Up to 20% of people who get COVID-19 experience skin and nail changes. COVID nails is a term used to describe nail changes that may appear after having the virus. They can look like reddish white half-moons, orange nail lesions, horizontal white lines, or horizontal dents that appear across the fingernails or toenails. In rare cases, the body’s immune response to getting the COVID vaccine may lead to similar nail changes.

Types of COVID nails you may experience include Beau’s lines, Mees’ lines, red half-moons, onycholysis, and orange nail discolorations.

1. Beau’s Lines

Beau’s lines are horizontal grooves or dents that form on one or more of your nails. When COVID temporarily interrupts the growth of the nail matrix, the area where your nails start to grow, this may lead to Beau’s lines forming.

COVID-related Beau’s lines can start forming anywhere from days to weeks after exposure to the virus or getting the vaccine, and symptoms resolve within a few months.

Beau’s lines can also be caused by nail injuries, chemotherapy, and nutrient deficiencies.

2. Red Half-Moons

Red half-moons appear as red crescent-shaped bands that form around the margin of the lunula, which is the white half-moon shape that naturally appears at the base of your nail. Red half-moons from having COVID may appear on all of your fingernails and can form in as little as two days after contracting the infection.

This type of COVID-related nail condition may happen when tiny blood vessels break under your nails, causing an inflammatory immune response.

3. Nail Discoloration

Discoloration of the nail plate is medically known as chromonychia. Chromonychia from COVID can appear as red or orange lesions, a sign of damaged tissue, going across the nail, also known as transverse orange nail lesions.

After having COVID, transverse orange nail lesions may form near the ends of nails, sometimes weeks after first experiencing other COVID symptoms. Typically, the end of the nail plate will appear orange with a distinct straight line separating the area of discoloration from the healthy portion of the nail bed.

4. Onycholysis

Severe COVID can sometimes cause a condition known as onycholysis. This is when the nail becomes separated from the nail bed, usually starting at the tip of the nail. Onycholysis is usually painless and may appear several months after having COVID.

Outside of COVID, you can develop onycholysis from getting manicures, fungal infections, and psoriasis.

5. Mees’ Lines

Mees’ lines appear as horizontal white lines that run across the width of your fingernails or toenails. Mees’ lines are medically known as transverse leukonychia. Transverse describes something that is lying across, and leukonychia is a term for white discoloration of the nail.

Mees’ lines take about three to six weeks to develop. These lines are temporary and will grow out over time as the nail grows.

You may experience Mees’ lines if you have COVID or conditions like acute kidney failure, heart failure, ulcerative colitis, and certain cancers. More research is needed to fully understand the connection between Mees’ lines and COVID.

COVID nails results from a severe immune system response, affecting your vascular system when you have COVID. The vascular system is a network of blood vessels that travel through the body.

Your body’s immune response to COVID can trigger inflammation. This can compromise the health of blood vessels in the vascular system, stopping the supply of nutrients that support nail health and growth.

Symptoms of COVID nails can take a few days to several months to develop after having COVID or getting the vaccine. They’re not permanent and will grow out with the nail. This can take up to six months for fingernails and 12-18 months for toenails.

You should see a healthcare provider if COVID nails don’t improve on their own as the nails grow out. This could be a sign of a different health condition.

Sometimes, a fungal or bacterial infection can occur in the nails. A fungus or yeast can alter the shape, color, and texture of the nails. Bacterial infections can also cause changes in nail color or painful spots of infection in the nail or surrounding skin. If left untreated, bacterial infections can cause nail loss.

If you experience symptoms of COVID nails that don’t go away or symptoms of a fungal or bacterial infection, visit your healthcare provider for diagnosis and treatment.

COVID nails are nail changes that may develop after having COVID or getting the COVID vaccine. Types of COVID nails include Mees’ lines, Beau’s lines, and red half-moons.

Most cases of COVID nails should resolve on their own without treatment, but if your symptoms don’t go away, you should see a healthcare provider. While most cases of COVID nails are not a cause for concern, persistent symptoms could be a sign of a different infection requiring treatment.