Tiny Dents in Your Nails
Nail Pitting Causes, Symptoms, Home Remedies & Best Treatment!
Bump Or Lump On Side Of Foot: The Most common cause of a bump on the middle side of your foot is #1) A Bunionette & #2) A 5th metatarsal styloid process.
What causes nail pitting? The most common causes include: #1) toenail and fingernail psoriasis, #2) atopic dermatitis & Others! Remedy & Treat IT At HOME!
What Is Nail Pitting and Why Is It Happening to You?
If you’ve noticed small, pinpoint depressions or dents on the surface of your fingernails or toenails, you may be experiencing nail pitting. This seemingly minor change can actually be an important clue about underlying skin or autoimmune conditions such as psoriasis, eczema, or alopecia areata. While often harmless on its own, nail pitting is worth investigating, especially when paired with other symptoms like discoloration or nail thickening.
Understanding Nail Pitting: Causes and What It Means
Nail pitting occurs when the nail matrix—the tissue under the base of the nail—gets disrupted. This interference affects how the nail grows, leaving behind tiny indentations. The most common causes include:
Psoriasis: A chronic autoimmune skin condition that affects the skin and nails.
Alopecia Areata: An autoimmune disorder that causes hair loss and can also impact nail health.
Eczema (Atopic Dermatitis): Long-term inflammation may affect nail formation.
Lichen Planus: An inflammatory condition affecting skin, hair, and nails.
Reiter’s Syndrome / Reactive Arthritis: Can cause nail and joint changes.
Trauma or Injury: Physical damage to the nail matrix may cause temporary pitting.
Nutritional Deficiencies: Rare, but low zinc or biotin may contribute to nail irregularities.
The pattern, depth, and distribution of the pitting often help in diagnosing the underlying cause.
Toenail Pain (Toenail Fungus, Ingrown Toenails, Discolored Toenails)
Noticing Dents in Your Nails? Let’s Get to the Root Cause
Nail changes like pitting may be more than cosmetic. At Balance Foot & Ankle Specialist, we evaluate nail health as part of your total wellness. Whether it’s psoriasis, trauma, or something else, we’ll help you find answers and solutions.
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Pictures of Keratin Buildup Under Toenails
Click on pictures for full size & descriptions:
Toe Nail Pitting Causes:
- The #1 cause of nail pitting is psoriasis.
- What we do know is that a good percentage of people suffering from psoriasis also develop nail problems as well.
- The reports vary with some saying only about 10-15% suffer from them, but other studies claim much higher numbers.
- The average seems to be around the 25% range.
You are more likely to have psoriasis under your toenails if:
- You have had psoriasis longer.
- You are older in age.
- Your psoriasis is more severe.
- 80% chance of toenail or fingernail psoriasis if you have psoriatic arthritis.
Symptoms:
Toenail psoriasis displays the following symptoms:
- A discoloration beneath the nail.
- The discoloration is described as an “oil spot”.
- The nail is much more thick and distorted.
- The nail is extremely rough.
- The nail displays characteristic pitting.
- The distal part of the nail appears abnormal.
- Beau’s lines – these are horizontal ridges.
- Callus formation under the nail.
- Loosening of the nail.

Diagnosis:
- The toenails are graded by a system known as the Nail Psoriasis Severity Index (NAPSI).
- Pitting is a hallmark sign of toenail psoriasis.
- It is a numerical and reproducible system for monitoring the toenail psoriasis.
- The system is based on assigning numerical values for some of the symptoms listed above.
Home Treatment for Toenail Psoriasis:
If you have finger nail or toe nail pitting, these can be some good treatment options:
- Keep your nails short and smooth. They are susceptible to bacterial and fungal infections which could make them look much worse.
- Wear gloves to protect your nails while you are performing activities to keep your nails protected.
- Wear properly fitted shoes to avoid excess pressure on your nails. Even light irritation and inflammation can make things worse.
- Make sure to dry your nails properly after bathing.
- Nail psoriasis is hard to treat, as nails grow very slowly. Be careful with them! They only grow 1mm per month.
- You can try topical steroid cream temporarily to improve nail appearance.
- Taking Vitamin D Vitamins may help.
- Moisturizing ointments at night before bed work well.
- Soak nails in vegetable oil while watching TV. You can then use an emery board or nail file to take the nails down a little bit.
- Synthetic nail hardeners can make the nails look much better. These are glossy covers, no one will know the difference!
- Acrylic nails are dangerous because you are more susceptible for nail psoriasis already with your psoriasis- I don’t recommend these.
- Salicylic ointment can work great for your psoriatic nails. Follow directions of your prescriptions.
- A mutlivitamin- while not completely proven through medical trials, has been recommended by many specialists.

Podiatrist Psoriasis Foot Treatment:
- There are many advances that are occurring in the field of psoriasis under toenail, so get excited!
- The outlook for psoriasis, while still dim is looking better and better every year.
- Treatments focus on managing symptoms with a rheumatologist.
- Individualized plans can included topical and intralesional creams and injections.
- You can combine these with systemic and combination oral medication therapies.
Toenail Fungus Home Treatment:
- These are our favorite products to treat toenail fungus at home.
- It is difficult to properly diagnose any health problem such as toenail fungus with 100% certainty. So see your podiatrist and make sure you are not missing anything!
- Also, many of these products are considered beauty products more so than health products. Just be aware that they are not always FDA evaluated or approved in any way.
How to Fix Toenail Fungus:
- There are many different types of toenail damage.
- In our experience, about easily 50% or more is related to toenail fungus.
- The key to toenail fungus is to trim it as much as possible and file that nail down vertically and length-wise.
- If you can do that, you have to make sure you can kill fungus the rest of the way with creams and topical medication.
- The best way to do that is to soak exfoliate the affected toenail skin. So, foot soaks can be a strong anti-fungus solution.
- At the same time, you have to apply anti-fungal medication such as these medications evaluated here or the toenail repair pens.










Recommended Foot Fungus Products:
- It is also vital to fix your foot fungus.
- Athlete’s feet can be beneficial to remove from the foot because if left unchecked, they can quickly spread back to the toenails even if they are fixed.
- Even if you cure your toenail fungus, keep your toenails trimmed in healthy: your foot fungus can spread back into toenails.
- So make sure you treat your foot fungus, as well as your toenail fungus.








Best Toenail Fungus Clippers & Files:
- You have to be careful using at home, and definitely be safe and don’t use these if you have dangerous health conditions.
- It is important to see a podiatrist for foot evaluation and care if you have continued health care issues or problems with your feet.
- These are some great value heavy-duty clippers and sets.
- The key is to cut straight across and file the nail down from the top to keep it from impinging in the corners.
- It is also important to make sure all dead, dry skin is removed surrounding the foot.
- This is where you should really see your podiatrist if you have any concerns or are worried about cutting or hurting yourself.
- This is something covered, so don’t take chances with your health!






Best Toenail Fungus Polish and Remover:
- There is some great toenail fungus polish options and polish removal options.
- There are no acetone-based toenail polish removers, they don’t dry as quickly, but they are less like a dehydrator toenail.
- This also applies to your fingernails and hands.
- The benefits of using these non-toxic toenail polishes are that they are filled with non-fungal options such as tea tree oil, preventing toenail fungus.
- These can also work well for the fingernails.
- So great combo is to use one of these healthier toenail paint options, as well as a non-acetone-based toenail polish remover.






Best Shoes For Toenail Injuries:
- The key to prevent toenail ripping and lifting is to have good supportive shoes.
- If you have a good supportive shoe that keeps pressure off your toes in your toenails, there will be no lifting and cracking to allow bacteria and fungus to get in.
- This almost seems counter-intuitive, but when people make a switch to perfect supportive shoes that fit properly, their toenail problems almost always get better over the next few months or a year.
- Your current nail is already likely destroyed, especially with joggers toe, but let the new nail growing healthy without new damage.
- Click the following link for our most recommended shoes. Try to focus on shoes with mesh and room around the big toe and also the smaller toes.
Best Antifungal Moisture Wicking Socks:
- These are some great options for moisture-wicking sucks.
- The more you can wick moisture from your foot, the less chance there is that toenail fungus, and athlete’s foot can survive.
- We tried to focus on budget value stocks that are not too expensive.
- Sure there are better stocks out there, but these are great socks for a great price for most people.
- If you have diabetes, focus on getting yourself some diabetic socks.
Best Woman’s Antifungal Socks:








Best Men’s Antifungal Socks:




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Toenail Pain (Toenail Fungus, Ingrown Toenails, Discolored Toenails)
Frequently Asked Questions About Nail Pitting
Tiny dents or depressions on the surface of your fingernails or toenails—often looking like pinpricks.
It can be. Pitting is commonly associated with psoriasis, autoimmune issues, or other skin conditions.
Yes, especially in cases of nail psoriasis or alopecia areata, the nails may be affected before the skin.
Nail pitting itself isn’t usually painful, but the underlying conditions may cause discomfort or other symptoms.
If it’s due to a temporary issue or trauma, it may resolve as the nail grows out. Chronic cases may persist.
A visual exam is often enough, but your doctor may perform a biopsy or blood tests to rule out systemic causes.
While you can keep nails trimmed and moisturized, treatment usually involves managing the underlying condition.
Nail polish won’t worsen pitting, but you may want to use non-irritating or breathable polish to avoid further nail damage.
Yes, especially if the pitting affects toenails. Podiatrists can assess your foot health and refer you to dermatology if needed.
Topical steroids, vitamin D analogs, or systemic medications may be prescribed—depending on the root cause.