Nail Analysis Flashcards
Nail structure
Nails can reflect the systemic and local medical history, as well as general lifestyle over the previous four–six months.Young children have a fast growth rate of about three months.
*Nail function is formed of three main structures:
1.The nail plate —a keratinised structure which continues to grow throughout life.
2.The nail bed —this is the vascular bed that is responsible for nail growth and support.
3.The cuticle —the epidermal layer between the proximal nail fold and the nail plate.
White nails
- Can be caused by anaemia, oedema, or vascular conditions.
- Apply gentle pressure to the nail bed and release. If it takes more than two seconds for the redness to reappear, it suggests anaemia.
- Consider the following possibilitiesif it fits with the client’s history:
- anaemia
- renal failure.
- liver cirrhosis
- chemotherapy treatment.
White spots
White spots like paint are linked to calcium, zinc or silicadeficiency / insufficiency.
TS: Calc phos.
Lunula: Absent
- If the lunula is absent on the thumbs, anaemia or malabsorption should be investigated.
Lunula: Pyramidal
- A pyramidal lunula might indicate an excessive manicure or trauma.
Lunula: Pale blue
- A pale blue lunula may suggest diabetes mellitus, anaemia or peripheral neuropathy.
Lunula: Red
- A red lunula may suggest cardiovascular disease, a connective tissue disorder or possible malignancy.
Terry’s nails
- Nails that are white, with a pink or brown band at the end.
Can be caused by: - Ageing.
- Liver cirrhosis.
- Chronic kidney disease.
- Congestive heart failure (also produces ear lobe crease).
- Type II diabetes.
*TS: Calc sulph. And / or Nat sulph.
Brown-grey nails may suggest
- Cardiovascular disease.
- Diabetes mellitus,
- Vitamin B12deficiency,
- Melanoma.
- Lichen planus.
- Topical agents (e.g. hair dyes).
Thin, brittle nails
- These are correlated with osteopenia, thyroid disorders, severe malnutrition and common mineral deficiencies.
*Hand cream, manicures, nail varnish / varnish remover (acetone) can also increase nail dryness and brittleness.
*TS: Silica and/or kali sulph.
Potential nutritional imbalances:
*Biotin: 300 mcg x five daily can improve thin brittle nails.
*Vitamin B12: Chlorella, wild salmon, grass-fed organic meat, organic eggs; supporting digestive health (e.g. stomach acid).
*Vitamin A: Eggshell nails: Delicate and curved.
Paronychia
- Infection of the tissues adjacent to a nail —with redness / tenderness.
- Paronychiamay be due to trauma, poor nutrition (e.g. low vitamin C), low immunityand poor hygiene.
- Supplement vitamin C / increase; vitamin C rich foods.
TS: Silica.
Wicks (or hangnails)
- Can be due to too little protein, a lack of B vitamins and vitamin C.
- Dryness may indicate lowered EFA status, vitamin A and D, or hypothyroidism. It can also be caused by chemical irritants.
- May indicate a need for nervous system / adrenal support.
- TS: Kali phos.
Clubbing
- A loss of the normal angle between the nail bed and fold.
- It is thought that clubbing can begin before the effects of pathology are noticed.
- To assess for clubbing: Place both forefinger nails together and look between them. A small diamond space is normal (‘Schamroth’s window’); a lack of a diamond indicates clubbing (‘Schamroth’s sign’).
Clubbing: Causes
- Pulmonary and cardiovascular causes (80%).
- Gastrointestinal causes (about 5%), hyperthyroidism, idiopathic.
Koilonychia
- Spooning (i.e. concavity) of the nails.
- To assess: Place a drop of water on the nail. If the drop does not slide off = spooning.
Koilonychia: Causes
Iron deficiency: Systemic lupus erythematosus.
Raynaud’s disease: Protein deficiency, especially in sulphur containing amino acids
(cysteine or methionine).
Diabetes mellitus: Haemochromatosis (iron overload).
- TS:Calc phos., ferphos., calc sulph. ornatsulph.
Beau’s Lines
- Interrupted growth at the nail matrix produces a furrow in the nail.
- Location may indicate the timing of the illness, whilst the depth may indicate the severity.
Beau’s Lines: Causes
- Severe infection.
- Myocardial infarction.
- Severe zinc deficiency.
- Surgery and chemotherapy.
- TS: Calc phos. And / or silica.
Mee’s Lines
- White bands traversing the full nail width that indicatesan acute illness / trigger.
- Like Beau’s, the line locationmight indicate the timing.
Mee’s Lines: Causes
- Heavy metal toxicity (i.e. arsenic).
- Chemotherapy.
Longitudinal ridges
- May be a sign of ageing.
- Consider B vitamin deficiencies.
Found in following pathologies:
* Rheumatoid arthritis.
* Peripheral vascular disease.
* Lichen planus.
- TS: Nat phos
Central ridges
- May be associated with repetitive trauma.
- Iron, folate or proteindeficiency(how might you distinguish between these deficiencies?)
*TS: Ferphos.
Nail pitting
Inflammation of the nail matrix distorts the nail plate, causing superficial dents.
Nail pitting: Causes
- Psoriasis (random pits).
- Alopecia areata(rippled grid).
- Eczema.
- Lichen planus.
*TS: Kali sulph.
Nail thickening
- Slowed nail growth which produces increased nail thickness.
Nail thickening: Causes
- Onychomycosis (fungal infection).
- Chronic eczema and psoriasis.
- Peripheral vascular disease.
- May be seen in the elderly.
- TS: Kali phos
Nail beading
- Nail beading may appear on one or multiple nails.
- Often associated with the following endocrine conditions:
- Diabetes mellitus.
- Thyroid disorders.
- Addison’s B vitamin deficiency.
*TS: Calc sulphand / or nat sulph
Onycholysis
A common condition where the nail plate splits from the nail bed.
* Can be caused by:
- Hyperthyroidism.
- Psoriasis and eczema.
- Trauma and contact dermatitis.
- Chemicals e.g. acetone.
*TS: Calc fluor.
Vitamin A deficiency
Brittle, peeling or splitting nails.
Vitamin C deficiency
Frequent occurrence of hang nails / swollen tissue.
Vitamin D deficiency
Brittle and peeling nails
Zinc / calcium deficiency
White spots, weak or brittle nails.
Iron deficiency
Pale nail bed, central ridge, spooning
Protein deficiency
Weak and brittle nails
EFA deficiency
Dry, peeling, swollen skin around nails
Tissue Salts:Nails
- Calc phos‘the cell restorer’: White spots on nails.
- Food sources: Oats, green leafy veg (spinach, cabbage), carrots, wholegrains, eggs, lentils. Herbs: Chamomile.
- Kali sulph‘the skin conditioner’: Fungal nail infections; for brittle nails alternate with silica.
- Food sources: Oats, linseed, barley, cottage cheese, chicory, lettuce, carrots. Herbs: Melissa, mustard, parsley.
- Silica ‘the skin cleanser’: Any nail malformations.
- Food sources: Tall grains (barley, oats, buckwheat, rice, etc.), celery, lentils, spinach, pomegranate, apricot. Herbs: Dandelion.
