Nail pitting may appear as depressions or dimples in your fingernails or toenails. It’s common in people with psoriatic arthritis. Oral and topical medications and lifestyle changes can help treat nail pitting.
If you’ve ever noticed small depressions in your fingernails or toenails, you may have experienced nail pitting. It can happen for a number of reasons and is often related to nail psoriasis.
You may also have discoloration and abnormal growth with this condition. While treatment can be challenging, some options include corticosteroid injections and supplements.
Read on to learn more about nail pitting, what causes it, and available treatments.
Nail pitting may show up as shallow or deep holes in your nails. It can happen on your fingernails or toenails. The pitting can look like white spots or marks.
If your nail pitting is
- changes to the normal shape (deformation)
- thickening
- changes in nail color (discoloration)
People with nail psoriasis may also experience loose nails that separate from their nail beds, which is also called onycholysis. In the most severe cases, nail psoriasis can cause your nails to crumble.
You may experience nail psoriasis with or without other psoriasis symptoms. Other potential symptoms
- scaly, discolored patches of skin
- dry, cracked, or bleeding skin
- itching or burning skin
- stiff or swollen joints
One of the most common causes of nail pitting is psoriasis. Up to 50% of people who have psoriasis experience changes in their nails, and you’re more likely to get it if you’re over
According to research, there may be a link between nail pitting and the severity of psoriasis. In one older 2013 study,
Other causes of nail pitting that are not related to psoriasis include:
- Connective tissue disorders: Examples include Reiter’s syndrome (a form of reactive arthritis) and osteoarthritis.
- Autoimmune conditions: Some of these include alopecia areata, sarcoidosis, and pemphigus vulgaris.
- Incontinentia pigmenti: This is a genetic disorder affecting the hair, skin, nails, teeth, and central nervous system.
- Dermatitis: Examples include atopic and contact dermatitis.
If you notice pitting in your nails, it’s a good idea to contact a doctor.
At your appointment, your doctor
They may also perform a skin biopsy. This test is done by taking a small sample of your skin or nails and looking at it under a microscope. Your doctor will likely take the sample after applying a local anesthetic, so this procedure shouldn’t hurt.
Treating nail pitting can be difficult because the pits are formed as your nail grows. Topical medications are unable to easily reach through the nail bed, so your doctor may consider corticosteroid injections into your nail beds.
Another option is to use phototherapy or light therapy on the affected nails.
Immunosuppressant medications, such as cyclosporine (Neoral) and methotrexate (Trexall), are also options. However, they typically aren’t recommended if you only have nail pitting due to potential side effects. Some doctors may recommend taking vitamin D3 supplements.
Treating nail pitting is often a long-term process that doesn’t always have the best results. Your doctor can guide you through the process in order to find something that works.
Treatment for nail pitting and other nail issues is often a long process. In some cases, treatment isn’t always effective, so it’s important that you try to avoid triggers that make pitting worse.
If you’re diagnosed with nail psoriasis, the outlook is varied. Psoriasis is a chronic condition that tends to flare up at different times of your life for reasons like stress or illness.
People who have nail psoriasis often deal with physical and psychological stress related to their condition. If you’re feeling stressed or upset about your diagnosis, discuss these feelings with your doctor. They can provide guidance and other resources for support.
You should also contact your doctor if you notice thickening of a nail or separation from the nail bed. This may mean you have a fungal infection that needs treatment.
You may not be able to prevent pitting in your nails, but you can reduce your risk of worsening symptoms. Keep your nails healthy by:
- staying hydrated
- eating well
- taking vitamin B and zinc supplements
You can also avoid triggers by:
- clipping your nails as short as you can
- wearing gloves if you’re working with your hands
- avoiding manicures
- using a moisturizer or cream
Can stress cause nail pitting?
If psoriasis is causing nail symptoms, stress can exacerbate the condition and cause pitting, ridges, and shredding.
What vitamin deficiency causes nail pitting?
Mineral deficiencies, like zinc deficiency, can cause white spots to develop on your nails.
Should I be worried about dents in my nails?
While nail pitting isn’t always something to worry about, it may be a sign of an underlying condition like psoriasis, dermatitis, and autoimmune conditions. If you have nail pitting, it’s usually a good idea to contact a doctor.
If you have nail pitting, you might notice depressions or dimples in your fingernails or toenails.
One of the most common causes is psoriasis. However, autoimmune conditions, deficiencies, and dermatitis can also cause nail symptoms.
Your doctor can diagnose the underlying cause of nail pitting. Medications, topical medications, and lifestyle changes can help treat your symptoms.