Beau's Lines: Causes and Concerns for Your Toenails - Dermatology

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Is this the Boas line?


I recently noticed that the toenails on both my big toes have suddenly developed a concave shape in the middle, but it seems to be growing lower from the area where the nails grow.
I found a reference online that resembles Beau's lines, but it doesn't seem as severe since it's only affecting two toes.
I'm unsure if this is serious.
If it is due to nutritional deficiencies, what might I be lacking? I've also read that nail indentations can be caused by stress, so I'm uncertain whether I should be concerned about this.
Thank you!

ia, 20~29 year old female. Ask Date: 2007/08/22

Dr. Zhang Zhibo reply Dermatology


Hello: Your question pertains to whether the horizontal grooves or pitted depressions in the nails have different underlying causes.
Beau's lines are horizontal grooves that occur due to a sudden illness or significant physiological stress that halts the growth of the nail matrix.
Therefore, to determine the exact cause, a detailed medical history and examination are necessary.
If the cause is systemic, all nails may be affected; if it is localized, it may only impact one or a few nails.
Additionally, if pitted depressions are present, consider the following: 1.
Nail biting (trauma) 2.
Periungual tumors 3.
Psoriasis 4.
Fungal infections of the nails, among others.
Nails are composed of proteins and a small amount of minerals, and a balanced diet should not lead to pathological changes.
Furthermore, there is limited scientific research on the relationship between stress and nail growth, so it is unclear whether stress leads to dietary imbalances in essential nutrients or if immune cells are damaging the nail matrix.
In summary, if the condition of the nails (or toenails) does not improve after three months (or six months), it is advisable to seek medical attention promptly.

Reply Date: 2007/08/22

More Info


Beau's lines are transverse grooves or indentations that can appear on the nails, often indicating a temporary interruption in nail growth. These lines can be caused by various factors, including trauma, severe illness, nutritional deficiencies, or significant stress. When you notice these lines on your toenails, particularly if they appear suddenly, it can be concerning, but understanding the underlying causes can help you determine the appropriate course of action.

In your case, the appearance of Beau's lines on your big toes may not necessarily indicate a severe problem, especially if they are only present on those two nails. However, it is essential to consider the potential causes. If you have experienced any recent trauma to your toes, such as stubbing them or wearing tight shoes, this could lead to temporary changes in nail growth. Additionally, if you have been under significant stress or have had an illness, this could also contribute to the development of these lines.

Nutritional deficiencies can also play a role in the health of your nails. Common deficiencies that may affect nail growth include a lack of biotin, zinc, iron, or protein. If you suspect that your diet may be lacking in these essential nutrients, it would be beneficial to evaluate your eating habits and consider incorporating more nutrient-rich foods. Foods high in biotin include eggs, nuts, and whole grains, while iron can be found in red meat, leafy greens, and legumes. Zinc is abundant in shellfish, meat, and seeds, and protein can be sourced from various foods, including dairy, meat, and legumes.

Stress is another significant factor that can impact nail health. High levels of stress can lead to various physical manifestations, including changes in nail growth. If you have been experiencing increased stress, it may be helpful to explore stress management techniques such as mindfulness, exercise, or talking to a mental health professional.

While Beau's lines can be benign, it is essential to monitor their progression. If you notice that the lines are worsening, spreading to other nails, or if you experience other symptoms such as pain, discoloration, or changes in the texture of your nails, it would be wise to consult a healthcare professional. They can perform a thorough examination and may recommend blood tests to check for nutritional deficiencies or other underlying health issues.

In summary, while the appearance of Beau's lines on your toenails can be concerning, they are not always indicative of a severe problem. Factors such as trauma, stress, and nutritional deficiencies can contribute to their development. By evaluating your diet, managing stress, and monitoring your symptoms, you can take proactive steps to address any potential issues. If you have ongoing concerns or if the lines persist, seeking medical advice is always a prudent choice.

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