Changes in the appearance, strength and growth pattern of person’s fingernails can tell you a great deal about their overall health. A quick glimpse at an aging loved one’s nails could clue you in to serious medical conditions such as heart disease, thyroid problems and malnutrition.

Keeping an eye out for the following nail symptoms can help you decide if further medical attention may be necessary.

Nail Separation

Known as onycholysis, this occurs when a fingernail or toenail lifts away from the pink nail bed. This condition is usually painless, but the affected nails may be prone to catching on things, which can hurt. Because of this, it’s important to trim affected nails carefully. Once the underlying cause is identified and treated, onycholysis will typically resolve in several months as the old nail grows out and is replaced/reattached.

What it looks like: Areas of the nail that have lifted away from the bed tend to be abnormally opaque in color, and the surface of the nail can be pitted or indented.

Possible causes:

  • Injury (trauma to the nail)
  • Infection
  • Thyroid disease (elevated or decreased activity)
  • Poor circulation
  • Raynaud’s syndrome
  • Drug reactions
  • Psoriasis
  • Connective tissue disorders (such as lupus)
  • Allergic reactions to nail products

Yellow Nails

Yellowing of the nails can occur for many reasons, some of which can be serious, while others may be due to simple lifestyle choices, such as smoking or frequent application of polish.

What it looks like: Fingernails become discolored and yellowish. They may thicken and new growth can slow down considerably. Nails may also lack a cuticle and detach from the bed.

Possible causes:

  • Respiratory conditions (chronic bronchitis, tuberculosis, sinusitis, etc.)
  • Swelling due to lymphatic system blockage (lymphedema)
  • Jaundice related to reduced liver function
  • Fungal infection
  • Diabetes

Spoon Nails

Spoon-shaped nails (called koilonychia) occur when the nails become extremely thin and brittle and therefore lose their natural convex structure.

What it looks like: Soft nails that look flat, scooped out or concave. The depression in the nail is usually large enough to hold a drop of liquid.

Possible causes:

  • Iron-deficiency anemia
  • Haemochromatosis (excess iron)
  • Plummer-Vinson syndrome (PVS)
  • Raynaud’s syndrome
  • Systemic Lupus
  • Rheumatic Fever

Nail Clubbing

Clubbing occurs when soft tissue underneath nail beds increases. This gives the fingertips a bulbous appearance and causes a rounded deformity of the nails.

What it looks like: The tips of the fingers become enlarged and the natural convex shape of the nails may become so exaggerated that they curve around the fingertips.

Possible causes:

  • Low blood oxygen levels
  • Inflammatory bowel disease (Crohn’s disease, ulcerative colitis, etc.)
  • Lung disease (cancer, bronchiectasis, cystic fibrosis, abscess, etc.)
  • Cardiovascular disease
  • Liver disease
  • Celiac disease
  • Graves’ disease
  • Endocarditis

Opaque Nails

If an individual nail is white, but not because it has detached from the bed, it may be caused by a fungal infection. If all nails are affected, this could be a condition known as “Terry’s nails,” resulting from decreased blood supply and increased connective tissue in the nail bed.

What it looks like: Nails appear mostly white but have reddened or dark bands at the tips. In cases of Terry’s nails, the light, crescent-moon shaped area of the nail bed (known as the lunula) is not usually present.

Possible causes:

  • Malnutrition
  • Congestive heart failure
  • Diabetes
  • Liver disease
  • Kidney failure
  • Overactive thyroid (hyperthyroidism)
  • Iron-deficiency anemia

If your aging loved one has one of these nail problems and it doesn’t go away, make an appointment with their doctor to ensure they do not have a more serious underlying condition. Keep in mind that some medications and medical treatments, such as chemotherapy, can have a pronounced effect on a person’s skin and nails.

It is also important to help your loved one regularly maintain the health of their skin and nails. Encourage them to use proper care products and practices and to eat a nutritious diet. A manicure or pedicure from time to time may prevent nail hygiene issues from arising.

For more information specific to senior foot care, read:

Senior Foot Health: Top Tips from Family Caregivers.