Can vertical lines on fingernails be a sign of a serious medical condition?

Vertical lines that appear on the fingernails, also known as longitudinal ridging, are often a normal and harmless change. Nails are composed of layers of a hard protein called keratin, and they reflect the body's general health. In many cases, these lines are simply part of the natural aging process, as nails grow more slowly and may become dull and brittle; these vertical lines may appear on both fingernails and toenails with age [2].

However, sometimes nail changes, including lines, may be an indicator of other health conditions. It is important to note any other accompanying changes in the shape, color, or growth rate of the nails, as these could be signs of heart, lung, kidney, or liver disease, as well as diabetes and anemia [1].

When are vertical lines normal?

As mentioned, vertical white lines or longitudinal ridges on the nails are considered harmless in most cases [1]. These changes are very common and increase with age, as nails become more prone to changes in texture and thickness. If these lines are the only change you notice in your nails and they are not accompanied by any other symptoms such as pain, swelling, significant discoloration, or a change in the shape of the nail, they are likely not cause for concern.

Warning signs to watch for

Although vertical lines are often benign, there are some nail changes that warrant consulting a doctor. Pay attention to the following:

• Changes in color: Any change in the nail color to yellow, green, black, or the appearance of unexplained dark spots.
• Changes in shape or thickness: If the nails become very thick, brittle and break easily, or their shape changes significantly.
• Pain or swelling: The presence of pain around the nail or swelling in the surrounding skin may indicate an infection [3].
• Nail separation: If the nail begins to separate from the nail bed.
• Dark or brown lines: The appearance of dark or brown vertical lines may be an indicator of a condition requiring urgent medical evaluation to rule out tumors.

These changes can be associated with iron deficiency, kidney disease, or nutritional deficiencies [2]. Furthermore, bacterial and fungal infections, tumors, and ingrown nails are nail problems that may require treatment [1].

Nail care and next steps

To maintain nail health and reduce the risk of problems, it is recommended to follow some simple guidelines:

• Hygiene and trimming: Keep your nails short and clean, and wash under the nails with soap and water regularly [3].
• Avoid trimming the cuticle: Do not trim the skin surrounding the nail (the cuticle), as it acts as a barrier to prevent infection [3].
• Use clean tools: Clean your nail care tools before each use [3].
• Avoid nail biting: Biting or chewing nails can contribute to the spread of germs and infection [3].

If you notice any worrying changes in your nails, or if vertical lines are accompanied by any of the warning signs, it is best to consult a dermatologist. The doctor can evaluate the condition and determine if additional tests or treatment are needed. Remember that nail health can be an indicator of your overall health, so do not hesitate to seek medical advice when needed. To learn more about common nail diseases, you can visit Common Nail Diseases: From Fungus to Hormonal Changes and How to Care for Them (Arabic).

Medical references

• Nail Diseases
• Aging changes in hair and nails
• Healthy Habits: Nail Hygiene