COVID nails are a possible symptom that may occur and persist weeks or months after COVID-19 infection, but what do COVID nails look like? Those changes may consist of dents, orange, red, or white discoloration, ridges, or Beau's lines—horizontal grooves across your nails. COVID nails are not permanent and typically resolve within a few months as your nails grow.
Consider seeing a healthcare provider if you notice nail changes after COVID infection to rule out other possibilities. Other causes of nail discolorations may include bacterial or fungal infections and health conditions like diabetes, heart disease, and lupus.
Read on to learn about COVID nails, if they are something to worry about, and what other factors may cause them.
In May 2021,Tim Spector, MD, a genetic epidemiologist and principal investigator of the Zoe Health Study, tweeted about the phenomenon and included a photo of COVID nails.
"Do your nails look odd? COVID nails are increasingly being recognized as the nails recover after infection and the growth recovers, leaving a clear line. Can occur without skin rashes and appears harmless," wrote Spector.
COVID nails do not necessarily happen to everyone, and it's more apparent in some people than others.
"Some people don't see it in the nail because it's not so obvious,"Doris Day, MD, a dermatologist based in New York, toldHealth. You will usually see changes in all of your nails—and possibly even your toenails—rather than just one nail.
Beau's Lines
Beau's lines run horizontally across your nails that can look like grooves, indentations, or ridges, said Dr. Day. Beau's lines most commonly involve the fingernails and may occur on one or more of your nails. You may also notice white discoloration.
Beau's lines typically occur a few weeks after injury to the nail. Some evidence suggests that people with COVID may develop Beau's lines weeks to months after infection.
Onchyomadesis may occur after Beau's lines develop. Onchomadesis happens when your nail slows or stops growth, causing gaps in your nails.
Nail Discoloration
Some people with COVID notice orange, red, or white discoloration on their nails. Researchers do not know exactly what causes nail discoloration with COVID. Some evidence suggests that abnormalgrowth of keratin (a protein that makes up your nails)or damage to the tiny blood vessels in your nail bed may be the culprit.
Different nail changes that may cause discoloration include:
- Chromonychia:Research has identified some cases of COVID that involve orange discoloration near the top of the nails. Chromonychia may develop as long as four months after COVID infection and has typically occurred in older adults with anemia or sarcopenia (muscle loss).
- Leukonychia: Also known as Mees' lines, this looks like white spots or streaks on your nails that resolve as your nails grow.
- Onycholysis: This is red-white discoloration of the nails. Research has found that onycholysis has occurred in some cases of COVID about four months after infection.
Red Half-Moons
These are red bands, shaped like half-moons, that may appear across your nails about two days to three weeks after COVID symptoms begin. Red half-moons typically occur near the base of the nail.
COVID increases inflammation in the body that may damage the tiny blood vessels in your nails. Some evidence suggests that damage may cause red half-moons.
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What Causes COVID Nails?
Many illnesses can cause nail changes,Amesh Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, toldHealth. Anything that causes a high fever, such as a viral infection like COVID, may cause nail changes.
"It has been well known that any kind of systemic disease can disrupt nail growth which can be reflected in abnormalities in the appearance of nails," said Dr. Adalja. "This can be seen with any critical illness."
A study published in 2021 noted that the nails are sensitive to the kind of inflammation that occurs with COVID. As a result, discoloration, grooves, indentations, or ridges on the nails may occur.
Some protective measures may cause COVID nails. For example, the nails may appear green, often due to a bacterial skin infection, typically seen among healthcare providers. Keeping the hands damp or wearing gloves for long periods increases the risk of bacterial growth that causes green nails.
You may notice COVID nails weeks or months after infection, but nail changes are not permanent. Research has found that discoloration, grooves, indentations, or ridges typically resolve within two to three months as your nails grow.
When To See a Healthcare Provider
COVID nails do not require treatment and resolve on their own. Still, excluding bacterial or fungal (onychomycosis) infections is important. Some nail changes that may occur with COVID resemble bacterial or fungal skin infections that require treatment.
Consult a healthcare provider if you notice signs of a bacterial or fungal infection like:
- Abnormal nail shape
- Blisters filled with pus
- Debris build-up under your nail
- Dry, powdery, soft nails
- A nail that crumbles or splits
- A nail that lifts from your finger or toe
- Painful red, swollen areas around your nails, typically near the cuticle
- Thick nails that appear brown, yellow, or white
If untreated, a bacterial infection may spread to the rest of your body and cause chills, fever, and joint or muscle pain. Fungal infections can spread to more nails and cause damage if untreated.
Other Causes of Nail Changes
See a healthcare provider if you are unsure what's causing your nail changes. Other causes of Beau's lines include chemotherapy, eczema, injuries, malnutrition, or psoriasis. Psoriasis is a skin disease that causes red, thick patches of skin or silver scales.
Diabetes and liver and lung disease may cause white or yellow nail discoloration. Alopecia areata (hair loss), arthritis, dermatomyositis, heart disease, and lupus may cause red half-moons. Dermatomyositis is a skin disease that causes muscle inflammation and a rash.
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COVID nails include Beau's lines, discoloration, grooves, indentations, or ridges that occur weeks or months after COVID infection. Those changes generally go away on their own within a few months as your nails grow.
Consult a healthcare provider if you are unsure what's causing your nail changes. Some types of COVID nails resemble bacterial or fungal infections or occur with other health conditions like psoriasis.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
