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Black Line On Nails—Should You Worry About Or Not?
Brown or black lines on nails formed vertically is known as Splinter Hemorrhage. Very often, your fingernails may give some insight into what’s going on within your body.
If you develop these, it could be due to numerous reasons which may be mild or severe, for instance, melanoma. This condition is referred to as Splinter Hemorrhage as it appears like a wood splinter beneath your nail. It is caused by small blood vessels that get damaged under the nails. Some of the features of damaged blood vessels include:
- It turns reddish-brown or black.
- Even after applying pressure on your nails, the color does not change.
- It might appear in one or many places on the nails.
Thicker black lines forming a horizontal stripe on the nails is known as Beau’s Lines. They are not generally harmful but might occur as a symptom of another underlying condition. One such severe or critical condition is subungual melanoma cancer.
If you have noticed a black line on nail recently, here are all the things you must know for complete information.
Causes of Black Lines On Nails
Numerous conditions may result in the formation of black lines on your nails. One such common condition includes trauma. It may occur when something hurts the nail bed deeply causing the blood vessels to burst underneath the nails. You might experience such trauma on your nails without even realizing or feeling the pain, such as when you press something too tight.
Another condition that causes a black line on the nail is Endocarditis. This is a heart condition and nearly 15% of the total population having endocarditis often report Splinter Hemorrhages or black lines on their nails.
This condition occurs when the inner valves or chambers of your heart develop an infection. You may also encounter other severe heart conditions due to endocarditis. It usually occurs in people that already suffer from other associated cardiac conditions.
Psoriasis might also result in Splinter Hemorrhages. It is a severe skin condition that manifest as scales or silvery plaques on your skin. Nearly 50% of people diagnosed with psoriasis develop Splinter Hemorrhage or black lines along with other similar nail conditions.
Another condition responsible for a black line on the nail is Melanonychia. This might be of different types including:
Linear Melanonychia
If an individual suffers from Linear Melanonychia, they will notice dark strips running down their nails. These lines or stripes might have color variations from gray and deep brown to black. These lines will normally develop on 2-5 nails but not significantly on all 10 fingernails.
Subungual Melanoma
When someone develops Subungual Melanoma, the black strip or line will appear on only one fingernail and not all. Most often, they cannot link the appearance of that line back to any injury. With time, this line tends to widen and darken and sometimes the nail will bleed and become painful.
The pigmentation might also exceed the region where your fingernails join with the cuticle. This is termed Hutchinson’s Sign and is often considered an indicator of melanoma. The stripe might occur on toenails or fingernails.
It is estimated that nearly 40 to 55% of melanoma that occurs is of the subungual category on the foot.
These were the main or common causes giving rise to the black line on nail. Some other causes include:
- Lupus
- Nail fungus
- Vasculitis
- Infections
- Lichen planus
- Chemotherapy
- Kidney, circulatory, or lung disease
- Raynaud’s Disease
- Medications altering the clotting of blood
If you notice lines on all the fingernails, it may be as a result of mumps, syphilis, diabetes, or thyroid disease. Let’s see how the black line on the nail is diagnosed for fast treatment.
Diagnoses Of Causes Of Black Line On Nail
If you are highly certain that the black line on your nails is not caused as a result of trauma or injury, contact your doctor for a diagnosis. Also, even if it is caused due to trauma but you do not see it healing for long now, contact a doctor.
If you speculate the cause of splinter hemorrhage to be another serious skin condition, you must immediately make an appointment with the doctor. For instance, if you have endocarditis, you might encounter some other symptoms of this condition too like shortness of breath, joint pain, fever, pale skin, etc. If the cause is Psoriasis, you might notice rashes, scales, or patches on your skin, especially on your face, feet, skin folds, scalp, and hands.
The black line on nails that recurs or appears on more than one nail must also be examined for further diagnosis by the experts. Once you visit a doctor, they will suggest further examinations to diagnose underlying conditions if they suspect any.
Your doctor might also enquire about your medical history regarding family medical issues or history. Some lab tests that determine the causes of black lines on nails include:
- Erythrocyte sedimentation
- Complete blood count
- Blood culture to detect fungi and bacteria in the blood
Imaging tests may also be ordered or suggested by experts to seek out the abnormalities. These involve echocardiograms and chest X-rays to take images of your heart.
Sometimes, a black line on your nails may be a symptom indicating melanoma, a type of cancer. If the doctor speculates a malignancy, a biopsy will be carried out to find out whether the black lines are benign or cancerous.
Some questions the doctors may ask and you must be prepared for include:
- How long has the line been there?
- When did you notice the line first?
- Did you notice any changes in the line recently?
- Did you experience trauma on the nail that may have caused a black line to appear?
If the condition is diagnosed in time, is there a treatment for the black line on the nail? Let’s find out!
Treatment For Black Line On Nail
Treatment varies based on the underlying cause of the black line on nail.
If the black lines are caused as a result of Splinter Hemorrhages caused due to trauma, then, based on how severe the trauma is, it will clear up within few days or slowly vanish as your nails grow. Nails grow at a very slow pace, so it may even take several months for the black lines to disappear completely if they are vertical.
If you endure pain after the injury on your toenail or fingernails, try to implement a cold compress to that area so that swelling can be reduced with inflammation, or try some over-the-counter medications prescribed by your doctor.
However, if the black lines formed are due to another underlying condition, they will only clear up once the condition is diagnosed and treated. Treatment for such conditions may vary and the doctors might prescribe antifungal mediations if it is caused due to fungal infection.
You might also be asked to use immunosuppressants or corticosteroids if the underlying condition is Nail Psoriasis or rheumatoid arthritis. If after examining the nails, bacterial Endocarditis is determined, the doctors may suggest surgery to repair the valves.
Sometimes, black lines might also indicate that you are having side effects as a result of the medication you are consuming now. Once you stop the medications, they should go away within a few days.
Complications As A Result Of Black Line On Nails
Possible complications due to black lines as a result of melanonychia includes:
- Bleeding beneath the nails
- Deformity of nails
- Splitting of the nail
Know that a nail biopsy might also cause deformity in the nails since it removes some portion of your nail.
The Bottom Line
Developing a black line on nails may either be completely harmless or an indication of serious health issues. If you can recall any trauma to your nail, it is most probably that as your nail grows, it will grow out and disappear with time. If you notice other symptoms with nail conditions, you must visit your doctors and await a proper examination.
Nails are often indicators of the overall health condition. If you encounter Splinter hemorrhages or a black line on your nails without any reason, it may be a sign that you should visit a doctor for a complete checkup.
