What are the causes of longitudinal ridging (vertical nail lines) of the nails?

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From the Research

Vertical nail lines are typically a normal sign of aging and usually don't require treatment, but certain patterns may indicate underlying health issues, and medical evaluation is recommended if they appear suddenly or are accompanied by concerning symptoms. These ridges occur when the nail matrix (the area where nails grow from) develops tiny projections that cause the nail to grow with vertical lines. For mild cases, keeping nails moisturized with regular hand lotion or nail oil can help improve appearance, as suggested by general dermatological practices 1. If the ridges are bothersome, gentle buffing with a fine-grit buffer can smooth them, but avoid excessive buffing which can thin the nail. While vertical lines are generally harmless, certain patterns may indicate underlying health issues - deep, prominent ridges accompanied by nail splitting might suggest nutritional deficiencies (particularly protein, iron, or zinc), while sudden onset of vertical ridges could signal inflammatory conditions like lichen planus. Some studies have explored the use of biotin for nail conditions, showing improvement in firmness, hardness, and thickness of brittle nails with oral biotin 1. However, the provided evidence does not directly address the treatment of vertical nail lines. Maintaining good nail health through proper nutrition, adequate hydration, and avoiding harsh chemicals can help minimize the appearance of these ridges. It's also important to note that surgical nail avulsion, as discussed in some studies 2, 3, 4, is not typically recommended for vertical nail lines, but rather for conditions like onychocryptosis or nail tumors. In cases where nail avulsion is necessary, a new surgical modification using an 11 no. surgical blade instead of nail clippers has been proposed to minimize trauma to the nail bed 3. Additionally, non-operative treatment has been shown to be effective for simple fingernail avulsion injuries in children, with no significant differences in outcome compared to surgical nail plate refixation 5.

References

Research

Biotin for the treatment of nail disease: what is the evidence?

The Journal of dermatological treatment, 2018

Research

Nail avulsion: indications and methods (surgical nail avulsion).

Indian journal of dermatology, venereology and leprology, 2012

Research

A New Perspective on Partial Nail Avulsion: Surgical Pearl.

Journal of cutaneous and aesthetic surgery, 2023

Research

Alternatives to complete nail plate avulsion.

Journal of the American Academy of Dermatology, 2008

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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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