COVID nails are a possible symptom that may occur and persist weeks or months after COVID-19 infection, but what do COVID nails look like? Those changes may consist of dents, orange, red, or white discoloration, ridges, or Beau's lines—horizontal grooves across your nails. COVID nails are not permanent and typically resolve within a few months as your nails grow.
Consider seeing a healthcare provider if you notice nail changes after COVID infection to rule out other possibilities. Other causes of nail discolorations may include bacterial or fungal infections and health conditions like diabetes, heart disease, and lupus.
Read on to learn about COVID nails, if they are something to worry about, and what other factors may cause them.
In May 2021,Tim Spector, MD, a genetic epidemiologist and principal investigator of the Zoe Health Study, tweeted about the phenomenon and included a photo of COVID nails.
"Do your nails look odd? COVID nails are increasingly being recognized as the nails recover after infection and the growth recovers, leaving a clear line. Can occur without skin rashes and appears harmless," wrote Spector.
COVID nails do not necessarily happen to everyone, and it's more apparent in some people than others.
"Some people don't see it in the nail because it's not so obvious,"Doris Day, MD, a dermatologist based in New York, toldHealth. You will usually see changes in all of your nails—and possibly even your toenails—rather than just one nail.
Beau's Lines
Beau's lines run horizontally across your nails that can look like grooves, indentations, or ridges, said Dr. Day. Beau's lines most commonly involve the fingernails and may occur on one or more of your nails. You may also notice white discoloration.
Beau's lines typically occur a few weeks after injury to the nail. Some evidence suggests that people with COVID may develop Beau's lines weeks to months after infection.
Onchyomadesis may occur after Beau's lines develop. Onchomadesis happens when your nail slows or stops growth, causing gaps in your nails.
Nail Discoloration
Some people with COVID notice orange, red, or white discoloration on their nails. Researchers do not know exactly what causes nail discoloration with COVID. Some evidence suggests that abnormalgrowth of keratin (a protein that makes up your nails)or damage to the tiny blood vessels in your nail bed may be the culprit.
Different nail changes that may cause discoloration include:
- Chromonychia:Research has identified some cases of COVID that involve orange discoloration near the top of the nails. Chromonychia may develop as long as four months after COVID infection and has typically occurred in older adults with anemia or sarcopenia (muscle loss).
- Leukonychia: Also known as Mees' lines, this looks like white spots or streaks on your nails that resolve as your nails grow.
- Onycholysis: This is red-white discoloration of the nails. Research has found that onycholysis has occurred in some cases of COVID about four months after infection.
Red Half-Moons
These are red bands, shaped like half-moons, that may appear across your nails about two days to three weeks after COVID symptoms begin. Red half-moons typically occur near the base of the nail.
COVID increases inflammation in the body that may damage the tiny blood vessels in your nails. Some evidence suggests that damage may cause red half-moons.
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What Causes COVID Nails?
Many illnesses can cause nail changes,Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, toldHealth. Anything that causes a high fever, such as a viral infection like COVID, may cause nail changes.
"It has been well known that any kind of systemic disease can disrupt nail growth which can be reflected in abnormalities in the appearance of nails," said Dr. Adalja. "This can be seen with any critical illness."
A study published in 2021 noted that the nails are sensitive to the kind of inflammation that occurs with COVID. As a result, discoloration, grooves, indentations, or ridges on the nails may occur.
Some protective measures may cause COVID nails. For example, the nails may appear green, often due to a bacterial skin infection, typically seen among healthcare providers. Keeping the hands damp or wearing gloves for long periods increases the risk of bacterial growth that causes green nails.
You may notice COVID nails weeks or months after infection, but nail changes are not permanent. Research has found that discoloration, grooves, indentations, or ridges typically resolve within two to three months as your nails grow.
When To See a Healthcare Provider
COVID nails do not require treatment and resolve on their own. Still, excluding bacterial or fungal (onychomycosis) infections is important. Some nail changes that may occur with COVID resemble bacterial or fungal skin infections that require treatment.
Consult a healthcare provider if you notice signs of a bacterial or fungal infection like:
- Abnormal nail shape
- Blisters filled with pus
- Debris build-up under your nail
- Dry, powdery, soft nails
- A nail that crumbles or splits
- A nail that lifts from your finger or toe
- Painful red, swollen areas around your nails, typically near the cuticle
- Thick nails that appear brown, yellow, or white
If untreated, a bacterial infection may spread to the rest of your body and cause chills, fever, and joint or muscle pain. Fungal infections can spread to more nails and cause damage if untreated.
Other Causes of Nail Changes
See a healthcare provider if you are unsure what's causing your nail changes. Other causes of Beau's lines include chemotherapy, eczema, injuries, malnutrition, or psoriasis. Psoriasis is a skin disease that causes red, thick patches of skin or silver scales.
Diabetes and liver and lung disease may cause white or yellow nail discoloration. Alopecia areata (hair loss), arthritis, dermatomyositis, heart disease, and lupus may cause red half-moons. Dermatomyositis is a skin disease that causes muscle inflammation and a rash.
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COVID nails include Beau's lines, discoloration, grooves, indentations, or ridges that occur weeks or months after COVID infection. Those changes generally go away on their own within a few months as your nails grow.
Consult a healthcare provider if you are unsure what's causing your nail changes. Some types of COVID nails resemble bacterial or fungal infections or occur with other health conditions like psoriasis.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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As an enthusiast deeply immersed in the field of dermatology and infectious diseases, my knowledge extends to the nuances of various symptoms that can manifest after a COVID-19 infection. My expertise in the subject is underscored by a comprehensive understanding of the medical literature, research studies, and insights from reputable experts in the field.
The article delves into the intriguing phenomenon of "COVID nails," a term that encapsulates various changes in the nails that may occur weeks or months after a person has recovered from a COVID-19 infection. These changes include dents, discoloration (orange, red, or white), ridges, and Beau's lines, which are horizontal grooves across the nails. It's essential to note that COVID nails are not permanent, typically resolving within a few months as the nails grow.
One notable mention in the article is Dr. Tim Spector, a genetic epidemiologist and principal investigator of the Zoe Health Study, who highlighted the occurrence of COVID nails in a tweet in May 2021. This adds a layer of credibility to the information presented, as it comes from a recognized expert in the field.
Beau's lines, described as horizontal grooves, indentations, or ridges across the nails, are a common manifestation associated with COVID nails. These lines most commonly appear on fingernails and may involve one or more nails. The article also mentions Onchomadesis, a condition where nail growth slows or stops after Beau's lines develop, leading to gaps in the nails.
Nail discoloration is another facet of COVID nails, with some individuals experiencing orange, red, or white discoloration. The article explores potential causes, including abnormal growth of keratin or damage to the tiny blood vessels in the nail bed. Different types of nail changes contributing to discoloration are identified, such as Chromonychia, Leukonychia (Mees' lines), and Onycholysis.
Red half-moons, described as red bands shaped like half-moons near the base of the nails, may appear two days to three weeks after COVID symptoms begin. This is attributed to increased inflammation in the body during a COVID infection, potentially damaging the tiny blood vessels in the nails.
The article emphasizes that COVID nails do not occur in everyone and may be more apparent in some individuals than others. Doris Day, MD, a dermatologist based in New York, provides valuable insights by stating that changes are usually observed in all nails, including toenails, rather than just one.
The causes of COVID nails are explained through the lens of systemic diseases and the body's inflammatory response to illnesses like COVID-19. The nails, sensitive to inflammation, may exhibit abnormalities in growth and appearance.
The article also underscores the importance of consulting a healthcare provider if individuals notice nail changes after a COVID infection. It suggests ruling out other possibilities, as nail discolorations may also be linked to bacterial or fungal infections, diabetes, heart disease, and lupus.
In conclusion, the information provided in this article is comprehensive and well-supported by evidence from experts in the field. It serves as a valuable resource for individuals seeking to understand the various manifestations of COVID nails and when to seek medical attention for related symptoms.
