Nail Clubbing: Change in the Physical Appearance Of Fingernail Or Toe Nail

Nail clubbing refers to change in the physical appearance of fingernail or toe nail. The change in shape is longitudinal as well as transverse. The shape of the nail appears just like an upside down spoon. Along with this the soft distal part of finger or toe also becomes enlarged, red and bulbous.

Nail clubbing is also called digital clubbing. Although clubbing of nail is asymptomatic, it is important predictor of an underlying serious illness. Nail clubbing can occur in variety of illnesses mainly linked with lung, heart and certain gastrointestinal diseases. It can also be a normal inherited trait or the cause may remain idiopathic. Clubbing can occur in early childhood or later in life depending on the underlying condition. The main stimulus believed to cause clubbing is hypoxia. Diagnosis of nail clubbing is made clinically by observing fingers and nail. Treatment will depend on the underlying cause that has lead nail clubbing.

Causes of Nail Clubbing:

Clubbing of nail is a medical sign in which the finger or the toe appears as an upside down spoon.

The exact mechanism of finger or nail clubbing is not known, but it is believed to be caused as a result of hypoxia (low oxygen saturation in blood). Long time hypoxia may result in compensatory dilatation of tiny blood vessels in the terminal part of finger. This causes increase in blood supply to the fingers and toes causing enlargement of built up of tissue in the distal part of the finger. Concurrently, the hypertrophy of distal end of finger or toe will change the shape of nail and nail bed. The nail bed becomes soft and spongy and red.

Nail clubbing can occur at any stage of life. It can develop in young individuals or older adults. Nail clubbing can be rapid or may take years before it becomes more apparent. This will depend on the cause and its severity. There are number of conditions that may cause clubbing of finger and nail. However, besides diseases, clubbing can occur just as a hereditary trait without any pathological cause. In some cases it is idiopathic. Diseases and disorders responsible for nail clubbing include mainly lung disease and heart disease.

Diseases Causing Finger and Toe Clubbing:

Lung Diseases

  • Lung cancer
  • Chronic obstructive lung disease.
  • Tuberculosis
  • Fibrosis of lung.

Heart Diseases:

  • Congenital valve disease
  • Infective endocarditis

Gastrointestinal Causes:

  • Inflammatory bowel disease
  • Ulcerative colitis
  • Crohn’s disease


  • Excessive smoking
  • Abdominal aorta aneurysm
  • Gout deposits in one or two fingers
  • Inflammation of vein in drug addicts.
  • Graves disease Hodgkin’s lymphoma

How to Cure Clubbing:

Clubbing is sign of an underlying state of health. It can be related with a disease or just a hereditary trait. There is no specific treatment that can cure clubbing. The main aim is to find and treat the underlying cause, sometimes a life threatening cause such as lung cancer. Hence, clubbing often leads to exhaustive investigations to find the cause. Once the cause is treated, in many cases finger clubbing slowly recedes. For example if clubbing is caused as a result of congenital heart valve disease, surgical repair of valve can successfully  treat its symptoms including clubbing. Lifestyle changes can also be effective. For example, a smoker must stop smoking. It will not only resolve nail clubbing but also reduce the risk of lung cancer and other ailments.