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Nail pitting may signal underlying inflammation, not just calcium deficiency, doctor explains

From Liberty Times · () Chinese

Translated from Chinese, summarized and contextualized by DistantNews.

At a glance

News Named sources Context piece
  • Small, scattered depressions on fingernails, known as nail pitting, may indicate underlying inflammation, not calcium deficiency.
  • Rheumatologist Shen Ming-chung explains that nail pitting can be a sign of immune system inflammation and may be linked to conditions like psoriasis or alopecia areata.
  • Treatment focuses on managing the underlying inflammatory disease, and improvement requires patience due to slow nail growth.

The appearance of small, scattered indentations on fingernails, often described as looking like they've been pricked by a needle, may signal more than just a simple cosmetic concern. Rheumatologist Shen Ming-chung clarifies that this condition, known as nail pitting, is not typically a sign of calcium or vitamin deficiency as commonly believed.

This is not the most common manifestation of calcium deficiency.

— Shen Ming-chungExplaining that nail pitting is not a typical sign of calcium deficiency.

Instead, Shen explains that nail pitting can be a marker of inflammation affecting the nail matrix during its growth. This inflammation can indicate that the immune system is actively inflamed and may be associated with various conditions. Among the most common links is psoriasis, with nail changes occurring in 40-50% of patients, and even higher in those with psoriatic arthritis. Other potential associations include alopecia areata, atopic dermatitis, eczema, and certain connective tissue diseases.

It is actually a trace left after the nail matrix is affected by inflammation, revealing that the immune system is inflamed.

— Shen Ming-chungDescribing the cause of nail pitting as inflammation impacting nail growth.

Treating nail pitting involves addressing the root cause – the underlying inflammatory disease. Depending on the severity, treatment options may range from topical steroids or vitamin D medications to localized steroid injections, phototherapy, or oral immunosuppressants and biologics. Shen emphasizes that since fingernails take about 4-6 months to grow fully, visible improvements often require considerable patience. He also notes that factors contributing to a chronically inflamed immune system, such as gut dysbiosis, vitamin D deficiency, omega-3/6 imbalance, chronic infections, poor sleep, stress, and metabolic issues like insulin resistance, may be evaluated and managed to support overall health.

Nails are a mirror of the body; sometimes they reveal that the immune system is inflamed even earlier than the skin.

— Shen Ming-chungHighlighting the diagnostic significance of nail changes.
DistantNews Editorial

Originally published by Liberty Times in Chinese. Translated, summarized, and contextualized by our editorial team with added local perspective. Read our editorial standards.

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