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Pitted or changed nails

Also called: Nail pitting, nail changes, onycholysis

Pitted, ridged, discolored, or separated nails can be caused by psoriasis, fungal infection, injury, or aging. Small pits in the nails often go with psoriasis or psoriatic arthritis. Nail changes are usually not serious, but a dark streak, clubbing, or changes with other symptoms should be checked.

Common causesPsoriasis, fungus, injury, aging, eczema
Usually serious?Usually not
Get checked ifA dark streak, clubbing, or other symptoms
If you think it's an emergency, call 911.Thinking about suicide? Call or text 988.

Overview

Nail pitting (tiny dents) is common in psoriasis and alopecia areata. Lifting of the nail from the bed (onycholysis) and oil-drop yellow spots also point to psoriasis.

Fungal infections cause thick, yellow, crumbly nails, usually toenails. Lines across nails (Beau's lines) can follow illness. Clubbing (rounded fingertips) can signal lung or heart disease. A new dark stripe can rarely be melanoma.

When to get medical care

Call 911Not an emergency.
Get care todayA red, painful, swollen nail fold with pus.
See a doctor soonA new dark streak in a nail. Clubbing. Pitting with joint pain or skin rash. Nail changes that keep spreading.

Causes

Causes include psoriasis, fungal infection, eczema, injury, alopecia areata, lichen planus, thyroid disease, iron deficiency, lung or heart disease (clubbing), and, rarely, melanoma.

OwieClear has pages on 2 conditions that can cause pitted or changed nails. Each shows how soon to get care.

Common causes

What you can do at home

  • Keep nails short and dry.
  • Avoid picking or trauma.
  • Wear gloves for wet work.

Medicines

Psoriasis nails may be treated with creams, injections, or systemic medicines. Fungal nails need antifungal pills or prescription polish.

At the doctor

The provider will look at your nails and skin.

Questions you may be asked

  • When changes started
  • Skin rash or joint pain
  • Injury
  • Family history of psoriasis

The exam

A nail, skin, and joint exam.

Tests

  • Nail clipping test for fungus
  • Biopsy of a dark streak

Prevention

Protect your nails.

  • Keep nails short
  • Avoid trauma
  • Keep feet dry

Check your symptoms

Most symptoms have more than one possible cause. The symptom checker looks at all of your symptoms together, plus your age, and shows how soon to get care.

Start the symptom checker

Sources

Last updated 2026-11-13.