What are the causes of nail striations (nail longitudinal ridging)?

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Last updated: April 21, 2025View editorial policy

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From the Guidelines

Nail striations are typically harmless and often a normal sign of aging, but in some cases, they can indicate underlying health issues, and it is essential to evaluate them by a healthcare provider, especially if they appear suddenly or are accompanied by other concerning symptoms. When considering the management of nail striations, it is crucial to prioritize morbidity, mortality, and quality of life as the outcome. The provided evidence does not directly address the treatment of nail striations, but it highlights the importance of evaluating nail changes in the context of underlying conditions such as psoriasis or onychomycosis 1.

Key Considerations

  • Vertical ridges (running from cuticle to tip) are usually benign and related to aging
  • Horizontal ridges (running side to side) may indicate underlying health issues and should be evaluated by a healthcare provider
  • Nail striations can occur due to aging, trauma, or systemic conditions that disrupt normal nail growth
  • If striations appear suddenly, are accompanied by nail discoloration, pain, or other concerning symptoms, consult a dermatologist as they could indicate nutritional deficiencies, skin conditions like psoriasis, or systemic diseases that require medical treatment

Management

For mild cases of nail striations, no treatment is necessary, but keeping the nails moisturized with regular application of hand cream or nail oil, particularly products containing vitamin E or jojoba oil, can improve their appearance. Gentle buffing with a fine-grit nail buffer can temporarily smooth the surface, but excessive buffing should be avoided as it can thin the nail. Given the potential association of nail changes with underlying conditions, the most recent and highest quality study on the management of psoriasis and psoriatic arthritis suggests that nail psoriasis can occur in all psoriasis subtypes and is a significant therapeutic challenge 1. Therefore, it is crucial to evaluate nail striations in the context of overall health and to consult a dermatologist if there are any concerns about the appearance or health of the nails.

From the Research

Striations in Nails

  • Striations in nails can be caused by various factors, including nutritional deficiencies, but there is no direct evidence in the provided studies to support this claim.
  • The studies provided focus on vitamin B12 deficiency, its diagnosis, and its relationship with various diseases, but they do not mention striations in nails as a symptom or effect of vitamin B12 deficiency.
  • Vitamin B12 deficiency can cause a range of symptoms, including weakness, lethargy, palpitation, headache, and shortness of breath, as mentioned in the study by 2.
  • The studies by 3, 4, and 5 discuss the importance of vitamin B12 in cellular metabolism, its deficiency, and its relationship with various diseases, but they do not provide any information on striations in nails.
  • The study by 6 examines the relationship between serum homocysteine, folate, and vitamin B12 levels in patients with psoriasis, but it does not mention striations in nails.
  • There is no direct evidence in the provided studies to support a link between striations in nails and vitamin B12 deficiency or any other nutritional deficiency, as discussed in the studies by 2, 3, 4, 6, and 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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