What causes nail ridges?

Nail ridges can have many different causes that may include local events or systemic conditions affecting your body as a whole. While some local events, such as trauma, may not be serious, systemic conditions that lead to nail ridges can be serious or life threatening.

Horizontal ridges across the nail can be a symptom of a serious underlying disorder, especially if discoloration is also present. Beau’s lines (trenches that run across the nail) may indicate a variety of problems that interrupt the normal growth of the nail, including an acute illness, a nutritional problem, or poisoning.

Localized causes of nail ridges

Nail ridges may be caused by localized events including:

  • Bacterial infections
  • Fungal infections
  • Trauma, such as slamming your fingernail in a door or accidentally hitting your nail with a hammer

Systemic causes of nail ridges

Nail ridges may be caused by systemic events including:

  • Alopecia areata (loss of hair in circular patches)
  • Anticancer chemotherapy
  • Hand-Foot-Mouth disease (viral infection)
  • Iron-deficiency anemia
  • Kawasaki disease (acute bout of blood vessel information, occurs mostly in children)
  • Psoriasis

Serious or life-threatening causes of nail ridges

In some cases, nail ridges may be a symptom of a serious or life-threatening condition that should be evaluated immediately in an emergency setting, particularly when ridges form horizontally across the nail or discoloration is also present. Life-threatening causes of nail ridges include:

  • Arsenic poisoning
  • Myocardial infarction (heart attack)
  • Nutritional problem, such as inadequate diet or difficulty absorbing nutrients from food that is eaten
  • Toxic ingestion, such as eating poisonous plants, mushrooms, or chemicals

Questions for diagnosing the cause of nail ridges

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your nail ridges including:

  • When did you first notice your nail ridges?
  • Do they occur on more than one nail?
  • Do your nail ridges run vertically or horizontally across the nail?
  • Do you have any other symptoms?
  • Do you have a history of other medical conditions?

What are the potential complications of nail ridges?

Nail ridges often develop as part of the aging process, but they can also develop suddenly because of local or systemic events. Although nail ridges that occur as a result of injury to the nail or rarely serious, nail ridges that occur as a result of an underlying event, such as an illness or poisoning, can lead to serious complications. Because nail ridges can be due to serious systemic events, failure to seek treatment can result in complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Cosmetic disfigurement
  • Dehydration due to vomiting, diarrhea, or a decreased desire to drink fluids
  • Organ failure or dysfunction
  • Unconsciousness and coma


  1. Paronychia nail infection. American Osteopathic College of Dermatology. http://www.aocd.org/skin/dermatologic_diseases/paronychia_nail_in.html.
  2. Nail abnormalities. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003247.htm.
  3. Richert B, André J. Nail disorders in children: diagnosis and management. Am J Clin Dermatol 2011; 12:101.

What are nail ridges?

Nail ridges are raised lines in the nails of the fingers or toes that may run vertically along the nail or horizontally across the nail. Nail ridges typically develop in adulthood and may become more pronounced with age. However, nail ridges can also develop more rapidly and may arise from a variety of causes, including localized infection or systemic illness, disease, or poisoning.

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What other symptoms might occur with nail ridges?

Other symptoms, which vary depending on the underlying disease, disorder or condition, may accompany nail ridges. Symptoms that frequently affect the nails may also involve other body systems.

Localized symptoms that may occur along with nail ridges

Additional localized symptoms may be present in areas around nail ridges including:

Medical Reviewer: William C. Lloyd III, MD, FACS Last Annual Review Date: Sep 20, 2013 Copyright: © Copyright 2014 Health Grades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Health Grades, Inc. Use of this information is governed by the HealthGrades User Agreement.

This Article is Filed Under: Skin, Hair and Nails

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