Because black skin cancer can also develop under fingernails and toenails   . So always keep a close eye on any visible changes there.

Yellow fingernails and toenails

Yellow discolored nails can have different causes. If you smoke (a lot), the nicotine contained in cigarettes will stain not only your teeth but also your fingers and nails yellow. The index and middle fingers are usually affected. A harmless cause of yellow fingernails and toenails can be colored nail polish if you don’t use a protective base coat.

Yellow discoloration of the nails is also a characteristic symptom of nail fungus. In the early stages, the fungus usually causes barely visible whitish changes. If it is not treated and the infection of the nails progresses, it is often noticeable by a yellow or brown discoloration of the toenails or fingernails.

In addition, yellow discoloration of the nails can also be a sign of respiratory diseases such as  chronic bronchitis  . Psoriasis can also   cause yellow nails. In this case, specialists speak of nail psoriasis. The yellow-brown spots that can form on nails from psoriasis are also known as oil stains.

Grooves in the nails: longitudinal grooves

Longitudinal grooves in the surface of the toenails and fingernails are normally signs of aging that have no pathological cause. Because with age, the blood flow to the nails usually decreases, resulting in grooves. Longitudinal grooves appear in some people after the age of 35, and this is also usually a normal development. If you’ve had such ridges since childhood, there’s even less to worry about – longitudinal ridges can be innate.

On the other hand, longitudinally corrugated nails can also occur in psoriasis. If the longitudinal grooves can only be seen on one nail, metabolic or digestive disorders may be to blame for the change.

Grooves in the nails: transverse grooves

The causes of transversely corrugated nails can be very diverse. If the  nail  root was injured during nail care, transverse grooves often develop. Hormonal fluctuations or metabolic disorders caused by an unhealthy diet, stress or environmental influences can also lead to transverse grooves in the fingernails and toenails. Transverse grooves are also among the side effects of certain medications, such as  antibiotics  or cystostatics (cancer treatment drugs).

Cross-ridged nails also develop in some people with  eczema  or when the nail is infected with a fungus. Above all, nail fungus manifests itself in very different forms – from discoloration to brittle nails, longitudinal and transverse grooves to the detachment of the nail in the advanced stage.


Watch glass nails are a deformity of the nails that can occur on both fingers and toes. In the case of some serious diseases of the internal organs (e.g.  lung cancer , chronic heart failure, hepatitis, chronic inflammatory bowel diseases), so-called drumstick fingers develop. The finger ends of those affected are swollen in the shape of a piston.

As a result, the fingernails also change, severely thickened and curved nails are formed. This change is medically referred to as watch glass nails. If you notice watch glass nails, a medical examination is recommended to determine the cause of the deformed nails.

spoon nails

Dented nail surfaces are usually caused by a lack of B vitamins or iron. The nail plate curves inwards, which is why experts also speak of spoon nails. In rare cases, Raynard syndrome can also be responsible for the development of spoon nails (koilonychia). The disease causes fingers and toes to have poorer blood circulation, which is why the nail plate deforms.

Claw nails on toes

One speaks of claw nails when claw-like deformed nails develop on the feet, which are usually also thickened and discolored. The causes are usually ill-fitting shoes or malpositions of the feet and toes, such as  hallux valgus . Circulatory disorders can also lead to claw nails. To treat the deformation, the causes should be eliminated, thickened nails can be   ground down to a normal level again with medical pedicure .

spotted nails

Experts understand pitted nails as small, punctiform dimples and indentations in the nail plate. First and foremost, pitted nails form in psoriasis. Indentations on the nails can also occur in the case of circular  hair loss  (alopecia areata) or eczema.

The indentations are round, oval, appear singly or in groups, and are about the size of a pinhead.

Top layer of nail peels off

If the nails split in horizontal layers and the upper layer of the nail detaches, specialists speak of onychoschisis or onycholysis. Frequent hand washing , cleaning with strong detergents, artificial fingernails or a lack of iron and calcium are possible causes for the splitting off of the top nail  layer.

In some cases, the entire nail detaches from the nail bed and falls off. Possible causes are then injuries, bruises (e.g. due to the wrong shoes), nail fungus or an infection of the nail bed. But various diseases can also be behind it. These include diabetes mellitus or diseases of the thyroid gland. Onychoschisis also often occurs in people with neurodermatitis or psoriasis. Skin cancer in the nail bed can also be behind nail detachment. Those affected should seek medical advice, also because there is a risk of fungal infection.

Nails splinter and split

If the nail splits lengthwise and looks split, external influences are usually to blame. Frequent washing of hands with degreasing soap, strong detergents, and nail polish and nail polish remover all strip moisture from nails and cause them to become dry. In addition, iron deficiency or an undersupply of calcium, biotin or  vitamin A  and B vitamins can lead to split nails. An  underactive or overactive thyroid  can also cause onychorrhexis, which is the medical term for split nails.

Regular creaming of the hands including the nails and nail beds, gloves when cleaning and washing dishes and temporarily avoiding nail polish help against split nails.

nail fungus

In most cases, an infection with nail fungus develops insidiously, so that many sufferers only notice the symptoms at an advanced stage. Most often, a fungal infection occurs on the nails of the feet, less often on the fingernails. Nail fungus is primarily caused by filamentous fungi, for which a warm, humid climate offers good growth conditions – which is why most people also get infected in swimming pools, saunas or  showers  in hotels.

Typical symptoms of nail fungus

The fungi usually attack the free edge of the nail and from there slowly spread over the entire nail. These symptoms are characteristic of a nail fungus:

  • white or yellow discoloration of the nails
  • thickening of the nail plate
  • brittle or peeling nails
  • itching
  • Inflammation of the affected nails
  • transverse grooves and longitudinal grooves

In order to get the changes under control and to prevent other nails from becoming infected as well, you should seek medical help in good time if you suspect a nail fungus infection.

Ingrown nails

Ingrown toenails are often caused by improper stress on the feet, improper nail care, shoes that are too tight or too high. The nail grows into surrounding tissue, which can become inflamed and swollen. In this case, you should carefully disinfect the area to prevent further aggravation of the  inflammation  .

A warm footbath and the application of wound and healing ointment to the nail and the edge of the nail can help with ingrown toenails. It is best to protect the area with a plaster afterwards. In order to prevent ingrown toenails, you should avoid tight shoes and cut your toenails properly. Cut the nails straight with no sharp corners.

nail bed inflammation

Nail bed inflammation can occur on both fingernails and toenails. The skin surrounding the nail becomes inflamed, either under or next to the nail. The inflammation manifests itself as redness, swelling and throbbing pain. Accumulation of pus and detachment of the nail can be the result.

Such infections are also known as nail ulcers and usually result from an injury that allows bacteria to penetrate the skin. But some medications, a zinc deficiency or  allergies  can also cause the inflammation. People with diabetes mellitus or circulatory disorders have an increased risk of developing nail bed inflammation. Inflammation of the nail wall is also known as paronychia or circulation.


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