What is up with my thumb nail?

November 29, 2017 9:44 AM

My thumb nail looks crazy. No, not a photo thumbnail, the actual nail growing on my thumb. It's been like this for years and it seems like it might even be getting worse. I never asked a doctor about this because my nail has looked weird for years so I assumed it's just one of those little imperfections we all have. Photos and details after the jump:

My thumb nail has always grown sort of wavy and has had random ridges. The ridges will grow out and off, the nail will look normal for a bit and then a new ridge will grow in and my thumb will look bumpy again. I even checked my computer and I have a thumb photoshoot from 2013 of the weird ridges. Lately it looks worse.

Here are some photos from over the past week: safe for work, but they are close-ups of my thumb so... weird for work. (Please ignore how I picked at my cuticles and bit my nail too close and stuff -- everything looks terrible but this thumb is distracting as hell, ha.)

You'll notice toward the top of the thumb nail is a bunch of little ridges. Toward the bottom of the thumb, closer to the nail bed, is a big divot. Weirdly, the nail itself peeled a little, which has never happened before, and I picked at it and made it worse, so it looks especially bad in the middle of the bottom third.

Is this, like, a medical condition I need to have evaluated or is it just a weird thing I should accept? I figure maybe I somehow damaged my nail bed when I was a kid or something that I don't remember. It doesn't really bother me much -- it looks ugly but I'm not sure it affects me beyond that. All my other nails seem fine, although I think my other thumb is slightly wavy too.

posted by anonymous to Health & Fitness (20 answers total)

It looks like a fungus to me. This is the sort thing that, once it gets in, tends to stay in without treatment. Since the nail is still growing, the ridges can come and go. I've had a similar one on my toe-nail for quite a while. I went through a process to get rid of it, which took a long time but worked, but then it came back. My dermatologist says there are other things I can do, but it's harmless. I elected to leave it alone. Fingernails are a bit more obvious, so you might want to do something about it, in which case, start with a visit to the dermatologist.

BTW, I am not a medical doctor and this is anecdotal, not medical, evidence. If you want to be certain of what it is, see a doctor.
posted by ubiquity at 9:51 AM on November 29, 2017 [3 favorites]

Looks like fungus. I would try an OTC anti-fungal nail product.
posted by xyzzy at 9:55 AM on November 29, 2017

Yeah it looks like fungus to me too. It's weird to see it on a thumb because we generally have drier hands than feet but who knows.
My husband had toe fungus since forever until a podiatrist told him to get a lab test to check for the specific type of fungus. And then he took a series of oral antimycotics that finally made it go away. (OTC never worked)
posted by CrazyLemonade at 9:57 AM on November 29, 2017

Yeah, I've had about 50/50 results on nail fungus stuff, but it doesn't hurt to try before the oral meds.
posted by xyzzy at 10:15 AM on November 29, 2017

Mod note: Followup from the OP:

I explained this in my question, but I want to clarify that the peeling you see is a new thing, which has prompted me to pay more attention to my thumb. Normally that's not there, so I don’t want people saying it's fungus and I've had fungus for years based off just that...

I'm asking mainly about the bumpy appearance, which I've had for years. I figured my nail has a cowlick, if nails can have that. My thumb can and does normally look smooth in appearance (not peeling), just with those weird ridges and bumpiness that seem to grow out in a pattern. Here are photos from 2013 of my nail — this is how it usually looks.

If people still think it’s fungus or if it could be something else, what kind of doctor should I see? Just my primary? Thanks again for the help.

posted by LobsterMitten (staff) at 10:21 AM on November 29, 2017

Are they Beau's lines? They could have many causes, check out the wikipedia link.
posted by zoetrope at 10:35 AM on November 29, 2017

When my thyroid issues surfaced one of the telltales was that my nails (always soft and prone to splitting) became super splitty and just fell apart. (Also my hair got suddenly brittle and dry)

If it's just your thumb maybe that's not it, but my nails are much more solid than they have been in years now that I'm taking synthroid.
posted by Lawn Beaver at 10:41 AM on November 29, 2017

I have the ridges you have in your 2013 photo and in my case it’s because I pick at the cuticles on my thumbs, which puts pressure on the soft, still-forming nail bed underneath. When the nail grows out it still has the marks of that trauma. At least, this is what numerous nail techs and aestheticians have told me. When I’m doing really really well with my cuticles for a few months and not picking, the ridges do abate a little and the nail grows out more smoothly, with less of a divot than you have in your photo (which I usually have, too).
posted by stellaluna at 10:41 AM on November 29, 2017 [3 favorites]

What kind of doctor should I see? Just my primary?

I'd say to start with your primary–they'll probably refer you to a dermatologist. If you don't need a referral I'd try and go straight to derm.
posted by Chutzler at 10:46 AM on November 29, 2017

I agree with a dermatology consult.
They are the folks who fixed my nail.
posted by SLC Mom at 11:55 AM on November 29, 2017

Lines like that are a sign that something is seriously wrong. In a family member that's been fungus, and it can spread and destroy the rest of your hands. Trust me when I'm say this is something you don't want. Don't mess around with OTC stuff, because you are playing with fire. Even the oral stuff doesn't always work-there's a chance the medication will start destroying your liver before it does the fungus. I've known two people (one feet, one hands) for whom that was the case. It can also be a sign of autoimmune conditions like arthritis, or some other kind of severe systemic stress (usually in more than one nail; are all your others 100% straight with not even mild dips?). Get it checked out. It is possible it's just a physically damaged nail bed, but I doubt it. You'd remember an incident dramatic enough to cause that kind of lasting damage. Is it possible it'll carry on like this without dramatically worsening? Sure, but do you want to take the risk if you have health insurance?
posted by liminal_shadows at 12:19 PM on November 29, 2017

By "playing with fire" I don't mean OTC stuff would cause damage, more that it's seriously unlikely to work or even stop the spread of a fungus so deeply embedded in the nail--what you're risking there is allowing it to spread. All the oral anti-fungal meds I know of have serious side effects and it's usually a race to see f you can destroy the fungus before the side effects are worse than the disease. But after you've watched fungus destroy someone's hands over years, ugh. Constantly cracking, bleeding, thickening, unable to play stringed instruments anymore. Seriously, if you can afford it, see someone. If it's not systemic (arthritis, psoriasis, etc) or fungal, but physical, at the very least it'll put your mind at rest.
posted by liminal_shadows at 12:23 PM on November 29, 2017 [1 favorite]

I will sometimes get odd ridges in my nails in winter when my skin gets very dry and the cuticle gets these annoying little splits. A damaged cuticle will cause the nail to grow in poorly, so if you are picking at your cuticles, you may be damaging your nail bed in the process, which then results in the ridges. I have been using shea butter on my cuticles every day (sometimes a few times a day in winter) and that helps a lot. It would probably help your nails a lot to kick the cuticle picking habit. Smoothing the cuticles with a fine emery board or stone nail file and using hand cream can help make there be less rough edges that can be picked at.
posted by 5_13_23_42_69_666 at 1:24 PM on November 29, 2017 [1 favorite]

Could be psoriasis.
But yes, if you're able to, consult a dermatologist.
posted by sciencegeek at 2:30 PM on November 29, 2017

I had a nail bed infection (swelling, redness, pain, but no broken skin) pop up after a knuckle injury. The infection went away, and the nail grew out looking basically like that; when the bed is damaged, you get deep ripples and flaking/splitting since it can't produce the proper structure. It took forever. Yours is open, though, and vulnerable to further infection even if it's not a fungus. Agree with the others that it's worth having it looked at.
posted by notquitemaryann at 3:17 PM on November 29, 2017

You could be damaging your nail bed when you pick your cuticles and then your nails grow in strangely.
Look up habit tic nails.
But yes, worth a check for fungus and other problems.
posted by littlewater at 3:32 PM on November 29, 2017

My nail sometimes looks like that - turns out it was psoriasis, not a fungus. I have lupus and this always happens when my steroids are failing.

So that’s possible. Despite being told it was a fungus for years.
posted by crankyrogalsky at 5:04 PM on November 29, 2017

My dad had a finger injury years when young, jammed it in a car door or something? Don't remember - but ever since then he's had a fingernail that grows in quite wavy and ridged. Have you ever injured that thumb?
posted by molasses at 5:16 PM on November 29, 2017

My right thumb pretty much looks like that off and on forever. I believe it's trauma to the tip of my thumb. Once for a while I messed with the tip of that thumb long enough to damage the nail-bed and turn it into regular flesh. Now the nail grows out and hits that non-nail-bed bit and backs up and goes wavy. And fussing with it make it worse. My right thumbnail is now about 1/4" shorter than my left thumbnail.

Check with doctor or whatnot....

Stop fussing with it. Moisturize. Take a hair-and-nails supplement. You'll still end up with a funky nail that overhangs that bit of damaged nail-bed.

IANYD. I do have one crazy thumb that tasks me, and I shall have it. I'll chase it round the Moons of Nibia and round the Antares Maelstrom and round Perdition's flames before I give it up!
posted by zengargoyle at 5:36 PM on November 29, 2017

I'll nth damage to the nail bed from picking or otherwise destroying the cuticle. I'm pretty bad with my nails, been biting them since 8 or so and even escalated to removing the skin to the sides and the cuticle with a large gague hypodermic needle from lab. I see you've bitten down the edges and also have the telltale sign of cuticle damage from (I'm guessing) peeling the skin across from where the skin edges have been bitten down to keep everything smooth.

On the plus side it doesn't look like a fungus, as the nail would be cloudier than it appears. The bad sign is that I think it is permanent damage to the nail bed and it will continue to grow like that from now on.
posted by koolkat at 7:20 AM on November 30, 2017