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Question:  DrRich,

My fingernails have developed ridges along their entire length - especially my thumbs.  And some of my other fingernails have a horizontal "dip" in them.  And instead of growing long like they used to, my nails now tend to chip and break.  I'm only 32, and I want my nails to look like they used to.  Could I have a nutritional deficiency?

Trudy1978

DrRich replies:

Trudy1978,

Ridges that run the length of the fingernail are normal, but become much more evident as one ages. (I hesitate to say this because 32 years old is so young these days. Yet, the ridges do tend to become more evident after age 30).

Horizontal depressions in the fingernails are called Beau's lines. Beau's lines (if that's what you have) are caused by acute illnesses, usually illnesses accompanied by fever.  Back in the days when I went to medical school (back when performing physical examinations was still in vogue), we were taught that finding Beau's lines could help you judge how accurate the patient was in relating his or her medical history. (If a patient denied recent illness but had Beau's lines, the grizzled professor said, that patient was perforce a "bad historian." Since then, I once noticed Beau's lines on myself, and didn't remember being sick. So now I'm not sure the old coot was completely accurate.) In any case, as the nail grows Beau's lines gradually progress up the length of the nail and are eventually trimmed off. 

Some nail findings (clubbing, spoon nails, pitting, onycholysis - none of which you describe) can indicate a body-wide disease process. But the ridges and horizontal dops you describe do not.

Nails that chip and break easily usually have no specific medical cause, and while some individuals (usually individuals who have some sort of supplement to sell) like to blame chipped nails on a nutritional deficiency, medical science has not made that correlation. Admittedly, however, research on chipped nails has not been a high national priority.

The fact that fingernails are exposed to a lot of water, soap and chemicals (more so than toenails, for instance) probably accounts for why they tend to break, chip and split more than toenails.

The doctors who best deal with nail problems are dermatologists (since nails are made up of, basically, dead skin.) You may want to consult with one if the chipping and breaking have become a real problem.

Best of luck.

DrRich

 

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