What should I do about small pitted dots on my nails?

Dec 01, 2025 Source: Cainiu Health

Dr. Liu Wenmin

Introduction

In general, small pitted dents on the nails may be caused by factors such as nutritional deficiencies, physical trauma, onychodystrophy, onychomycosis, or nail psoriasis. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general management, medication, or other treatments. In daily life, avoid frequent filing of the nails to reduce damage to the nail plate.

Generally, small pits or depressions on the nails may be caused by nutritional deficiencies, physical trauma, nail dystrophy, onychomycosis (fungal nail infection), or nail psoriasis. It is recommended to seek medical attention promptly, identify the underlying cause, and follow a treatment plan under medical guidance, which may include general care and medication. Specific causes are analyzed as follows:

1. Nutritional Deficiency: A long-term lack of vitamin A, calcium, or protein can lead to insufficient nutrition for nail growth, resulting in abnormal nail plate structure and the appearance of small pits. Adjust your diet by consuming more nutrient-rich foods such as eggs, milk, and carrots, maintain a balanced diet, and avoid picky eating.

2. Physical Injury: Trauma from impact, pressure, or prolonged exposure to irritants can damage the nail plate, causing small indentations. Wear gloves when doing housework or lifting heavy objects to protect your nails, avoid direct force on the nails, and apply hand cream after contact with detergents to nourish the surrounding skin.

3. Nail Dystrophy: Abnormal keratinization of the nail plate leads to rough nails and small pits, often accompanied by thinning or discoloration. Follow your doctor’s advice to take supplements such as multivitamin tablets, calcium gluconate oral solution, or vitamin B complex tablets. Trim nails regularly, avoiding lengths that are too long or too short.

4. Onychomycosis (Fungal Nail Infection): Fungal infection damages the nail plate structure, causing pitting and brittleness, typically starting at the nail edge and spreading inward. Use antifungal medications as prescribed, such as bifonazole cream, terbinafine hydrochloride cream, or itraconazole capsules. Continue treatment until a new, healthy nail has fully grown in. Avoid sharing nail clippers with others.

5. Nail Psoriasis: When psoriasis affects the nails, the nail plate develops pinpoint-sized depressions, often accompanied by subungual hyperkeratosis and discoloration. Use medications such as calcipotriol ointment, tacrolimus ointment, or halometasone cream as directed by your doctor to control symptoms. Avoid scratching the skin around the nails to prevent worsening of the condition.

In daily life, avoid frequent filing of the nails to reduce nail plate damage. Keep the skin around the nails clean and dry. Trim hangnails with scissors instead of tearing them. Maintain a regular sleep schedule and avoid staying up late. Adopting a healthy lifestyle helps create favorable conditions for proper nail growth.

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