Seven Signs of Healthy Nails

White spots/white spots on the nail surface, a sudden increase/decrease in the number of crescents in a short period of time, black lines under the nail, anti-onychia (spoon-shaped nails), repeated growth of periungual barbs, yellowing and thickening of the nails, and dense pits on the nail surface.

Let’s talk about the white spots on the face that everyone hasn’t understood since they were young. When I was a child, my mother would tell me that I had roundworms in my stomach when she saw white spots on my nails, and she would give me anti-worming medicine. It wasn’t until I worked as a dermatologist for so many years that I realized that this statement was not entirely wrong, but it was not needed in 90% of cases. The current mainstream clinical view is that most white spots are caused by minor trauma to the nail matrix - for example, if you chewed your nails in the past two weeks, knocked your fingertips when opening the door, or were polished too hard by a nail polish strip during a manicure, your newly grown nails may have white spots. You can just cut them off after the nails have grown to the fingertips, and there is no need to patch this or that. Last year, I treated a boy who was a sophomore in high school. He had been biting his nails for five or six years. Eight of his ten nails had white spots. His family insisted on checking for parasites. However, he found nothing wrong with his regular bowel movements. I went back and forced him to stop biting his nails. After more than three months, new nails grew and all the white spots disappeared. Of course, if you have recurring white spots, and often have inexplicable stomachaches or itchy buttocks, you can also check your stool routine. If there are indeed parasites, you don’t need to beat the elders to death with a stick.

After talking about the trivia, we have to mention the most controversial Crescent Moon. There were rumors on the Internet that if there were less than 6 crescent moons, it was a sign of kidney deficiency and poor qi and blood. There were also people who counted their crescent moons exclusively and felt anxious for a long time if one was missing. In fact, the views of Chinese and Western medicine on this matter are really different: in Chinese medicine theory, the number and size of crescents are indeed related to the circulation of Qi and blood. If you have always had 7 or 8 crescents in the past half a month, and suddenly only 1 or 2 are left in the last half month, and you are also afraid of the cold, tired at every turn, and have low menstrual flow, it is probably a sign of insufficient Qi and blood, and proper supplementation is really useful. But the point of view of Western medicine is more direct: the essence of lunula is the new keratin of nail matrix, and the amount of it is different for each person. Some people are born with lunula only on their thumbs, and live for decades without any problems. There is no need to compare the number with others. What really needs to be vigilant is the "sudden change" - I just received a doctor last month from a 32-year-old Internet operator. Before, he only had three crescents all year round. In the past half month, all the crescents on all ten fingers have grown out. He was always flustered, his hands were shaking, and he lost weight after eating too much. After a check up, it turned out to be hyperthyroidism, and timely intervention prevented serious problems.

Compared with signals such as small white dots and crescent moons, which are mostly false alarms, long black lines under the nails are probably the most likely to scare people into cold sweats. Many people think it is melanoma when they see black lines, and search "how long can people live with black lines under their nails" all night long? In fact, it is really unnecessary. The vast majority of subungual black lines are nevus. To put it bluntly, it means a mole growing on the nail bed. It is no different from a spot on your face. As long as its width does not exceed 3mm, its border is clear, its color is uniform, and it has not changed for several years, you can leave it alone. But if you find that the linea nigra suddenly widens, becomes mixed in color, and has blurred boundaries, or even the skin around the nail becomes dark and ulcerated, then don’t hesitate and go to the dermatology department for a dermoscopy. Don’t blindly apply nail polish to cover it up yourself, let alone go to a nail salon to polish it off for you. It will delay the real business.

Let’s talk about something less common, but often problematic when it appears - inverse nails, also called spoon-shaped nails, where the nails are concave in the middle and the edges are turned up, just like a small spoon. This condition in most people is a sign of iron deficiency anemia. I once met a 20-year-old girl who lost 20 pounds after dieting for half a year. When she came to the doctor, her nails could catch a drop of water. She also felt dizzy and gasped after climbing two floors. The hemoglobin was only 80g/L. After three months of iron supplements and normal meals, her nails slowly returned to normal. However, there are exceptions. I once met an old man in his 60s who was born with anti-armour. He has worked hard all his life. He is in great health and has no anemia. So you have to judge based on your own physical condition and don't impose rigid standards.

Next, almost everyone has had it - hangnails around the nails. Have you ever been told that you are vitamin deficient when you have a hangnail? I wash my hands every day in the winter, sometimes more than a dozen times a day, and I get hangnails. Do I still lack vitamins? 90% of hangnails are caused by the skin around the nail being too dry. For example, the cleaning products you use for washing your hands are too irritating, you don’t apply hand cream in winter, and you often use dishwashing detergent and washing powder when doing housework. The cuticle around the nail becomes dry and warped, turning it into a hangnail. It hurts like hell to tear it off, and it is also easy to become infected with paronychia. Applying hand cream for two or three days will cure it, and you don’t have to take a lot of health products. Of course, if your hangnails grow well and grow, and you also suffer from angular stomatitis, seborrheic dermatitis, and athlete's foot, you may indeed be deficient in B vitamins, and there is no harm in supplementing them appropriately.

Let’s talk about yellowing and thickening of nails. Many people’s first reaction is onychomycosis and they rush to buy nail polish. I have seen too many people fall into this trap. First of all, external causes must be eliminated: for people who smoke regularly, their nails will definitely turn yellow if they are exposed to smoke tar for three to five years. ； If you often wear dark nail polish without applying base coat, the pigment will settle and turn yellow. ； In addition, the metabolism of the elderly is slow, and their nails are naturally thicker and yellower than those of young people. These are not onychomycosis. Only when the nails turn yellow and become brittle, flake off, and feel hollow under the nails when cutting them, like sawing wood, can it be onychomycosis due to fungal infection. You must first go to the hospital for a fungal microscopy to confirm the diagnosis before using medicine. Applying medicine randomly by yourself may burn the nail bed, which will slow the recovery.

Finally, let’s talk about something that many people don’t take seriously – the small pits on the nail surface are densely packed pits on the nail surface, just like thimbles used to sew clothes at home. Many people's first reaction when seeing this is calcium deficiency, and even after half a year of calcium supplementation, it has no effect. In fact, this kind of small pits is most likely a manifestation of psoriatic nails, that is, psoriasis has grown on the nails. In a few cases, it is caused by alopecia areata or chronic eczema. I once had a patient who had small pits on his nails for half a year. He always thought it was calcium deficiency. Later, he developed a rash on his body and came to see a doctor. He was diagnosed with psoriasis. If he had discovered the signs of nails half a year earlier and intervened promptly, he would not have suffered the consequences later.

In fact, after all is said and done, the signals like fingernails are just a reference. You really don’t have to go through the article one by one and be scared to death if something is a little different. Don’t ignore it at all and let the abnormal signals develop. If you really find something wrong, first think about whether you have any bad habits recently: Do you bite your nails every day? Have you lost weight recently and skipped meals? Are you getting manicures done too often? After excluding these external factors, there is still an abnormality. Going to the hospital to see a doctor is much more reliable than blindly diagnosing the disease on Baidu.