Nail Pitting: Causes, Links to Health Conditions, and What to Do

When you notice small dents or pits in your fingernails or toenails, it’s easy to brush it off as bad manicures or aging. But nail pitting, a condition where the nail surface develops tiny depressions or holes. Also known as nail lacunae, it’s often a visible clue that something deeper is going on in your body. This isn’t just about appearance—it’s a signal your skin, immune system, or even your joints might be reacting to something.

Nail pitting is most commonly tied to psoriasis, a chronic autoimmune condition that speeds up skin cell growth. Up to half of people with psoriasis develop pitted nails, sometimes before any skin rash shows up. It’s also linked to eczema, a skin inflammation disorder that causes dry, itchy patches, and even alopecia areata, an autoimmune disease that causes patchy hair loss. These aren’t random connections—they’re all conditions where the immune system attacks healthy tissue, including the nail matrix where nails form.

It’s not always autoimmune. Fungal infections can mimic pitting, especially if the nail looks thickened or discolored too. Trauma, like repeated tapping or biting, can cause similar dents—but those usually heal once the pressure stops. The real concern is when pits appear without clear cause, especially if they’re deep, widespread, or come with other symptoms like joint pain, scalp flakes, or hair loss. That’s when you need to look beyond the nail and check what’s happening inside.

What you’ll find in the posts below are real, science-backed discussions about how nail changes connect to larger health patterns. You’ll see how conditions like psoriasis don’t just show up on the skin—they show up on the nails. You’ll learn why some medications can worsen nail texture, and how to tell the difference between harmless wear and a red flag. There’s no fluff here—just clear links between what you see on your fingers and what’s happening in your body.