Koilonychia or Spoon Nails: Causes, Symptoms, Treatment, Prevention

What is Koilonychia or Spoon Nails?

Koilonychia is a condition where the nails do not develop normally and are very thin and concaved with raised edges. Due to the concavity of the nails, they are also known as “spoon” nails. Other than the concavity, koilonychia also affects the texture, color, shape and thickness of the nails. Koilonychia can affect both fingernails as well as toenails. Koilonychia is quite a common nail abnormality where the nail plate that normally has a convex contour becomes concave in the center with upturned or raised lateral and distal margins. In Koilonychia, nails also become very brittle and thin.

There are many causes for Koilonychia or Spoon Nails, among which, one of them can be genetic. Iron deficiency anemia can cause acquired koilonychia. The affected nails in koilonychia take a long time to get back to their normal appearance. Koilonychia or Spoon Nails.

What is Koilonychia or Spoon Nails?

Causes of Koilonychia or Spoon Nails

Some of the causes of Koilonychia or Spoon Nails include:

  • Iron deficiency anemia is one of the causes of Koilonychia.
  • This condition can also be congenital.
  • The cause could be genetic.
  • Problems with digestion and absorption.
  • Inability to digest nutrients.
  • Chronic rubbing of nails and chronic nail polish can also cause Koilonychia or Spoon Nails.
  • Direct injury or trauma to the nail can also result in Koilonychia or Spoon Nails.
  • It can occur from impaired peripheral circulation.
  • Inadequate nutrients intake from unbalanced diet.
  • Musculoskeletal conditions can also cause Koilonychia.
  • Thyroid dysfunction can also cause Koilonychia or Spoon Nails.
  • Renal disease can also lead to spoon nails.
  • Systemic lupus erythematosus can also cause Koilonychia.
  • Nail Patella Syndrome can also lead to Koilonychia.
  • Raynaud’s disease can also cause Koilonychia.
  • Hypoplastic patella can also cause Koilonychia.
  • Contact dermatitis from petroleum-based solvents can also cause development of Koilonychia.
  • Excessive use of nail polish, oil or soap can also cause Koilonychia.

Common Causes of Infected Koilonychias are:

Signs & Symptoms of Koilonychia or Spoon Nails

  • As mentioned before, one of the symptoms of koilonychias is that the nails have a concave middle and appear as “spoon shaped.”
  • In Koilonychia or Spoon Nails, the nail plates become soft and brittle with thinning.
  • There can also be detachment of the nails. In some cases, the nails can come off completely.
  • Pain is felt if the nail gets detached from the nail bed or if there is an active infection present.
  • There is discoloration seen under the nail due to secondary infection.
  • Signs of malnourishment can be seen in the person affected with Koilonychia or Spoon Nails.
  • The nails have embossed edges.
  • Koilonychia or Spoon Nails can also indicate iron deficiency anemia.
  • Koilonychia or Spoon Nails can also be seen with Plummer-Vinson syndrome.

Koilonychia or Spoon Nails can be an indication of iron deficiency anemia and needs to be treated as soon as diagnosed. Even if the Koilonychia or Spoon Nails occurs from any nail trauma, chronic rubbing, picking the skin under the nail, chronic nail polish use etc., it needs immediate treatment and cannot be ignored.

Diagnosis of Koilonychia or Spoon Nails

Koilonychia or Spoon Nails can be diagnosed easily upon visual inspection of the nails. For diagnosing Koilonychia, “water test” can be done where after a drop of water is dripped on the nail, it does not spill, but stays in the concave indention of the nail.

Treatment of Koilonychia or Spoon Nails

As soon as diagnosis of Koilonychia or Spoon Nails is made, treatment needs to be started immediately. Treatment also depends on the cause and treating the cause resolves Koilonychia. If the cause is iron deficiency anemia, then iron supplements are prescribed, which need to be taken about half an hour before meals. Iron supplements should not be taken with tea or coffee, as they can hinder with iron absorption.

Preventing Koilonychia or Spoon Nails

  • For Koilonychia or Spoon Nails which occurs as a result of ingrown toenails, proper footwear should be worn so that the toes do not crowd together. It is also important to cut the toenails straight across the top.
  • Diet which is rich in vitamins and iron should be followed.
  • Iron supplements should be taken as prescribed by the doctor to avoid iron overload.
  • Always wear gloves when doing gardening, dishes or when there is any exposure of the nails to harsh chemicals.
  • A skin softening cream should be used after washing or bathing for optimal nail heath.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 19, 2017

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