Nails: The Final Stop En Route to a Complete Hair Examination

When I examine a patient’s hair, I generally examine the nails too.  Hair and nails are closely related in terms of their constituents and rely on similar nutrients for growth. In fact, I often tell my patients that hair and nails are like “cousins” and a lot can be learned by looking at the nails. 

For example, patients with the autoimmune hair loss condition alopecia areata may have changes in the nails, with the most common change being nail “pitting” or little dents in the nails. Patients with a rare scarring hair loss condition known as lichen planopilaris may also have lichen planus of the nails. Patients with hair loss from severe iron deficiency may have spoon shaped nails – a phenomenon known as koilonychia. The list goes on and on and these are three examples.

A close inspection of the nails can often reveal incredibly useful information about an individual’s hair and the cause of their hair loss.  The opportunity should not be missed.