Nail Abnormalities - Part 2 (Koilonychia, Clubbing & Onycholysis)


Koilonychia is also known as spoon nails, which are ‘thin and soft and shaped like a little spoon that capable of holding a drop of water’. Koilonychia often appears on fingernails, but they can also develop on your toenails. Koilonychia can affect one or many nails. 

The most common cause of Koilonychia is iron deficiency, or anemia, ‘which makes your level of red blood cells lower than normal’. Iron deficiency is mostly seen among children and women of childbearing age. Here’re a few reasons that can lead to an iron deficiency: 

  • Consume too little iron 
  • Inability to absorb iron from food 
  • Malnutrition 
  • Bleeding in the intestinal tract 
  • Cancer 
  • Celiac disease 
  • People with Plummer-Vinson syndrome 

People who live at higher altitudes may also have a higher risk of developing Koilonychia. This is because the air at higher evaluations contains less oxygen, so this prompt our bodies to produce extra red blood cells in order to maintain a normal oxygen level. It needs extra iron to do this, and this can leave our bodies short of iron. 

Another cause of Koilonychia comes from frequent exposure to petroleum solvents or detergents. This makes a certain jobs more prone to developing Koilonychia, for example, hair stylists, who may frequently work with hair products that contain petroleum, or cleaners, who often exposed to detergents. 

Koilonychia can also occur as a results of some genetic conditions, for example ‘hemochromabtosis or nail-patella syndrome’

Other health conditions that are linked to Koilonychia are: chemotherapy, radiation therapy, diabetes, heart disease, hemochrombtosis, lupus, protein deficiency, psoriasis, Raynaud’s syndrome, thyroid disorders, vitamin B deficiency. 

To prevent Koilonychia, start eating more iron-rich food, for examples red meat, pork, poultry, seafood, beans, leafy vegetables, peas and dried fruits, such as raisins and apricot. 

If you developed Koilonychia, please go see your doctor for accurate diagnosis of the underlying health conditions and appropriate treatment plans. 


Nail clubbing refers to changes in the structure of fingernails or toenails. These changes can include: 

  • Widening and increased roundness of your nails
  • Increased angle between your cuticles and nails 
  • Downward curving of your nails 
  • Nails may become sponge-like and soft 
  • Budging of the tip of your fingers or toes, which may be accompanied by redness or warmth 

Causes to nail clubbing are not fully understood. However, there’s a variety of underlying lung issues, many of which are serious, that can lead to the development of nail clubbing; they are lung cancer, cystic fibrosis, pulmonary fibrosis, bronchiectasis and asbestosis. 

Clubbing can also be a symptom of other diseases and disorders, such as, Hodgkin’s lymphoma, heart defects (e.g. tetralogy of Fallot), overactive thyroid gland (e.g. Graves’ disease), inflammation of your intestines (e.g. Crohn’s disease) and liver disease. 

If you developed clubbing on your nails, talk to your doctor to find out the associated medical conditions, and appropriate treatment plans. 

However, there’re a few steps you could take to prevent nail clubbing in the first place: 

  • Avoid tobacco smoke, and limit your exposure to toxins to reduce your risk of having lung cancer 
  • Get vaccinated against measles and whooping cough to lower your chance of having bronchiectasis 
  • Put on protective equipment to avoid inhaling asbestos toxin (that cause asbestosis), which is used a lot in the construction industry and the textile industry 


Onycholysis happens when the nails seperate from its pink nail bed. When Onycholysis happens, the affected nail can become white, grey, yellow, green or purple depending on the original cause. 

Onycholysis can last for several months, until a new nail grows to replace the old one, then the symptoms should resolve. In this case, fingernails take around 4-6 months to fully regrow, and toenails can take up to 12 months. 

Injury to the nails can cause Onycholysis. Some examples of nail injury are slamming a finger in a car door, stubbing a toe, or repetitively tapping or drumming of the fingernails. 

Other typical causes of Onycholysis include: 

  • an allergy to nail polish, nail polish removers or household chemicals 
  • Fugal infections 
  • Reaction to a systematic medication 

Onycholysis can also develop as a symptom of underlying health problems, including a severe yeast infection, thyroid disease, vitamin and mineral deficiencies. 

The first step in treating Onycholysis is to determine what is causing the nail to lift. 

If Onycholysis arose as a result of fungal infections, then it will require antifungal medication to heal the underlying infection. 

Thyroid issues that cause Onycholysis often require medication that help regulate hormone production. 

Onycholysis that originates from vitamin and mineral deficiency can be treated with dietary changes. 

Further sources you can read from 

Spoon Nails: Identifications, Causes, and More - Healthline 

Koilonychia: Why Are My Nails Spoon Shaped? - Medical News Today 

Why Do Fingers Or Toes Start Clubbing - Healthline 

An Overview of Nail Clubbing - Verywell Health

Onycholysis: Treatments For Detached Nails - Medical News Today 

Onycholysis: Causes, Symptoms, and Treatments - Healthline 

If you need advice on nail abnormalities, reach out to one of our nail technicians at The Nail Bar. We're more than happy to help you out!


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