How to Treat Small Depressions (Pits) on the Nails

Mar 03, 2022 Source: Cainiu Health

Dr. Yan Min

Introduction

1. Onychomycosis: Typically caused by dermatophytes infecting the nail plate and subungual tissues, resulting in small depressions or pits on the nail surface. 2. Psoriatic nails: Nail changes arising from psoriasis affecting the nail bed or nail matrix. 3. Daily care: If nail pitting is observed, it may be associated with recent heavy physical labor; prolonged heavy physical labor may also contribute.

Pits or small depressions on the nails require identification of the underlying cause before appropriate treatment can be initiated. Common causes include onychomycosis (fungal nail infection) and psoriatic nail changes. These conditions can be managed with pharmacological interventions. So, how are nail pits treated? Below is a detailed explanation.

How to Treat Nail Pits

1. Onychomycosis

Onychomycosis is typically caused by dermatophytes infecting the nail plate and subungual tissues, resulting in nail pitting. Additional symptoms may include nail opacity, thickening, onycholysis (separation from the nail bed), discoloration, atrophy, shedding, or lifting. Topical antifungal agents such as amorolfine hydrochloride cream or ciclopirox cream may be applied locally. Additionally, patients should maintain proper hand hygiene—washing hands regularly with lukewarm or running water—and avoid using hot water or vigorous scrubbing.

2. Psoriatic Nail Disease

Psoriatic nail changes occur when psoriasis affects the nail matrix or nail bed, leading to characteristic nail surface abnormalities. Clinical manifestations commonly include pitting, onycholysis, subungual hyperkeratosis, structural deformities, and splinter hemorrhages. Treatment options include topical application of urea cream. In cases complicated by secondary bacterial infection, oral cephalosporin antibiotics—such as cefaclor capsules or cefradine capsules—may be prescribed.

3. Daily Care

Nail pitting may sometimes be associated with recent heavy physical labor. Prolonged strenuous activity can impair peripheral circulation at the fingertips, potentially leading to nail pitting over time. Therefore, balancing work and rest is essential. Regular finger massage may help improve local blood flow and alleviate nail pitting. Moreover, prolonged exposure to extremely cold environments may also contribute to nail pitting; thus, such exposure should be minimized whenever possible.

We hope this information is helpful to you.

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What Causes Indentations in Fingernails?

Depressions in the fingernails—often referred to as “spoon nails” or koilonychia—may result from nail dystrophy, which can be associated with prolonged or excessive nail grooming. It may also stem from nutritional deficiencies of trace elements essential for nail health. In some cases, patients may present with dehydration or iron-deficiency anemia, both of which can contribute to nail concavity. Since the underlying causes of fingernail depressions are varied, treatment strategies must be tailored accordingly.