Nail Pitting

Fingernails have a lot of uses, but in terms of personal appearance, they’re almost an accessory. Depending on your mood and style, they can be colored, lengthened, reshaped and literally manicured. But, since this is DermTV, there’s always a “but”... so... there are a bunch of problems that can PREVENT your nails from looking their best. The problem we’re going to discuss today is one of the strangest: nail pitting.

In nail pitting, small pits develop in one or several nails. These pits can be cone shaped with slanted angled borders as if an ice pick had been stuck into your nail. In fact, they can even resemble ice pick acne scars, but these nail pits are much smaller. Or, they can have vertical parallel walls like drill holes. But regardless of their shape, they compromise the appearance of your nails. And nail polish, which isn’t spackle and cant fill them in, just exaggerates the way they look.

Nail pits occur while the nail is being formed, under the skin next to the back end of the nail over here.

There’s a tiny organ under the skin here called the nail matrix and that’s the organ that actually makes the nail. Nail pits occur most commonly in people with psoriasis, eczema or in people with an allergic form of hair loss, called alopecia areata, where you lose round patches of hair. In all of these conditions, there are usually several pits in any nail, and many fingernails may be affected. However anyone can get one or two occasional random nail pits for no apparent reason, and one or two pits usually are of no cosmetic or medical importance.

The treatment of multiple nail pits usually requires treating the associated skin conditions I mentioned. However, there is a treatment that can be done to the skin next to the nail overlying the nail matrix. It involves injections of cortisone which of course are uncomfortable, but they usually work after a few monthly treatments. And of course, as a last resort, you can hide your nail pits with nail tips!