Nail Clubbing: Signs, Stages and Treatment

When your body is going through some health issues, it may cause different symptoms to show up. Nail clubbing is one of these symptoms! If you have any nail or digital clubbing, it could indicate a much more serious underlying health condition.

In this article, we’ll review the signs and stages of clubbing on nails, along with other details that you should look out for.


What Is Nail Clubbing?

nail clubbing

Nail clubbing, also known as hypertrophic osteoarthropathy (HOA), describes fingernails or toenails that slope downward, similar to a spoon. 

Clubbed fingers alone are not harmful but a sign of disease.  These can be indicators of health problems, so it may be pertinent to discuss your concerns with a doctor or healthcare professional.


Signs of Nail Clubbing

Signs of Nail Clubbing

Certain underlying medical conditions that you may have caused finger clubbing to develop over the course of several weeks, months or years. When you have clubbing, you might notice these changes:

  • Your nails widen or become more rounded than usual
  • There is an increased angle between your nails and cuticles
  • Your nails appear to have a downward curve
  • The nail beds soften, giving your nails a floaty appearance
  • Your fingertips and toes appear to bulge or turn red as if inflamed.

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Stages of Clubbing

Stages of Nail Clubbing

There are several stages of clubbing as this condition progresses. Here’s what you need to look out for to check how far your toe or fingernail clubbing has progressed.

  • Early Stages:
    • Your nail beds may feel soft or spongy.
    • The skin around your fingernails or toenails will be reddened.
  • Intermediate Stage:
    • The angle between your nails and nail bed increases beyond the usual 160 degrees.
    • Your nails and fingertips may have a convex appearance.
    • Your fingertips appear to ‘dip’ or deepen.
    • The joints between the two top bones of your fingertips appear to be extended, causing your fingers to appear clubbed.
  • Final Stage:
    • Your nails and skin around the fingertips appear shiny.
    • Your nails start growing vertical ridges.

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What are the Causes of Nail Clubbing?

The causes of clubbing on fingers and toenail can’t be pinned down to a single cause. Instead, there are several possible health conditions that may cause the tissues beneath your nails to thicken – leading to widened nails.

Here are some of the health conditions which may cause clubbing.

  • Lung cancer – uncontrollable lung cell growth & generation
  • Asbestosis – lung-scarring caused by asbestos fiber inhalation
  • Cystic fibrosis – the genetic condition which causes excess mucus secretion due to improper water & salt transfer within the body
  • Bronchiectasis – widened and scarred airways caused by infections or mucus secretion failures
  • Pulmonary fibrosis – thickened and scarred lung tissue without any specific reasons



Since the clubbing on nails is one of the symptoms of an underlying health condition, the treatment will be targeted toward diagnosing the actual health condition and treating that.

Some of the treatment options that you might get depending on your diagnosis include:

  • Chemotherapy and radiation therapy to tackle lung cancer.
  • Oxygen therapy, pulmonary rehabilitation & some other medicinal combination to reduce the symptoms of cystic fibrosis, pulmonary fibrosis, asbestosis, and bronchiectasis.


Prognosis of Finger and Toenail Clubbing

Prognosis of Finger and Toenail Clubbing

Your finger and toenails should return to their original state sometime after the health condition has been treated. Depending on the type of health condition you have, the treatment could take anywhere from a few weeks up to several years.

Some chronic conditions will require symptom management rather than treatments, so you can expect clubbing to take longer to resolve.

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How Can You Prevent Nail Clubbing?

Prevent Nail Clubbing

The best way to prevent clubbing is by taking steps to prevent and manage the underlying causes that lead to this condition. 

  • Avoid tobacco smoke and limit exposure to toxins.
  • Seek prompt treatment for lung infections.
  • Get vaccinated against measles and whooping cough to lower the chances of bronchiectasis.
  • Use protective equipment if you’re working in industries like construction, where you might be exposed to asbestos.

By following these steps, you can prevent further nail clubbing from occurring. Seeking treatment for the underlying health conditions causing nail clubbing can also be beneficial.



Can nail clubbing be reversed?

Nail clubbing can be reversed if the underlying cause is treated. However, “if the condition is chronic or associated with a malignancy, clubbing is long term,” according to the National Center for Biotechnology Information.


What does clubbing nail indicate?

Nail clubbing can indicate the following:

  • Lung cancer, chronic lung infections, and lung diseases that reduce oxygen in the blood
  • Congenital heart defects
  • Pulmonary fibrosis
  • Bronchiectasis
  • Asbestosis
  • Celiac disease
  • Cirrhosis of the liver and other liver diseases
  • Dysentery
  • Graves disease
  • Overactive thyroid gland
  • Other types of cancer


How long can nail clubbing take to fully develop?

Clubbing can develop suddenly, perhaps within weeks. You may even see dramatic changes in 1-2 weeks. The first stages of clubbing begin with a softening of the nail bed, followed by an increase of the nail fold, and eventually, the depth increases.


Does anemia cause nail clubbing?

In many cases, nail clubbing is a sign of an iron deficiency called anemia, in which your body absorbs too little iron from the food you eat.

If you have soft scooped-out fingernails with a depression in the middle, then it is commonly associated with anemia, but it may also be in association with thinning of the nail plate from any cause, including irritants. 


Is nail clubbing genetic?

Nail clubbing can appear as a hereditary condition. However, given the prevalence of it being caused by illness and disease, it is best to get these ruled out. 

Clubbing may be present as abnormal genetics in certain families. When this abnormality occurs in seemingly healthy individuals, one should look to genetics. It is also more common in African American people and those of North African descent.


From the above information, it is clear that there is no sure way to prevent clubbing. Rather, just to play safe, it’s better to keep a healthy lifestyle to avoid getting health conditions that may cause nail clubbing.

If you notice any early signs of clubbed fingers or other health issues, consult a doctor immediately for some professional medical opinions and early treatments.

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