Nail Matrix

my pinky toenail grows up
my pinky toenail grows up

What health conditions can affect my nail matrix?

Some health conditions and other factors can affect your nail matrix, including:

  • Fungal infection: Certain types of fungus (mold) can infect your nails, usually your toenails. Toenail fungus may appear as thick, yellow, cracked or cloudy nails.
  • Illnesses: A serious health event like a heart attack or an illness like COVID-19 or pneumonia can interrupt new nail growth and cause Beau’s lines (horizontal ridges in your nails).
  • Injuries: Pinching or crushing your finger or dropping something heavy on your toe can injure your nail matrix. After a nail matrix injury, you may have bruising, ridges or discoloration. Your nail may fall off. Some injuries to your fingernails or toenails can cause a nail infection.
  • Medications: Chemotherapy and other medications can temporarily affect your nail matrix, causing Beau’s lines or slow nail growth. Medications may also cause Mees’ lines (white bands across your nails) and nail color changes. Usually, these changes go away after you finish the medication.
  • Peripheral artery disease (PAD): Peripheral artery disease causes less blood flow to your legs and feet. This reduced blood flow affects your nail matrix and can make nail growth slower.

Additionally, certain skin conditions and diseases can affect your nail matrix, such as:

  • Eczema: Severe eczema can affect your nail matrix and temporarily interfere with nail growth. You might see Beau’s lines, pitting (small, pinhole-like dots) and texture or color changes.
  • Psoriasis: Up to 80% of people with psoriasis develop nail psoriasis. Nail psoriasis can cause changes to your nails, including white lines, pitting and crumbling.
  • Subungual melanoma: Nail matrix melanoma, also called subungual melanoma, is a type of skin cancer that affects your nail matrix. Brown or black discoloration on your nail is the most common sign. Seek medical care if you see any color changes in a single nail.

What are common signs of nail matrix problems?

Any change to the appearance or texture of one or more of your nails could be a sign of a nail matrix problem. If you have nail matrix damage or a condition affecting your nail matrix, your nails may have:

  • Dents (large or small).
  • Horizontal ridges or lines.
  • Pain or soreness.
  • Splits or cracks.
  • Spots or streaks of color.
  • Texture changes, such as becoming thicker or crumbly.

It can be difficult to tell the difference between a harmless nail change and one that requires treatment. If you notice any change to your fingernails or toenails, see a healthcare provider. They can determine the cause and recommend treatment, if needed.

How do I know if my nail matrix is damaged?

Not all nail changes mean your nail matrix is damaged. Some nail problems affect the nail bed, nail plate or nail folds, and not your nail matrix.

Your healthcare provider can tell you whether it’s a nail matrix problem or some other issue. Let your provider know if you notice any nail changes, from a small spot of color to lines or ridges.

How are nail matrix problems treated?

Treatment for a nail matrix condition depends on the cause. For example, your provider may recommend:

  • Medication: Prescription antifungal pills are the typical treatment for nail fungus. If you have nail psoriasis, certain medications can help you manage the condition. These may include pills, injections or topical treatments, depending on your needs.
  • Relieving nail injuries: If you have a bruise under your nail, you may benefit from a procedure that drains the trapped blood. This procedure, called nail trephination, provides pain relief and helps your new nail grow in correctly. Providers must perform this procedure within 48 hours of the injury, before your blood clots.
  • Surgery: Subungual melanoma needs to be removed with surgery. Your provider may take a biopsy (sample of tissue) to get a diagnosis. If the biopsy shows melanoma, your provider will remove the affected area in your nail matrix and under your nail. If the cancer has spread, you may need other treatments, such as chemotherapy or radiation.