Nail Pitting: What It Means and How It Links to Health Conditions

When you notice small dents or holes in your fingernails or toenails, you're seeing nail pitting, a condition where the nail surface develops tiny depressions, often resembling pinpricks. Also known as nail lacunae, it’s not just a random flaw—it’s a visible signal from your body that something deeper might be going on.

Nail pitting most often shows up in people with psoriasis, a chronic autoimmune disease that speeds up skin cell turnover and can affect nails. About half of all people with psoriasis develop nail changes, and pitting is one of the most common. It’s not the same as a bruise or injury—it’s a structural issue caused by problems in the nail matrix, the tissue under the cuticle that makes the nail grow. But it’s not just psoriasis. eczema, a skin condition that causes inflammation and dryness, can also lead to similar nail changes, especially if you scratch or pick at your cuticles. Even some fungal infections or autoimmune conditions like alopecia areata can cause pitting, though less often.

What makes nail pitting tricky is that it doesn’t always come with pain or redness. You might not even notice it until someone points it out. But if you see multiple pits on several nails, especially if you also have flaky skin, joint pain, or a family history of autoimmune disease, it’s worth paying attention. Your nails are a mirror. They reflect what’s happening inside your body—like how your immune system is behaving, how much inflammation you’re carrying, or whether your skin cells are growing abnormally. It’s not something you should ignore just because it’s "just a nail".

There’s no magic cream that fixes pitting overnight. Treatment depends on the root cause. If it’s psoriasis, topical steroids, light therapy, or oral meds might help. If it’s eczema, managing flare-ups and avoiding triggers can reduce nail damage. In some cases, the pits fade as the underlying condition improves. But if you’ve never been checked for an autoimmune issue and you’ve had pitting for months, it’s time to ask your doctor. Don’t wait for it to get worse. Early detection can stop more serious problems down the line.

Below, you’ll find real, practical advice from people who’ve dealt with this—whether it’s learning how to spot early signs, understanding what tests your doctor might run, or figuring out how to manage the emotional side of having visible nail changes. These aren’t generic tips. They’re based on actual patient experiences and clinical insights.