What causes these VERTICAL ridges in my fingernails?

Dermatologists are the doctors for skin, but also for hair and nails.  Most of the time patients ask questions about their nails as an afterthought at their visit.  Questions about ridges in fingernails are very common.

Generally there are two main types of ridges in the nails – horizontal and vertical.  We’ll talk about vertical ridges today.  To learn more about horizontal ridges, see my previous article below.

First let’s do a review of the anatomy of the nail.  The nail is surrounded on three sides by what is called the nail fold.  Two lateral nail folds on each side, and the proximal nail fold is at the base of the nail by the cuticle.  The hard part of the nail is called the nail plate.  The nail plate is synthesized by the nail matrix which sits under the cuticle and proximal nail fold.  Vertical  grooves in the nail plate generally occur due to focal damage to the nail matrix.  This can occur for a few reasons.

Trauma to the proximal nail fold.  In most cases this is manicurist induced.  No matter if you are doing your own nails or someone else is pampering you – DON’T MESS WITH YOUR CUTICLES.  Remember the nail matrix that synthesizes the nail plate sits under the cuticles.  Repeated damage to the cuticles by trimming, picking, and pushing them back.  I promise your cuticles will do just fine if you leave them alone.  For more tips or cuticles, see my previous article below.  Vertical grooves come from focal damage to the nail matrix versus horizontal grooves come from a sporadic one time insult to the entire width of the matrix.   

Medical Problems. Thyroid disease and Iron Deficient Anemia are two common medical problems that can lead to multiple vertical grooves.  These are often more shallow than the permanent ridges caused by trauma.  If other symptoms such as lethargy are occurring, ask your doctor to check your labs.  For a more detailed discussion of labs to check for skin, hair and nails, see our prior article below.  As a reminder, Biotin supplements which are often taken to help strengthen the nail plate can interfere with thyroid test results.

Normal Aging. Some mild ridging of the nails can be seen with normal aging.  Just like our skin gets wrinkly, the nails can lose their luster and have a more wrinkles appearance with dozens of shallow vertical ridges. 

Unlike horizontal ridges that tend to grow out over time without leaving a trace, deep vertical grooves  often persist throughout life.  More shallow vertical ridges can be improved slowly over 6 months or more by taking a Biotin Supplement ( at least the RDA of 300 mcg) or using a nail conditioner such as Elon Nail Conditioner which is available of Amazon.  

Hope that helps in deciphering the ridges on your nails.  For more about nails, check out the articles below.

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