How Aging Changes Your Nails

The nails change with aging, growing more slowly, and becoming dull and brittle. The color may change from translucent to yellowed and opaque. Nails, especially toenails, may become hard and thick and ingrown toenails may be more common. The tips of the fingernails may fragment. Sometimes, lengthwise (longitudinal) ridges will develop in the fingernails and toenails. This can be a normal aging change. However, some nail changes can be caused by infections, nutritional problems, trauma, and other problems.

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COMMON NAIL DISORDERS

While uncommon in children, nail disorders affect a large number of older adults. As we age, nails thicken and become more susceptible to fungal nail infections. Circulatory problems and use of medications, which also tend to increase as we age, raise the risk of developing a nail condition. The following describes common nail conditions and the causes:

• WHITE SPOTS

Most often caused by mild trauma, such as catching one’s finger in a door, these small spots appear when the base (matrix) of the nail is injured. Such white spots are very common, eventually grow out, and are no cause for concern.

• SPLINTER HEMORRHAGES

Appearing as a red to reddish-brown fine, vertical line that resembles a splinter beneath the nail, this disorder occurs when blood vessels in the nail bed are damaged. The most common cause is nail injury.

• INGROWN TOENAIL

This common nail disorder occurs when the corner of the nail curves downward into the skin. The big toenails are particularly vulnerable. Improper nail trimming, tight shoes, or a poor stance can lead to this common nail problem.

Fungal infections of the nail can cause discoloration and abnormal growth

• FUNGAL INFECTIONS (ONYCHOMYCOSIS)

When a nail infection develops, the most common cause is a fungus. More frequent on the toenails than on the fingernails, fungal nail infections affect about 12% of all Americans. The two most common types of fungi affecting the skin are dermatophytes and yeast (Candida).

• BACTERIAL INFECTIONS

• TUMORS AND WARTS

These may be found in any portion of the nail and can cause the nail plate to change shape. When a growing tumor or wart interferes with nail growth, it can destroy the nail.

• MUCINOUS CYSTS

Appearing as clear, jelly-filled papules at the base of the nail, these cysts can become painful and may damage or deform the nail. Treatment involves removing the cyst.

• DARK SPOTS OR STREAKS

If a dark spot or streak appears on any nail, and is not the result of an injury, it must be examined by a dermatologist. This could be melanoma, the most lethal form of skin cancer.

Psoriasis can also affect the nails

• PSORIATIC NAILS

Psoriasis is a chronic skin condition that causes red, scaly patches. Approximately 10% to 50% of people with psoriasis, and 80% of people who suffer from psoriatic arthritis have nail problems, especially with their fingernails. The most common signs include pitting, rippling, and discoloration of the nail. With psoriatic nails, it is common for the skin beneath the nail to develop a reddish-brown discoloration. Splinter hemorrhages can form. The nail may separate from the nail bed, crumble, and/or split. Swelling and redness of the skin surrounding the base of the nail also are common.