Pitted Nails

Nail pitting is a problem that can affect the nails on both the fingers and the toes. It is the result of missing keratin cells in the upper nail plate, which weakens its structure. This condition tends to be more obvious on the fingernails than on the toenails. Nail pitting can be the result of several conditions, a very common cause is the bad habit of nail biting.

Pitted nails have a distinctive aspect, with small depressions on their surface that are usually more visible on the finger nails. The root cause is a problem in the growth of the superficial nail plate layers. It can be a side effect of many diseases, for example about half of the people who suffer from psoriasis also have pitted nails.

However, many other conditions can make the nails develop pits. Any disease that leads to dermatitis, which is a localized skin inflammation, can also cause nail pitting as a side effect. Some other conditions that are known to be linked to nail pitting are alopecia areata, connective tissue problems or sarcoidosis. Pits can also be found on nails that are damaged by any other cause and become flaky or brittle. If a single nail is affected by pitting, the reason could be an injured nail bed. However, if multiple nails or all of them are pitted, this is a sign of a possible serious disease and should be a cause of concern, so you should go see a doctor.

What are the symptoms of pitted nails?

Nail pitting causes the nails to develop dents, which can be small or quite deep. All of the nails of the hands or feet can be affected. The aspect of the pits is variable, sometimes the nails appear to have been pierced with a sharp tool and in some cases the pits are similar to white spots.

A common cause of nail pitting is the skin disease psoriasis. If that's the case, the nails will also have other problems, besides pitting. These include an unusual color, lack of pigmentation, abnormal shape (deformation) or thickening of the nail. Psoriasis patients might also experience onycholysis. This is a medical term for nails with a very weak structure that are so loose that can detach from their beds and even fall off. People with severe cases of psoriasis can have their nails crumble completely.

Even if psoriasis is a skin disease, it can only affect the nails and nothing else in some cases. It will usually have other symptoms as well, which include patches of discoloured, red or scaly skin, itching, burning, bleeding, skin that becomes very dry and cracks or inflamed joints that turn very stiff.

Treatment options

It is not easy to treat nail pitting because the pits appear early in the growth phase of the nails. Even if some medication is available, the active agents are unable to penetrate the nail bed if applied topically. One possible treatment that is effective only in some cases is the injection of corticosteroid directly into the nail bed. Other modern treatment options are phototherapy or light therapy, which is much less invasive.

Since vitamin D3 is known to strengthen the nails, some specialists recommend taking supplements with a high content of this vitamin. If pitting is the side effect of an autoimmune disease, Neoral (cyclosporine), Trexall (methotrexate) and other drugs that suppress the immune system can also be effective. These medications can be toxic to the internal organs and should only be prescribed by a doctor and not used only to treat nail pitting, if there are no other symptoms.

Nail pitting treatments are not always effective. Even if they are, the process is very long due to their slow rate of growth. The nails can be completely removed through a surgical procedure, which will force a new nail tissue to grow. Another options is to be patient and choose a long term treatment, using cosmetic techniques such as polishing or filling to hide the pits.

In many cases, nail pits are not related to any disease. This makes them harmless and you can safely ignore their existence or just treat them with a few simple home remedies. A habit of daily nail maintenance can be very effective, as well as a healthy and balanced diet. In time, all of the pits will disappear and the nails will look smooth and healthy again, without any depressions.

Proper hydration is very important, so make sure you drink enough water. Health spas and holistic centers offer dedicated types of hydrotherapy that can be even more effective. A balanced diet, with a high intake of vitamin D and other vitamins and minerals is also very beneficial.

Some of the best foods for the nails are products with a high content of silica. These include many vegetal foods, such as celery, cereals, onions, cucumbers, barley, oats, slippery elm powder as well as green leafy vegetables and root plants in general.

Essential fatty acids are very good for both the skin and the nails. These compounds are found in fish oil, avocado, flaxseed oil, fish, tofu, walnuts, sunflowers, seaweed, wheat germ oil and most types of seeds or nuts.

Green leafy vegetables are another excellent choice because they provide not only silica but also generous amounts of vitamin B and folic acid. Some examples are broccoli, slippery elm powder, spinach, bok choy and kale. A proper intake of proteins is also important for nail structure. These are provided by eggs, red meat, organic chicken, tempeh, tofu, nuts and seeds as well as fish.

In order to extract the most from your food and boost the supply of minerals, you can also add to your diet some foods that provide enzymes or improve your digestion. These include lemon juice, apple cider vinegar, rocket, endive, raddichio, kale and other bitter lettuces.

One of the most effective home remedies against pitted nails is to soak them in warm water with some added Epsom salt. Pits can also be treated by applying vinegar on top of them. Many natural oils, especially those with a high content of vitamin D, are able to repair nail damage of any kind. Some of the best are neem oil and tree tea oil.

It is also a good idea to protect your nails when possible. If you do house work like washing the dishes, use gloves to protect your hands from chemicals. Long nails have a weaker structure and can break, so keep yours short at all times.

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