Red Vertical Lines on Nails: When to See a Doctor for Dizziness?

If you are experiencing a large number of red longitudinal lines on your nails that resemble bruising, along with dizziness, you should consult a specialist in dermatology for the nail symptoms and possibly a hematologist for the dizziness and any underlying blood-related issues?

The issue with my nails has been present for three months, but there hasn't been much discomfort, just a bit of fatigue.
However, since I woke up last week and noticed a large number of red vertical lines on my nails, I have started to feel dizzy and lightheaded when walking.
It seems that as soon as the red lines diminish a little, the dizziness lessens.
I would like to ask the doctor if this is simply a skin issue or if it could be caused by something else.
If I need to see a doctor, should I choose a dermatologist or a family medicine physician?

Xiao Ting, 20~29 year old female. Ask Date: 2017/04/11

Dr. Chen Taicheng reply Family Medicine

● The presence of red lines in the nails is most commonly caused by trauma leading to the rupture of microcapillaries beneath the nail.
Other less common causes include infective endocarditis, psoriasis, and autoimmune diseases.
● If there is a sudden appearance of numerous red lines, it is important to be cautious about potential coagulation disorders.
● It is recommended to consult a dermatologist (some physicians specialize in nail conditions).
For other internal medicine-related issues, you may seek further consultation from family medicine or rheumatology and immunology specialists.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital's Family Medicine Department cares for you~

Reply Date: 2017/04/11

More Info

Red vertical lines on the nails, also known as longitudinal erythronychia, can be indicative of various underlying health conditions. While they may sometimes be benign, their sudden appearance, especially when accompanied by symptoms like dizziness, warrants further investigation.
In your case, the presence of these red lines, particularly after a period of feeling fatigued and then experiencing dizziness, suggests that there may be more than just a superficial skin issue at play. The dizziness you describe, especially if it feels like a sensation of lightheadedness or imbalance, could be related to several factors, including but not limited to:
1. Nutritional Deficiencies: Deficiencies in vitamins and minerals, particularly B vitamins, iron, or vitamin D, can lead to changes in nail appearance and can also cause fatigue and dizziness.

2. Circulatory Issues: Conditions that affect blood flow, such as peripheral vascular disease or other circulatory disorders, can manifest in changes to the nails and may also lead to symptoms like dizziness.

3. Systemic Conditions: Certain systemic diseases, such as autoimmune disorders or infections, can cause changes in the nails and may also present with dizziness as a symptom.

4. Dermatological Conditions: While less common, some skin conditions can affect the nails and may be associated with systemic symptoms.

Given that you have noticed these changes over the past three months and that they have coincided with new symptoms of dizziness, it is advisable to seek medical attention.

When to See a Doctor
You should consider seeing a healthcare provider if:
- The dizziness persists or worsens.

- You experience additional symptoms such as shortness of breath, chest pain, or significant fatigue.

- The red lines on your nails continue to spread or change in appearance.

- You have any other concerning symptoms that arise.

Which Specialist to See
In terms of which specialist to consult, it would be prudent to start with a family medicine physician or a general practitioner. They can conduct a thorough evaluation, including a physical examination and possibly some laboratory tests to check for nutritional deficiencies, blood counts, or other underlying conditions.
If the family physician suspects a dermatological issue, they may refer you to a dermatologist for a more specialized assessment of your nails and skin. Conversely, if they suspect a systemic issue, they may refer you to a specialist in internal medicine or a hematologist, depending on the findings.

Conclusion
In summary, while red vertical lines on the nails can sometimes be benign, their sudden appearance alongside dizziness is concerning and should not be ignored. It is important to seek medical advice to rule out any serious underlying conditions. Starting with a family medicine physician will provide you with a comprehensive approach to diagnosing and managing your symptoms effectively.

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