Systemic diseases are seen in the nails of some clients.  Some of these diseases are life-threatening.  Your nail technician could save your life!


Nail diseases and disorders may reveal an underlying disease.
Photo by Andrew Ruiz on Unsplash

Editor:  Julie, I want you to visit nail salons to find a story on nail diseases.  I heard that nail diseases might be in different colors, like blue, red, and yellow.  I am not sure what you will find but keep digging. There are several stories, and you are the one to find them.

Julie:  O.K. Chief, I am already out the door, looking for nail diseases.

Start With the Problem


Nail diseases and disorders may reveal an underlying systemic disease –  Nail clubbing
Photo by James Heilman, MD

Julie (at the nail salon):  Hi. I am from the local news magazine and doing a story on nails and how they show diseases of the body.  I would like to talk with the manager/owner of this business.

Maria (receptionist): Just a minute I’ll see if she has time.  

Moments go by and she returns.

Maria: You are in luck. Her 2 o’clock canceled.

Is There a Problem?

Julie:  Hello. May I speak with you about nail diseases?

Sonya:  Yes. Of course. Although primarily cosmetic, there is a health component to our business as well.

Julie:  I have heard from my grandmother that you can tell a lot about a person from their hands, especially their nails.  Is this true?

Sonya: You bet!  We are not palmists, but the hands of executives are very different from the hands of day workers.  It is fascinating that different colored nails can indicate various underlying disorders.

Julie:  What do you do when you see nail diseases? 

Sonya:  Many of our girls used to paint the nails regardless, but I have been training them to take pictures for the doctor first. We have a referral list in case the customer needs treatment. 

The before and after photos for regular customers are great for business as well.

The Problem Did Not Make Sense


Nail diseases and disorders may reveal an underlying systemic disease – Cyanosis
Photo by 7mike5000

Julie:  Can you think of a particular customer, where you intervened to help them?

Sonya:  There was the case of a 13-year-old girl, who was brought in by her mom, fortunately.  When the operator saw her nails, she called me over.  They were very blue.  That means there is a lack of oxygen.  I asked the mom if her daughter played any sports.  The mother said no, instead she mostly read books and used her computer.  I then explained to the mother that these nails are an indicator, like the red light on the dashboard of your car. Only this is a blue light saying that the body is desperate for oxygen. 

I suggested they go to the emergency room for an evaluation.  We can always paint her nails later.  Fortunately, the mother, did what I suggested, and they found that her congestive heart failure had worsened. She was scheduled for a heart operation.

Dig Deeper Cub Reporter

Why would someone who had white nails naturally, want white nail polish?  I looked at the photos and explained to the operator that this young woman had a disease, a liver disease, which could be serious.  I went over to the young lady to explain what we suspected and to get her to go to a doctor.

“SONYA” – MANAGER OF A NAIL SALON

Julie:  Wow, when I walked in your nail salon looking for a story, I didn’t expect to find this!  You could do a blog on “Tales from the Salon”.

Sonya:  I could from what is said in here. But it would kill my business!  It is not often that we see such dramatic signs in the nails, but we do see them.

Still, I Fought On

Julie:  Do you have time for another story?

Sonya:  One more.  As you know, it is easy to take photos using cell phones.  So, to keep the quality high in our store, we do before and after shots.  This way, I can see what was done for every customer.  I review them and critique the work. 

This time a young woman came in with nails that were mostly white with a rim of flesh tone.  The new operator took the photos and then asked what the customer wanted.  The customer said she wanted the nails to be painted white.  This surprised the operator, so she came to me with the photos and the request for white nails. 

Why would someone who had white nails naturally, want white nail polish?  I looked at the photos and explained to the operator that this young woman had a disease, a liver disease, which could be severe.  I went over to the young lady to tell what we suspected and to get her to go to a doctor.

At first, she became very hostile, “what do you know about diseases? You just polish nails!”  When I explained the state licensing for our service, she calmed down.  Then I got out a textbook and showed her nails that looked like hers.  She thanked me and apologized and wanted the name of a doctor. 

Julie:   I am very thankful for your stories and time.  I wonder if I could have the names of some doctors that you refer to. 

Sonya:  Yes, of course, Didi! Give the doctors list to this young lady. 


The next day Julie enters Dr. Smith’s office. (Not his real name.)

Bluish nails show the lack of oxygen

Rippled or pitted nails are possible signs of psoriasis

Cracked or split nails are probable signs of thyroid dysfunction or disease

Then there are dark lines beneath the nail, which is caused possibly by melanoma

DOCTOR “SMITH”

Julie:  Dr. Smith, thank you for seeing me today. I am doing a story on fingernails as an indicator of health.  I started in a local nail salon talking with Sonya, who referred me here.  Is it true that fingernails have diseases and can be signs of some general or body disease, and if so, what conditions?

Dr. Smith:  Sonya is correct. Many diseases and conditions of the body can be seen in the fingernails.

Julie:  Can you give me some examples?

Dr. Smith: Let me think of some. 

  • Pale nails can be a sign of anemia, congestive heart failure, liver disease, or malnutrition
  • Then there are mostly white nails with a dark rim, that suggest jaundice or a liver problem
  • Yellow nails, usually are not a systemic disease but, are the result of a fungus

There is more. Ah, yes, I remember, of course:

  • bluish nails show the lack of oxygen
  • rippled or pitted nails are possible signs of psoriasis
  • Cracked or split nails are probable signs of thyroid dysfunction or disease
  • Then there are dark lines beneath the nail, which is caused possibly by melanoma

I did not know that we were going to talk about this, or I would have refreshed my memory before we met.  There are two more, O.K.

Puffy nail fold which is not the nail but the tissue surrounding the nail can be a sign of lupus or systemic inflammation

And the last one on my list is gnawed nails from nail biters.  These are usually anxious people, and some have an obsessive-compulsive disorder – I need a cup of coffee after that trip down the medical school lane.  How about you, would you like some coffee?

Julie:   Thanks maybe another time.

Dr. Smith:  You know it is interesting how people think.  They think a liver problem is only in the liver and not somewhere else, like the nails.

Julie:    You mean like blue nails caused by poor oxygen in the bed of the nail?

Dr. Smith:  Bravo, young reporter!  Yes, that is what I mean.

I Need to Go Above and Beyond


Nail diseases and disorders may reveal an underlying systemic disease – Onychophagia
Photo by Avexdevil at English Wikipedia

Julie:   Do you have a patient story that I could use?

Dr. Smith: You know there are HIPPA laws about what can and cannot be said?  So, I will have to be careful. 

When the patient arrived here, she was meticulously dressed, on time, and wanted to wash her hands immediately.  She went into the restroom for quite an extended period.  When she came out, she was escorted to the examination room without her touching anything, like a door, etc. She was asked to have a seat by my assistant, but when I came in, she was still standing.

I asked her why she was in my practice, and she said that she bites her fingernails.  It was evident to me that this woman was an obsessive-compulsive type and needed psychological treatment more than medical treatment, so I referred to the right person who could help her psychologically.  When that is underway, her nails will grow back. 

Here we have a connection between psychological problems and nails.  Other patients show us examples of an organ like the liver with a disease that shows up in the nails.  Interesting isn’t it, how the body works?

Julie:  Yes, it is.  Thanks for your time and contribution to my story.  I think I have enough information to know that this is real.  Now I will do some library research.  Thanks again.

Julie: In Conclusion, Dear Reader


Nail diseases and disorders may reveal an underlying systemic disease – Onychomycosis
Photo by James Heilman, MD
  • Blue nail bed or cyanosis is the result of lower oxygen saturation which can be caused by congenital heart diseases
  • Yellow nail beds can be caused by several means, cigarette smoke, fungus, and a severe form of liver disease
  • Splinter hemorrhages occur commonly in psoriasis and infective endocarditis and other heart conditions
  • The red lunula is seen in collagen, vascular disease, cardiac failure, COPD, and more
  • Clubbing is seen as increased curvature, both longitudinally and transversely.  It may be the result of a wide variety of diseases, including;
    • cyanotic congenital heart disease
    • infective endocarditis
    • primary and metastatic lung cancer and more.

If, like Julie, you were stunned by the information about our bodies contained within the nails of our fingers and our toes, please share your thoughts in the comments section below.