Nail Clubbing

What is nail clubbing?

Nail clubbing is a change in the appearance and structure of your fingernails or toenails that can occur as a symptom of an underlying health condition. If you have nail clubbing, your nails may:

• Feel soft and sponge-like.
• Feel warm to the touch.
• Form a rounded, bulging shape, giving the appearance of an upside-down spoon.
• Look red.
• Widen and wrap around the sides of your fingertips.

Nail clubbing can affect a few of your nails or all of them. Often, it starts in your thumb and forefinger (pointer finger) before spreading to other nails.

What are the early stages of nail clubbing?

Nail clubbing often occurs gradually and may be hard to spot at first. In the early stages, you may notice any of the following:

• Floating nail: The root of your nail becomes separated from the bone. When you press on the nail plate, it moves slightly. The base of your nail may feel springy or like it’s floating on a soft cushion.
• Lovibond angle sign: When you view your fingernail from the side, it should have a slight dent at the base. This dent, known as the Lovibond angle, makes a slight upward curve as your nail grows toward your fingertip. In the early stages of nail clubbing, your nail and nail bed look flat from the side.

What are the most common causes of nail clubbing?

Nail clubbing is most often associated with diseases of the heart and lungs, like lung cancer, lung infections, interstitial lung disease, cystic fibrosis or cardiovascular disease.

What are other possible causes of nail clubbing?

Nail clubbing can also happen if you have:

• Family history of nail clubbing: Some people inherit a gene that causes nail clubbing. If your biological parents had clubbed nails, you might develop them, too.
• Digestive conditions: Crohn’s disease, celiac disease or other conditions that cause inflammation in your digestive system can lead to clubbed nails.
• Liver disease: Cirrhosis of the liver may lead to nail clubbing in some people.
• Other cancers: Besides lung cancer, other cancers that can cause nail clubbing include esophageal cancer, Hodgkin lymphoma and rhabdomyosarcoma.
• Thyroid conditions: Hyperthyroidism and Grave’s disease cause nail clubbing in some people.

Can nail clubbing be harmless?

Nail clubbing itself isn’t harmful and usually isn’t painful. Sometimes, nail clubbing occurs in a healthy person without an obvious reason. However, it’s often a sign of a serious health condition that needs medical care, so don’t wait to get it evaluated by a healthcare provider.

How is nail clubbing treated?

Because nail clubbing is usually a sign of an underlying health condition, providers typically direct treatment at the underlying cause. For example, your treatment plan may include:

• Chemotherapy, surgery, radiation therapy or medications for lung cancer.
• A gluten-free diet for celiac disease.
• Heart surgery for congenital heart conditions.
• Medications or surgery for hyperthyroidism.

Can nail clubbing be cured?

After treating the cause of nail clubbing, your nails may gradually return to normal. However, nail clubbing isn’t always reversible.

How can nail clubbing be prevented?

There’s no known way to prevent nail clubbing. But you can prevent some of the conditions that lead to nail clubbing by doing the following:

• See a healthcare provider regularly for a physical examination and preventive healthcare. Tell them about any new symptoms or problems you notice.
• Don’t smoke. Smoking is a leading cause of lung cancer and heart disease. Talk to your provider if you need help quitting smoking.
• If you drink alcohol, do so in moderation — one drink per day for women and people assigned female at birth, and two drinks per day for men and people assigned male at birth. Heavy alcohol drinking or alcohol use disorder can cause cirrhosis of the liver.

When should I see a healthcare provider for nail clubbing?

If you notice nail clubbing or any changes in your nails, see a healthcare provider. Nail clubbing may be a sign of a health condition that needs treatment.

A note from Cleveland Clinic

The health and appearance of your nails are a window into your overall health. See a healthcare provider if you notice any nail changes. Getting treatment for the underlying cause of nail clubbing can help you live your healthiest life possible.