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9 Common Nail Disorders in Children

Kristie Rivers, MD, FAAP, Board Certified Pediatrician
January 3, 2019 . 2 min read

Nail disorders are common among infants and children. Usually these are simply a cosmetic problem and no need for concern. Here are a few of the most commonly seen disorders:

1. Beau’s lines. These appear as indentations that run across the nails. In infants, these lines are commonly seen after birth. In older children they can be seen after a high fever or uncommonly, can be a sign of zinc deficiency.

2. Koilonychia (spoon nails). These nails have a soft texture and appear scooped out, due to the thin, soft nature of a young child’s nails. They often occur on thumbs and big toes. Uncommonly, koilonychias has been linked to iron deficiency.

3. Onycholysis. In this condition, a fingernail becomes separated from the nail bed. In children, this is usually due to trauma but can sometimes be seen with autoimmune diseases as well.

4. Onychoschizia. The ends of the fingernails become frayed and split in this common condition. Commonly seen in the first few years of life, onychoschizia is usually present on the thumbs and big toes and thought to be due to repeated trauma, thumbsucking, and nail biting.

5. Onychomadesis. Typically in this condition, all of the nails will separate from the nail bed at the cuticle and peel off completely. These shedding nails can be associated with viral infections, particularly hand, foot, mouth disease, measles, and Kawasaki disease, or any other infection that causes a high fever.

6. Paronychia. This is due to an infection that occurs on or near the edge of the nail. Symptoms include redness, swelling, and a puss filled area in the corner of the nail.

7. Leukonychia. Seen as white spots on the fingernails, these areas are thought to be caused by minor trauma and are not a sign of excessive vitamin or mineral intake as commonly believed.

8. Onychomycosis. A common fungal infection in adults, this condition is much less common in children and is notoriously difficult to treat.

9. Nail pits. Small pinpoint indentations in the nail bed may be a normal finding in infants and young children.

Uncommonly in children, nail disorders can indicate an underlying disease such as psoriasis, connective tissue disorders, or autoimmune diseases. If your child’s nails concern you, be sure to see a pediatrician or pediatric dermatologist for reassurance and guidance.


  • Mayo Clinic
  • 7 fingernail problems not to ignore.

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