We Ask a Derm: What is Nail Pitting (And Is It Serious)?

We’ve all broken a nail or two from tearing through an Amazon box or experienced some mild peeling after mindlessly picking off a gel manicure during a meeting, but if you’re noticing small indentations on your nails, you may have a case of nail pitting.

As Dr. Ted Lain, a board-certified dermatologist and chief medical officer at Sanova Dermatology explains: “With nail pitting, the indentations are very small—think less than one millimeter in diameter. These little divots are typically an indicator that there’s a problem with the nail matrix, which is the collection of cells just behind the nail that are responsible for making them grow.”

“Usually, it’s an inflammatory skin condition that may lead to pitting of the nails,” says Lain. “It is most often associated with psoriasis but can also be found with other skin or hair conditions, like eczema,” he adds.

Note that in addition to the pitting, you may also notice other symptoms like flaking, crumbling or yellowing of the nails. And, not to alarm you, but in some cases, psoriasis can also cause nails to thicken or lift from the nail beds, which is called onycholysis.

“Mechanical damage to the nail, either from improper fake nail or gel polish removal, or from trauma, often appears as nail splitting, white spots on the nail, or a thickening of the edge of the nail, whereas the pitting looks like tiny little dents,” explains Lain. “Also, mechanical damage involves an injury to the nail after it has already formed, whereas pitting develops during the growth process,” he adds.

If you notice some pitting on your nails, don’t ignore it. See a board-certified dermatologist who can properly diagnose and prescribe treatments that can clear up the symptoms, reduce any associated pain and prevent the situation from getting worse.

Some common treatments that are prescribed include topical or oral medications, laser treatments or receiving steroid injections directly into or near the affected nails.

A final word: Clearing up nail pitting is a long game. Just as nails grow slowly, the treatments may take several months before you see results and you may need to try a few different treatments before you find the one that works for you.

In the meantime, keep your nails short to prevent them from lifting or getting buildup underneath them. It’s also good to wear gloves whenever you’re doing any type of manual work around the house like doing the dishes, cleaning or yard repairs. You want to keep your nails as clean and dry as possible to reduce chances of infection or further flare-ups.