Clubbing of the Fingers or Toes
Clubbing of the fingers or toes refers to certain changes in your fingernails or toenails that occur due to an underlying condition. These changes can include:
- softening of the nail beds, which makes the nails seem to float instead of being attached
- an increase in the angle between the cuticle and the nail
- enlarging or bulging of the tip of the finger, which may also be red and warm
- downward curving of the nail
These changes can happen in a matter of weeks. Many of the conditions associated with clubbing are serious, so it is important to see your doctor for an accurate diagnosis. Clubbing of the fingers or toes is a general symptom of numerous diseases and disorders. These include:
- lung cancer
- heart defects at birth
- chronic lung infections
- heart chamber and heart valve infections
- celiac disease (an autoimmune disease of the small intestine that prevents it from absorbing gluten from food)
- cirrhosis of the liver
- Graves’ disease (an autoimmune disease that causes the thyroid gland to overproduce hormones)
- several types of cancer, including liver and gastrointestinal cancers
Clubbing of your fingers or toes results in your nails becoming wider and rounder. The nails curve downward and become soft, and the angle formed by the nail and cuticle becomes straighter. Your fingertips may also appear red and swollen and feel warm.
Underlying Causes of Clubbing
The nail widening that characterizes clubbing occurs because the tissue under the nail plate becomes thicker. This can be caused by a number of conditions that lead to a decrease in the amount of oxygen in your blood, such as lung disease and heart disease. Clubbing has also been associated with overactive thyroid glands, inflammation of the intestines (principally the colon, known as dysentery), and liver disease.
The most common cause of nail clubbing is lung cancer. This disease develops when you have abnormal lung cells that grow out of control. The National Cancer Institute places the estimate for new cases of lung cancer in 2012 at more than 226,000. (NCI)
This condition occurs when your lung tissue becomes thick and scarred, which interferes with your breathing. In most cases, there is no known cause. It cannot be cured, but treatment can stop additional scarring and relieve some of your symptoms.
Tetralogy of Fallot
This is a heart defect that you are born with. It affects how blood flows through your heart. According to the National Heart Lung and Blood Institute, it is present in around five out of every 10,000 babies. (NHLBI)
This type of cancer occurs in the lymphatic system, which in turn affects your immune system. Other symptoms include painless swelling in your lymph nodes, night sweats, and fever.
This condition occurs when your airways become widened and scarred due to an infection or other condition that stops them from getting rid of mucus. It can be managed but not cured. Treatment is important, since this condition can lead to heart failure or respiratory failure.
This disease occurs when inhaled asbestos fibers cause scarring on your lung tissue. This leads to breathing difficulties and a decreased amount of oxygen in the blood. The scarring occurs gradually, and it can take up to 20 years for symptoms to appear. (AmericanLungAssociation) It cannot be cured, but the symptoms can be managed.
When to See Your Doctor
Make an appointment with your doctor if you notice any signs of clubbing in your toes or fingers. Most of the underlying conditions that can lead to clubbing are serious, but early diagnosis and treatment may improve your outlook.
Treatment involves addressing your underlying condition. The type of treatment you will need depends on what that condition is.
- Lung cancer can be treated with surgery, chemotherapy, and radiation.
- Common treatments for pulmonary fibrosis include medication and oxygen therapy.
- Tetralogy of Fallot can be corrected with open-heart surgery, in most cases.
- Hodgkin’s lymphoma can be treated with chemotherapy, radiation, or stem cell transplants that replace diseased bone marrow.
- Medication, drinking lots of fluids, and chest physical therapy are common treatments for bronchiectasis.
- Asbestosis can be treated with respiratory therapy to break up mucus, an oxygen mask, and aerosol medication.
What Can I Expect in the Long-Term?
Your toes or fingers may return to their normal shape once the underlying condition is treated, but this depends on which condition you have. Some of the conditions that cause clubbing are chronic but manageable. Others are much more serious. Your doctor will be able to give you a better idea of what the outlook is for your particular situation.
The only way to prevent clubbing is by taking steps to prevent the underlying conditions that cause it. You cannot prevent certain conditions, such as cancer, but you can lower your risk of developing them.
You can reduce your risk of lung cancer by not smoking, avoiding secondhand smoke, and limiting your exposure to toxins in the workplace.
This condition can be prevented by:
- getting childhood vaccines against measles and whooping cough, which are conditions that can cause lung infections
- staying away from substances that can harm your lungs, such as smoke and toxic fumes
- having all lung infections promptly treated
You can help prevent asbestosis by using protective equipment if you work in an industry where you might be exposed to asbestos, such as construction.