From the Research
Koilonychia is a nail abnormality that should be evaluated for underlying iron deficiency anemia, and treatment should focus on addressing this potential cause, as it is the most common association, as indicated by the study published in 2018 1. The condition is characterized by thin, spoon-shaped nails that curve outward instead of having the normal gentle curve. It can also occur due to other conditions such as hemochromatosis, Raynaud's disease, trauma to the nails, or certain occupational exposures. Key considerations in the evaluation of koilonychia include:
- Investigating for iron deficiency, as it is a common cause of koilonychia, as noted in the study published in 2018 1
- Evaluating for other potential causes, such as inflammatory dermatoses, onychomycosis, or nutritional deficiencies, as discussed in the study published in 2016 2
- Assessing for systemic associations, such as Plummer-Vinson Syndrome or occupational exposures, as mentioned in the study published in 2016 2 Treatment for iron deficiency anemia typically involves oral iron supplements, such as ferrous sulfate, ferrous gluconate, or ferrous fumarate, for 3-6 months. It is essential to confirm iron deficiency through blood tests before starting treatment, as recommended in the study published in 2018 1. During treatment, patients should take iron supplements on an empty stomach with vitamin C to enhance absorption, though they can be taken with food if stomach upset occurs. Protecting the nails from trauma and keeping them clean and dry can prevent further damage while the underlying condition is being treated. The nail appearance typically improves gradually as iron levels normalize, though complete resolution may take several months as nails grow slowly.