Some research associates nail changes, such as fungal infections, clubbing, and pigment changes, with HIV. However, more research is necessary to understand how HIV may affect the nails.
Nail changes in people with HIV may occur due to a weaker immune system, HIV medications, or co-occurring health conditions that affect the nails.
People who notice nail changes can discuss this with their healthcare team. Healthcare professionals can suggest suitable treatment and ensure there are no severe underlying causes to address.
Nail changes in people with HIV
The following sections detail research that associates certain nail changes with HIV:
Fungal infections
People with stage 2 HIV may be
According to a 2019 article, onychomycosis, a fungal infection of the nail bed, is the most common type of nail disease.
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People with HIV may also experience paronychia, which is an infection of the skin around a nail.
Nail color changes
A 2022 study of 205 hospital patients with HIV in Mexico City examined nail changes. Among people with nail symptoms, 37.1% saw changes in the color of their nails.
Research in the study suggests that the most common nail color changes may include:
- Longitudinal melanonychia: Melanonychia causes black or brownish discoloration of the nail. Longitudinal melanonychia may involve streaks of discoloration running the length of the nail.
- Transverse lines: A transverse line will pass through two other lines at distinct points. In nails, this may present as discoloration or grooves on the nails.
- Leukonychia: Leukonychia is a type of discoloration that turns parts or all of the nail white and opaque.
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Learn about the meaning of a black line on the nails.
Clubbing
2022 research suggests that some people with HIV might experience nail clubbing. However, a 2015 article suggests this symptom may be more likely in children with HIV.
Clubbing generally involves shape changes of the nails and fingers
In HIV, clubbing may be associated with hypertrophic osteoarthropathy, which
Nail or finger clubbing can occur due to underlying health conditions or, less commonly, may occur with no apparent cause.
However, more research is necessary to understand the prevalence of nail clubbing in people with HIV.
Learn more about HIV in children.
Anolunula
The lunula is the pale, semicircle area at the base of a nail. An older 2014 study of 168 people with HIV and 168 without suggests a significant association between anolunula, the absence of lunulae, and HIV.
The authors suggest that anolunula was proportional to the stage of HIV, with people in later stages being more likely to have anolunula on multiple or all fingers.
However, it is important to note that this study only highlights an association and does not prove that HIV caused anolunula. More research is necessary to understand the potential link between them.
Trauma-related nail changes
The 2022 study found the following trauma-related causes of nail changes in some people with HIV:
- ingrown toenail
- nail separation
- bleeding under the nail
- splinter hemorrhages, which cause small streaks under the nail
- anonychia, which is nails failing to form
- nail splitting
The study’s authors highlight that trauma to the nails was one of the most frequent occurrences. Traumatic nail-cutting techniques were one potential cause of these nail changes.
Learn more about nail bed injuries.
The 2022 study emphasizes the importance of systemic nail examination as part of routine care for people with HIV.
The authors highlight that certain nail changes, such as nail infections, are more common in people with HIV, and some of these may relate to the suppression of the immune system.
Some nail changes may also occur due to manageable causes, such as inappropriate nail-cutting techniques. Healthcare professionals may be able to work with people with HIV to reduce the rate of trauma-related nail changes through proper nail care.
The study identified two malignant tumors among the study participants during their nail examinations, which highlights the importance of speaking with a doctor about any nail changes.
Nail changes may also indicate other health conditions, such as psoriasis, that may require treatment.
Learn more about nail diseases, identification, and remedies.
Nail changes may not always indicate a severe issue. However, people with HIV should discuss any nail changes with their healthcare team to ensure they start suitable and prompt treatment for any necessary issues.
Certain nail conditions, such as fungal infections, are more common among people with HIV. Without treatment, fungal nail infections may:
- spread to other nails
- spread to the skin
- lead to bacterial infections
- affect standing, walking, or daily function
- cause pain and tingling
- lead to nail abnormalities, which may cause difficulty cutting nails and wearing shoes
- lower a person’s self-esteem
Learn more about what nail changes say about your health.
What is nail clubbing, and is it related to HIV?
Nail clubbing typically involves swelling of the soft tissues that cause changes in the angle between the nail and nail bed. The nails may then appear broader and flatter.
Research in a 2022 study suggests that clubbing may occur in people with HIV.
Do nail changes always indicate HIV progression?
More research is necessary to understand whether nail symptoms may occur due to HIV progression. However, it is important to note that not everyone with HIV will experience nail changes.
How common is onychomycosis in people with HIV?
A 2019 article suggests that the rate of onychomycosis varies depending on the population researchers examine but may range from 3.33% to 44% of people with HIV.
HIV and AIDS resources
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Research reports associations between HIV and certain nail changes, including fungal infections, discoloration, and trauma-related symptoms.
More research is necessary to understand whether nail changes link to HIV progression. However, regular nail checks may be an important part of routine healthcare visits for people with HIV.
Doctors can prescribe treatment for nail issues to prevent complications. Without treatment, problems such as infections can spread and affect a person’s self-esteem and daily functioning.
