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What causes small pits or depressions in the nails?

Mar 22, 2025 Source: Cainiu Health
Dr. Liu Wenmin
Introduction
In general, nail depressions or pits may be caused by genetic factors, physiological concavities, malnutrition, onychomycosis (fungal nail infection), or nail damage due to psoriasis. The appropriate solution depends on the specific underlying cause. Patients should enhance their awareness of self-care, maintain healthy lifestyle and dietary habits, and undergo regular physical examinations.

Generally, nail pits or depressions may be caused by genetic factors, physiological depressions, malnutrition, onychomycosis, or nail damage due to psoriasis. The appropriate solution depends on the specific cause, and prompt medical consultation is advised for treatment as directed by a physician. Details are as follows:

1. Genetic factors: Nail depressions may be related to hereditary factors, manifesting as similar symptoms among multiple family members. This is usually associated with gene expression that influences the morphology of the nail during its growth. It is recommended to maintain proper nail care, keep nails clean and dry, and avoid excessive trimming or friction.

2. Physiological depressions: Slight pits occasionally appearing on the nail surface may represent a physiological response during nail growth. These depressions typically do not present with other symptoms nor significantly affect nail health. No specific treatment is required; maintaining good lifestyle habits, including sufficient sleep, regular作息, and a balanced diet, is recommended.

3. Malnutrition: Deficiency in essential trace elements such as iron, zinc, calcium, and vitamins like vitamin A and B-complex may lead to poor nail growth and the formation of pitted depressions. This condition is often associated with iron-deficiency anemia or an unbalanced diet. It is recommended to adjust dietary habits and increase intake of foods rich in protein, vitamins, and minerals, such as lean meat, milk, eggs, fresh vegetables, and fruits.

4. Onychomycosis: Onychomycosis is a nail disease caused by fungal infection, with pathogens such as Trichophyton rubrum and Trichophyton mentagrophytes. The fungi erode the keratin layer of the nail, causing thickening, uneven surfaces, depressions, and possible yellowing of the nail. Antifungal treatments such as ciclopirox cream, terbinafine hydrochloride cream, and terbinafine hydrochloride tablets may be used under medical supervision.

5. Nail damage due to psoriasis: Psoriasis is a chronic inflammatory skin disease caused by multiple factors including genetics, immunity, and environment. When psoriasis affects the nails, it may lead to nail pitting, thickening, separation, and possibly skin erythema. Treatment should follow medical advice and may include medications such as acitretin capsules, compound amino acid tablets, and Yuxue Ling granules.

Patients should enhance self-health awareness, maintain good lifestyle and dietary habits, and undergo regular physical examinations to detect and treat health problems promptly.

References

[1] Zhang Xuejun. Dermatology and Venereology [M]. People's Medical Publishing House, 2018.

[2] Wang Baoxi. Chinese Medical Encyclopedia: Dermatology. Beijing: Chinese Union Medical University Press, 2017.

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