The Center for Podiatric Care and Sports Medicine

Exploring Patient Concerns: What Causes Toenail Ridges?

Posted by on Friday, May 23rd, 2014

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Changes to the body can be alarming. Nail ridges are one of the changes patients frequently ask their podiatrists about. What causes them? Are they a sign of an underlying medical condition? Will they go away? “Usually toenail ridges are associated with the natural process of aging and are not a cause for concern,” says Dr. Nadia Levy of The Center for Podiatric Care and Sports Medicine in New York. “However, you should definitely stop in and see me if your nail color or texture changes, if the nails begin growing unusually fast or slow, and if the ridges appear unevenly spaced or sized.” In today’s post, we’ll delve into more detail about the dreaded toenail ridges.

toenail ridges
Vertical nail ridges in the hands and feet are perfectly normal in most cases.

Vertical Toenail Ridges

Vertical ridges are common among healthy men and women. They are evenly spaced, extending from the cuticle to the tip of the toenails. They may be caused by the following:

– Aging: The natural ridges in the nail become more pronounced the older you get. “As we age, the nail matrix becomes atrophied in areas, resulting in longitudinal ridging of nails,” Dr. Phoebe Rich of Oregon Health Science University explained to the Huffington Post. You can think of them as “wrinkles in the nails,” she added.

– Dryness: Eczema or dry feet may indicate that your ridges are associated with a lack of moisture. Even though there are a ton of sweat glands on the feet, this doesn’t necessarily translate to nail moisture. Usually dry nails are not a problem, but one-quarter of the population will suffer from a condition known as onychorrhexis at some point in their lives. It is not a terribly serious condition, but rather, just implies that one has particularly brittle nails. Special care should be taken in certain situations. Patients should wear gloves when working in the kitchen or the yard, and moisturizer should be applied daily to prevent breakage.

Trauma: Injury is a common cause of ridging. Bruises, cuts, tears, or smashing trauma can all compromise the appearance of the nail. Usually these ridges go away after the nail heals itself. It’s important to prevent infection after trauma by using over-the-counter Polysporin.

nail trauma ridges
The deep ridges in this toenail indicate a past trauma where the nail stopped growing for a period of time.

Horizontal Toenail Ridges

Horizontal ridges extending across the nail are commonly referred to as “Beau’s lines,” and can be a sign of trouble. These lines are generally deeper and more uneven than benign vertical ridges. Their appearance suggests that the nail has actually stopped growing for a period of time, due to distress like sickness, serious injury, or chemotherapy. Other causes of Beau’s lines include:

  • Vitamin deficiency: A lack of zinc or iron can cause discoloration and ridges. See a doctor immediately if you feel dizzy or nauseous — two other signs of malabsorption.
  • Liver problems: An overabundance of iron in the body causes a disease called hemochromatosis, where the nails develop ridges and curve upward in a spoon shape. Blood removal is the recommended treatment. Afterwards, patients will need to monitor their diet carefully and avoid supplements, shellfish, and tea.
  • Arsenic poisoning: Although rare, people who have been poisoned by arsenic encounter horizontal nail ridging, as well as stomach pain, dizziness, skin discoloration, and dehydration.

Beau’s lines aren’t the only type of horizontal nail ridge. Muehrcke’s lines — white lines extending across the nail that disappear when pressed — occur as the result of a vascular abnormality, but do not affect the nail bed or growth of the nails. Patients with kidney disease often exhibit this nail abnormality. Terry’s nails are seen in patients with diabetes or kidney disease, and feature a white nail plate with a narrow horizontal band near the tip of the nails.

chemo nails
The person with these nails has undergone chemotherapy.

New York Treatment of Toenail Problems

To treat toenail ridges, you can slather on moisturizing lotion, Vitamin E oil, or petroleum jelly — especially around the cuticle. A podiatrist may be able to buff the nails to diminish the appearance of ridges. Patients are not advised to attempt the buffing on their own, as improper technique can weaken the nail plate. Laser treatment can also reduce the appearance of ridging and stimulate the body’s natural healing processes for more aesthetically pleasing toenails, too. Contact The Center for Podiatric Care and Sports Medicine in Manhattan or Westchester for more details on treatment for toenail issues.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.