If your nails look as though someone pressed a pin into them in a few places, that is nail pitting. The dents are small and shallow, and they form because the area that builds the nail is briefly disrupted. The most common reason behind them is psoriasis, often before any obvious patch shows up on the skin.
This page covers what pitting means, the conditions it travels with, and when those little dents are worth a closer look. You can scan your nails to track whether the pitting is spreading or settling.
What pitting is
Pits appear when the top of the matrix, the part that shapes the upper layer of the nail, makes flawed cells for a short time. Those weak spots break away as the nail grows, leaving a shallow depression. You might see a handful of pits or dozens, on one nail or many.
The main cause: psoriasis
Psoriasis is the headline link. In people with the condition, the nails are involved a large share of the time, and pitting is one of the earliest signs. What surprises people is that nail changes can show up before the familiar skin plaques, so clear skin does not rule it out.
Other causes
Pitting is not only about psoriasis. It also shows up with:
- Eczema affecting the hands and nail folds
- Alopecia areata, a form of patchy hair loss
- Reactive arthritis and some other inflammatory conditions
- Occasionally no identifiable cause at all
The pattern and the company it keeps, such as skin or joint symptoms, help point to the reason.
What it means for you
A few shallow pits with no other symptoms is usually a minor cosmetic issue. The more useful question is what else is going on. Itchy, scaly skin patches suggest psoriasis or eczema. Patchy hair loss raises alopecia areata. Joint pain or morning stiffness is the one to flag promptly, because nail psoriasis can accompany psoriatic arthritis, and early treatment protects the joints.
When to see a doctor
Make an appointment if:
- Pitting comes with joint pain, swelling, or stiffness
- You also notice scaly skin patches or patchy hair loss
- Many nails are affected, or the nails are thickening or lifting
- The change is spreading or bothering you cosmetically and you want options
Frequently asked questions
What does nail pitting indicate?+
Most often psoriasis, even when your skin looks clear. Eczema and a form of hair loss called alopecia areata are the next most common links.
Can nail pitting go away?+
It can improve when the underlying condition is treated, but because the dents form at the base, the nail has to grow out before the surface looks smooth again.
Is nail pitting serious?+
On its own it is usually not urgent. Pitting with joint pain or stiffness deserves a check, since nail psoriasis can travel with psoriatic arthritis.
Related
Sources
- Cleveland Clinic, Nails and your health
- MedlinePlus, Nail abnormalities
This article is for general education and is not medical advice. It does not replace a consultation with a qualified clinician. If a symptom worries you, see a doctor.