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Nails
Gray's Anatomy (1918) plate, public domain
Nails are hard plates of keratin that protect the fingertips, support fine touch and picking grip, and act as tools. They grow from a root (the matrix) hidden under the skin fold at the base; the visible plate slides forward over the nail bed, whose rich blood supply gives nails their pink colour. Fingernails grow about 3 mm a month, toenails about half that, so a fingernail replaces itself in roughly six months.
Key facts
- The pale half-moon at the base (lunula) is the visible part of the growing matrix.
- Nail growth slows with age and in winter, and the dominant hand's nails grow slightly faster.
- The cuticle seals the gap between plate and skin fold, keeping microbes out of the matrix.
- Nails are a record of recent health: a severe illness can leave a groove (Beau's line) that dates the event.
What can go wrong
Nail changes are common clinical clues: fungal infection thickens and discolours toenails; psoriasis pits and lifts the plate; iron deficiency can spoon the nails; clubbing (bulbous fingertips with curved nails) can signal lung or heart disease. Splinter haemorrhages, new pigmented bands, and ingrown toenails — where the edge digs into the fold — are frequent presentations. Persistent single-nail changes are examined to exclude tumours under the nail.
Related conditions
Related procedures & tests
Related symptoms
Frequently asked questions
Why do nails club in lung disease?
Clubbing — loss of the nail-bed angle with spongy, curved nails — develops in several chronic lung, heart and gut conditions through changes in blood flow and growth factors in the fingertips.
What causes white spots on nails?
Usually minor knocks to the growing matrix weeks earlier; they grow out harmlessly and are not a sign of calcium deficiency, despite the popular belief.
Educational information only. This atlas explains normal anatomy and describes conditions in general terms; it is not medical advice and does not replace assessment by a qualified clinician. If you have symptoms that worry you, seek medical care.
