What Causes Ridges in Fingernails? (2024)

Ridges in nails can run horizontally or vertically. These marks are common and usually harmless, but some fingernail ridges—particularly horizontal ones—can indicate a health problem such as a thyroid issue.

This article will discuss the types of ridges found on fingernails, what causes them, and what you can do about them.

Vertical Ridges in Nails

Vertical ridges that run from the cuticle towards the tip of the nail are common and typically harmless. They often become more noticeable with aging.

Onychorrhexis

Onychorrhexis describes vertical ridging and is considered a natural variation of the nail. It may appear as a single ridge or multiple ridges that may be shallow to deep. There may also be splitting.

Onychorrhexis doesn't always have an identifiable cause, but certain medical conditions and lifestyle factors may contribute, such as:

• Anemia
• Skin conditions such as eczema or psoriasis
• Hypothyroidism
• Rheumatoid arthritis
• Eating disorders
• Picking or biting the nails or nail trauma
• Using nail polish remover

Trachyonychia

Trachyonychia is a nail disorder that affects people of all ages but is more common in children. There are two types:

• Opaque trachyonychia causes rough, vertical ridges on the nail.
• Shiny trachyonychia causes pitting and an opalescent appearance.

In opaque trachyonychia, the nails may look as if they have been rubbed with sandpaper. The condition can affect some or all of the nails. Nail plates may be thickened or thinned, and cuticles are often ragged and thickened. Nails may also be brittle.

The cause of trachyonychia isn't always known but inflammation is believed to play a role in its development. Certain skin conditions are also associated with it. Trachyonychia does not cause permanent damage to the nails.

Median Canaliform Nail Dystrophy

Median canaliform nail dystrophy is a central, vertical ridge that is feathered and has a fir-tree pattern.

The cause of median canaliform nail dystrophy is unknown, but some researchers believe it happens when trauma or infection creates a temporary defect in the nail.

Vertical ridging may also be a result of:

• Vitamin and mineral deficiencies, including vitamin B12, iron, zinc, or magnesium deficiencies
• Aging
• Lichen planus (swelling and irritation of the skin, nails, and mucous membranes)
• Psoriasis (an autoimmune condition that causes skin inflammation)
  
• Fungal nailinfection
• Darier disease (a skin condition that causes wartlike blemishes)
• Habit of picking at the nails/cuticles
• Endocrine disorders, such as thyroid conditions
  
• Alopecia areata (an autoimmune disorder that causes patchy hair loss)
  

Horizontal Ridges in Nails

Horizontal ridges that run from one side of the nail to the other are more likely to be an indication of an underlying medical condition.

Beau's Lines

Beau's lines describe one or more horizontal, band-like depressions affecting one or multiple nails. It can lead to the separation of the nail plate and the shedding of the nail.

Beau's lines happen when the nail temporarily slows or stops growing. They can be an indication of:

Injury

• Crushing of the nail bed or base of the nail
• Trauma involving proximal nail fold
• Exposure to extreme cold

Infection

• Fungal or yeast infection
• Bacterial infection
• Viral warts

Medical Conditions

• Eczema (an inflammatory skin condition)
• Psoriasis
  
• Parakeratosis pustulosa (deformed nail, surrounded by red,scalyskin)
• Fever
• Severe malnutrition
• Pemphigus (causes blisters, sores, and fluid-filled bumps on the skin)
• Raynaud’s disease (causes blood vessels in the fingers to narrow in response to cold or stress)
• Heart attack
• Psychological stress
• Mumps (an acute contagious virus)
• Pneumonia (infection of one or both lungs)
• Coronary thrombosis (blood clot in the blood vessels or arteries of the heart)
• Kawasaki disease (acute inflammatory condition of unknown cause that involves inflammation in blood vessels)
• Syphilis (sexually transmitted infection)
• Hypoparathyroidism (insufficient production of parathyroid hormone)

These factors cause a temporary disruption to nail growth. The horizontal line forms from this temporary lack of growth and then moves up the nail as the nail grows.

What Medications Can Cause Ridges in Fingernails?

Ridges in fingernails have been associated with some medications, particularly some types of chemotherapy (anticancer therapeutic agents).

How to Get Rid of Nail Ridges

Addressing ridges in nails starts by managing their cause. See your healthcare provider if you're not sure what's causing the lines on your nails.

If caused by an injury or isolated event, Beau's lines can grow out as the nail grows. Ridges caused by a condition such as trachyonychia also tend to go away on their own. The recommended management strategy is typically to wait and watch.

Some people want to reduce nail ridges for cosmetic reasons. To get healthy looking nails, try the following strategies:

• Take a multi-vitamin containing vitamin B, iron, and magnesium
• Ask your healthcare provider about biotin, a B complex vitamin thought to help strengthen brittle fingernails
• Try topical remedies such as emollients (moisturizers) or corticosteroids
• Avoid picking or trimming your cuticles and biting your nails
• Keep your nails trimmed into a curved shape; cut your toenails straight
• If you handle chemical products such as household cleaners, wear gloves
• Take a break from applying artificial nails or manicuring your nails with products that can weaken and dry them
  

When to See a Healthcare Provider

See a healthcare provider if you notice any changes to your nails, such as shape, texture, or color. This is particularly important if you have:

• Clubbed nails
• Horizontal ridges
• Blue nails
• Distorted nails
• Pale nails
• White lines
• White color under the nails
• Painful nails
• Pits in the nails
• Peeling nails
• Ingrown nails

See a healthcare provider immediately if you have:

• Splinter hemorrhages: Thin, red/reddish-brown bloodlines under the nails that run in the direction of nail growth.
• Hutchinson sign: Brownish-black area of pigmentation originating from the nail bed and nail matrix and subsequently involving surrounding skin).

Summary

Nail ridges are small, raised lines on the nail that can run vertically or horizontally. Vertical nail ridges are typically harmless. Horizontal nail ridges (Beau's lines) are more likely to be associated with a medical condition.

Nail ridges can be caused by aging, injury, infection, illness, or medical condition.

To get rid of nail ridges, you need to identify the underlying cause. Often, ridges will clear up on their own. In other cases, such as with trachyonychia, you may need to see a healthcare provider.

Talk to your healthcare provider if you notice changes to your nails.