QUESTION

Some of my fingernails have developed indentations, and there’s a bump at the edge of one cuticle. Should I be concerned?

ANSWER

Possibly. An indentation on the fingernail and a bump at the edge of the cuticle mean that the matrix (the tissue beneath the fingernail) is affected. The matrix, which contains blood vessels and nerves, constantly produces new cells. These new cells force old cells to clump together to create your fingernail. By the time the nail emerges from beneath the skin, the cells are dead. Otherwise, it would be very painful to cut your nails! To find out what’s causing these conditions, you should consult a dermatologist. The bump that you describe at the edge of the cuticle could be a wart, cyst or other benign condition…or it could be malignant (melanoma, squamous cell carcinoma or basal cell carcinoma). The only way to know for sure is to have a sample (a biopsy) of the bump taken and analyzed. If the bump is malignant, your dermatologist can recommend treatment, such as complete removal of the tumor, and refer you to a cancer specialist. If the bump is due to a cyst, it will need to be surgically removed. A wart can be removed by freezing it with liquid nitrogen, but the treatment will need to be repeated. There could be a variety of explanations for the indentations in your fingernails. Skin conditions such as psoriasis or a fungal infection can sometimes cause small dents or pits in fingernails. A deficiency of vitamin B-12 or iron can often result in nail ridges or dents. A large indentation can also be due to “spoon nails,” so-called because the nail becomes concave and shaped like a little spoon. Spoon nails can be caused by iron-deficiency anemia, heart disease or an underactive thyroid. A deep, horizontal ridge across the nail, sometimes called Beau’s lines, can also resemble a dent. This condition can be caused by a reaction to a drug, such as chemotherapy, or even a zinc deficiency that interrupted nail growth and then the growth resumed once you stopped the drug or corrected the nutritional deficiency. In some cases, Beau’s lines can signal a chronic underlying health condition, such as diabetes or peripheral vascular disease. A dermatologist can examine your nail ridges to determine whether you may have an underlying health condition and refer you to an appropriate specialist, if needed, for treatment.