What Does A Purple Fingernail Mean?

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A poerson holding his hand with a black fingernail on his thumb with the title "What Does it Mean to Have a Purple Fingernail?"

If “the eyes are a window to the soul” then your fingernails may be a window into your health. The condition of your nails can give an insight into the health of your heart, lungs, circulatory system and more. However, we don’t usually pay any attention to them until something goes wrong – like a purple fingernail

Surprisingly there are a lot of different reasons why one or more of your fingernails can appear purple. I’m going to outline the most common ones and let you know the warning signs to look out for. Read on to find the answer to the question “what does a purple fingernail mean?”

The Basics of Fingernail Health

Before I begin, I must point out that everything I mention here about fingernails also applies to your toenails. They are essentially the same and both provide insight into your total body health.

Your fingernails are made of layers of keratin. Keratin a strong and flexible protein also found in our hair. New nail growth comes from the white “half moon” area just under the cuticle.

Healthy finger and toenails will always be pinkish in colour, depending on your particular skin tone. Your nails should be smooth, uniform in color and free of discoloration, pits and grooves. (source)

A change in fingernail colour, texture or strength can be a sign of systemic illness or nutrient deficiency. Usually, by the time your nails are affected, chances are you will have other symptoms too. (source) Of course your health state is best determined by a healthcare professional, but here are a few things to consider when you notice one or more purple fingernails.

What Does A Purple Fingernail Mean?

If you have just one purple nail and the rest look perfectly healthy, it’s not likely to be a sign of systemic illness. A purple fingernail is usually a result of an infection or injury in the nail or close by. Let’s look at some of these cases in more detail:

1. Injured Nail

If you’ve caught your finger in a door or dropped something heavy on your toe, chances are it’s turned purple as a result of broken blood vessels beneath the nail. This stops the blood from flowing naturally in the area and is called a “subungual haematoma”.

In other words, it’s just a bruise under your nail and is nothing to worry about. It will heal in a week or two. (source) If the nail is severely painful or swollen and you can’t move the finger or toe, it could be broken so you’ll need to see a doctor in that case.

2. Infected Nail

Especially if you get manicures or pedicures regularly, your purple nail could be caused by infection. You will also notice swelling around the nail, throbbing pain and possible leakage of clear fluid or pus. You are also at risk for infection if you pick at or cut your cuticles.

Infection can become severe so if it doesn’t improve in a few days or seems to be getting worse, you need to see a doctor and most likely take antibiotics. Always use licensed nail salons and make sure tools are sterilized before use. (source)

3. Nail Fungus

Nail fungus is not usually purple – it’s more likely to be yellow, brown or black, but we can’t rule it out in this case. If your purple nail is accompanied by the following symptoms it could be caused by onychomycosis i.e. toenail fungus.

  • Thickened nail
  • Brittle nail
  • No pain but may be itchy
  • Scaly skin next to the toenails
  • No pain, usually

Unfortunately toenail fungus can be quite hard to get rid of, so nip it in the bud quickly and head to your local pharmacy for an antifungal treatment. (source)

What If All Of Your Nails Are Purple?

So we’ve discussed the most common causes if one of your nails is purple. What if they all are? This is usually related to your blood circulation. Fingers and toes are “extremities”, i.e. the furthest body parts from your heart. This can make it hard for blood to reach them efficiently.

A person holding her hand in seeming pain.

When fresh blood doesn’t reach your extremities, it can lead to a bluish discoloration. Fresh blood supplies a lot of oxygen. Oxygen makes your blood appear red – with low oxygen, your blood appears blue. You may also notice a feeling of “pins and needles” if you have poor blood circulation to your extremities. Let’s look at some of the causes for purple fingernails.

1. Cold Weather

Cold weather can constrict your blood vessels as your body tries to trap heat inside. This slows blood flow temporarily, leading to bluish skin in the fingers and toes. It’s more common for females than males and will always return to normal quite quickly once you warm up. (source)

2. Smoking

Yet another reason to stop smoking – it causes poor circulation depriving your extremities of oxygen and causing purple fingernails. (source)

3. Anaemia

Iron deficiency is called anaemia. If you are anaemic, it means your blood doesn’t transport oxygen as efficiently, leading to a bluish purple colour in the fingernails.

If you have this symptom, your anaemia is probably quite severe so you should have a blood test immediately to determine the right level of iron supplement. You should also boost your vitamin C intake to increase iron absorption. (source)

4. Severe Anxiety

If you suffer from severe anxiety or panic attacks, it can affect your circulation. Moments of high stress invoke the primal “fight or flight” response. In anticipation of “flight” your body directs blood to your heart and leg muscles and away from non-critical areas such as fingers and toes. Your fingers should turn back to normal when the anxiety has resolved. (source)

5. Raynaud’s Disease

Raynaud’s disease is a disorder of the blood vessels in the hands, feet and other extremities. It causes your veins to spasm and block blood to your extremities particularly during stress or exposure to the cold.

During an attack you can feel cold, numb, your fingers and toes may throb and tingle and your fingernails will turn from white to bluish purple to red. You will need to see a doctor to confirm diagnosis of Raynaud’s disease. (source)

6. Heart and Lung Problems

In rare cases, purple nails can be a sign of a problem with the heart or lungs. You will most likely have additional symptoms such as shortness of breath, chest pain or palpitations. (source)

Some examples of conditions causing purple fingernails are: asthma, polycythemia, emphysema, chronic obstructive pulmonary disease, chronic bronchitis and overdose of drugs (e.g. narcotics, benzodiazepines). (source)

What To Do About A Purple Fingernail

Unless the problem is clearly due to temporary issues such as mild injury or cold weather, you need to see your doctor to check for a systemic illness. If your doctor says it’s nothing to worry about, you can try the following tips to improve circulation.

Heat and massage are great for increasing circulation to your extremities. If you suffer from cold hands, try squeezing a small rubber ball periodically. (source)

Exercise is another way to keep your heart healthy and your blood flowing. Try to get 30 minutes 5 times a week and you may notice the problem disappear. (source)

Conclusion

As you can see, a purple fingernail can mean so many different things. Most are harmless but some can be quite serious so never put off visiting a health professional if the condition doesn’t resolve. As I always say – it’s better to be safe than sorry!

References: 1, 2, 3, 4

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