What Can Your Nails Tell You About Your Health? 7 Changes Women Over 50 Shouldn’t Ignore

Your fingertips are doing more than showing off your favorite nail polish shade. They’re offering a little window into what’s happening inside your body. From subtle vertical ridges to sudden color changes, nails can flag everything from an iron deficiency to something more serious like heart or liver disease. So what can your nails tell you about your health, especially as we get older? Quite a lot, it turns out—and the good news is that most changes are easy to address once you know what you’re looking at.

What can nails tell about your health?

Healthy nails are smooth, both firm yet flexible and have a healthy pinkish nailbed. If yours don’t quite fit that description—whether you’re dealing with nails prone to splitting, ridges or other nail porblems—this handy guide can help you pinpoint what might be going on inside your body. If you notice any of these warning signs, schedule a visit with your doctor or dermatologist. 

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Vertical ridges in nails are often just aging

Up to 85 percent of women over 50 develop fine vertical ridges running from cuticle to tip, and most of us blame the wrong thing. “There is a lot of misinformation out there,” says Melanie Palm, MD, a board-certified dermatologist at Art of Skin MD in San Diego. “As we get older, cells that produce the nail plate may not turn over quite as evenly or efficiently, which can result in fine vertical lines. They’re comparable to fine lines on the face.”

You can smooth them by very gently buffing them, using moisturizing jojoba oil and apply a ridge-filling base coat. That said, horizontal ridges are a different story. Called Beau’s lines, they can appear after intense stress or serious illness, so be sure to mention this type of nail problem to your doctor.

Brittle, splitting nails may point to hormone or thyroid problems

If your nails peel, split or break more easily than they used to, menopause and aging may be to blame. Levels of cholesterol sulfate, which helps keep the nail plate flexible, drop with age. Underlying conditions like thyroid disease, Raynaud’s disease and protein deficiency can also show up first in your nails, explains New York dermatologist Dana Stern, MD. Ask your doctor to rule out any underlying health issues first. 

“Think of brittle nails that have a tendency to break as analogous to overly-processed hair that frizzes and has ends that split,” Dr. Stern says. “We condition and protect our hair to avoid these issues. To avoid future broken nails, you need to take care of your nails and use the right products.”

That may include using a glass nail file instead of a cardboard emery board for at-home nail care, moisturizing hands and nails and using a gentler, conditioning nail polish remover, Dr. Stern says, to help keep nails healthy.

Spoon-shaped nails may signal iron deficiency

Nails that curve inward, forming a slight dip in the nail bed, are called koilonychia—or spoon nails. “Spoon-shaped nails that curve inwards can be a sign of iron-deficiency anemia,” notes Bhavini Shah, MD. Other clues include fatigue, pale skin, headaches and shortness of breath.

The good news? It’s usually simple to correct with iron-rich foods like red meat, beans and dried apricots—or with iron tablets your doctor may recommend after a quick blood test.

White nails with a pink strip could mean liver trouble

Nails that appear mostly white with a red or pink band near the tip are called Terry’s nails. “Terry’s nails are a tell-tale sign of liver disease,” Dr. Shah says. “Other symptoms of the disease include fatigue, yellow skin and loss of appetite.” Reduced blood vessels beneath the nail bed may be the culprit, so book an appointment with your doctor right away if you notice this change.

Redness can signal blood sugar issues

Redness around the nails, known as periungual telangiectasias, affects about one in two people with diabetes, according to a review by Rowan Hillson, MBE, MD, FRCP. Diabetes-related vascular issues can also disrupt healthy nail growth and leave nails brittle and prone to fungal infections that discolor them white, yellow or green. Your doctor can confirm prediabetes or diabetes with a quick blood test, and managing your glucose levels should help clear up nail problems over time.

Dark lines or clubbing may be symptoms of heart problems

Unexplained red or purple lines under the nail—or clubbed nails that curve over the fingertip—can point to heart disease. “Other symptoms that indicate heart disease include extreme fatigue, swollen ankles and pain in the chest, stomach, legs, arms, jaw or back,” Dr. Shah notes. If you notice these warning signs, visit your doctor.

Pitting or separation could indicate psoriatic arthritis

Tiny dents, nails lifting from the bed, thickening or reddish spots underneath can precede joint pain in psoriatic arthritis (PsA). “Up to 80 percent of people with PsA also experience nail changes,” explains Raj Dasgupta, MD, FACP, FCCP, FAASM. “The same inflammation that affects the joints and skin can also target the nail matrix and nail bed.”

If you have PsA, you’ll want to work with your doctor to control the underlying autoimmune inflammation as well as reduce stress, follow an anti-inflammatory diet and apply a cuticle or nail cream. “Affected individuals should definitely avoid gel/acrylic nails or aggressive manicures,” Will Haas, MD, MBA, Founder & CEO of VYVE Wellness. Regular nail polish is often still safe to use if you don’t have active nail psoriasis.

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What to do if you notice nail changes

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The first step is a conversation with your doctor, who can order blood tests to check iron, thyroid function or blood sugar. Treating the underlying cause—whether that’s starting an iron supplement, adjusting thyroid meds or managing blood sugar—often restores nail health right along with the rest of you.

You can also protect your nails with these simple habits:

• Boost circulation with regular cardio. Nails get oxygen and nutrients from your bloodstream.
• Moisturize hands and cuticles daily, especially after washing. Jojoba oil and thick creams work well.
• File smarter with a glass file, which creates a clean edge instead of the microscopic tears emery boards leave behind.
• Skip harsh removers and long gel soaks. Look for acetone-free formulas with added oils.
• Wear gloves while cleaning to shield nails from water and chemicals.
• Eat protein and iron-rich foods rather than betting on biotin supplements, which research hasn’t shown to help most women.
• Skip back-to-back acrylic salon manicures, which may increase the odds of weak or brittle nails over time, and opt for a gentler manicure like Heyhae’s sun-curing gel nail strips or traditional nail polish. Or simply take a break from polish altogether now and then.

The bottom line on what nails can tell you about your health

See a dermatologist right away if only one nail is affected, a change comes on suddenly or you notice pain, swelling or a new dark streak. Your nails are working hard for you—a little TLC goes a long way.