What your looks say about your health

Elizabeth Rogers

Can you spot the signs of serious disease just by looking in the mirror? We look at 10 ways appearances can warn of underlying health issues.

It’s long been said that “beauty is skin deep” but our skin, hair, teeth and nails aren’t just pretty packaging for our internal organs. They’re an integral part of our body’s complex systems. We often think what happens “on the inside” isn’t visible from the outside, but experts can pick up important clues about our health from our appearance.  

Some signs are fairly obvious — we know that extreme weight loss, sallow skin and dark circles under the eyes aren’t the hallmarks of good health, for example. However, sometimes the signs can be more subtle.

Here are some of the ways appearances could point to underlying health conditions.


You know wrinkles are part of the aging process, but did you know they might predict a woman’s risk of osteoporosis too? Last spring, researchers at Yale University found that women who have deeper, more numerous wrinkles also had lower bone density — regardless of their age.

The connection isn’t that far fetched because skin and bones share building blocks like collagen. Deficiencies in the skin could reflect deficiencies elsewhere in the body too. More research is needed, but researchers hope these findings will offer a way to catch “the silent thief”. 

For more information, see the Yale University press release and related article on ABCNews.

Tooth loss

What about your pearly whites? Believe it or not, your dentist may one day be able to screen for osteoporosis too. Several studies have found a link between the disease and loose teeth or tooth loss. The reason: osteoporosis can affect any bone in the body including the jawbone that supports our teeth. A dental x-ray could provide important clues about bone density — especially since many people see their dentists more often than their doctor.

True, tooth loss has other causes like injury or periodontal disease. Still, women who have osteoporosis are three times as likely to experience it as women who don’t have the disease, say researchers — even when you factor in age and smoking.

For more information, see the NIH Osteoporosis and Related Bone Diseases National Resource Center and read one of the study abstracts.

Poor dental health

Another reason to keep up with those dental check ups: a chronic inflammatory condition known periodontal disease or gum disease has links to other chronic conditions like diabetes, cardiovascular disease and Alzheimer’s disease. Experts used to think it was oral bacteria that was the problem, but current thinking suggests that chronic inflammation might be more troublesome. Experts still aren’t sure if periodontal disease contributes to other chronic conditions or if there is a common disease process that affects oral health as well as other parts of the body.

The good news is that if you treat the inflammation and infection, you’ll help manage both gum disease and related chronic conditions. Periodontal disease is more than just inflamed gums — it can attack the connective tissue and bone that support the teeth — and we’re more vulnerable to it as we age. It often takes an expert to spot the early warning signs.

For more information, see the American Academy of Periodontology (try its online risk assessment) and the National Institute of Dental and Craniofacial Health.

“Spots” on the face

Skin problems can be an embarrassment at any age, but they’re worth discussing with a doctor — even if most are fairly harmless. Acne could be a sign of a condition affecting hormone cycles, like polycystic ovary syndrome, and some natural health experts say it could be the result of food intolerances.

However, those red “bumps” on your cheeks could have another cause: rosacea – a skin condition that affects the blood vessels under the skin in the face. It’s often misdiagnosed as adult acne, but won’t respond to acne treatments. (See Rosacea.org and the Canadian Dermatology Association for more information.)

Another culprit: a “butterfly rash” that spread across the nose and cheeks is a common symptom of lupus,  a systemic autoimmune disorder that affects mostly women. (See the Mystery of Lupus for a primer on this condition.)

Swollen feet and ankles

It may not be pretty, but there’s more to worry about than your shoes not fitting. Known in the medical community as peripheral edema, this painless swelling of the feet, ankles and lower legs is caused by an abnormal build up of fluid in the body. Thanks to gravity, this fluid often ends up in our extremities. The swelling can be a warning sign of heart, liver or kidney disease, a blood clot in the leg, a circulatory issue or an infection.

However, there are many not-so-serious causes too — like pregnancy, sitting or standing for long periods of time or the side effects from certain medications. When in doubt, it’s worth a conversation with a doctor. However, if you experience other symptoms like chest pain or difficulty breathing you’ll want to head to the emergency room instead.

Discoloured nails

Embarrassed by your toenails? A fungal infection could be responsible for those thick, yellow nails, and yes, it can spread to your fingernails too. Today, laser treatments can cure the infection without the side effects of traditional treatments. (For more information, see What your feet reveal about your health.)

However, your beauty routine could be the problem instead: the chemicals in nail polish can discolour nails too. Doctors recommend giving your nails a breather on a regular basis.

What about black or blue spots? The culprit is often a bruise under the nail. Beware: this bruise could lead to other issues like a fungal infection or an infected sore.   

Likewise, half white, half brown nails could signal kidney failure, and white nails could warn of liver, heart or kidney failure as well as diabetes or a thyroid condition.  Brown streaks can be a sign of serious melanoma.

Nail abnormalities

Colour isn’t the only concern — other nail abnormalities can say a lot about your health too. For instance:

- Certain infections in the body (like in the heart valve) can cause red streaks known as splinter hemorrhages.

- Brittle nails could be the effects of aging… or a thyroid condition, nail psoriasis or reactive arthritis.

- Indented, spoon-shaped nails could warn of lupus or anemia.

- Pitted or dented nails can warn of psoriasis.

- While white spots and streaks on the nail are generally normal, white lines extending all the way across the nail can warn of a lack of protein in the blood — often due to liver disease or malnutrition.

Of course, these signs are just a few of the ways our health shows up in our nails. The American Academy of Family Physicians and NHS Choices have good overviews with visuals.

Hair loss

We constantly lose hairs due to their normal growth cycle — as many as 50 to 100 per day — and we expect some loss as we age thanks to our genes. It’s normal for men to lose hair from their front hair line and the top of the head. Women can also experience thinning hair though they typically don’t develop bald spots.

What isn’t normal is hair that comes out in clumps or loss that leaves bald patches. This type of hair loss is usually reversible when the underlying problem is addressed — like a thyroid condition or an autoimmune disorder which is attacking the hair follicles. Infections, skin conditions, malnutrition, hormone changes and extreme stress can cause temporary hair loss too.

Sometimes we’re our own worst enemies: some styles like tight braids can cause hair loss, as can damage from rough handling and styling. Be gentle, say experts. (Learn more about possible causes of hair loss on WebMD.)

Excess body hair

What if you have too much hair — and in all the wrong places? Some people have more body hair than others, but women typically don’t grow dark, coarse hairs on their chest, abdomen, lip, chin or back. When they do — a condition known as hirsutism — it’s often because their bodies are producing larger than normal amounts of male hormones.

One common cause is polycystic ovary syndrome — a condition where many small cysts develop in the ovaries that can affect hormone cycles. Conditions affecting the ovaries and adrenal glands like Cushing’s syndrome or tumours can also cause hirsutism. Certain medications can also cause unusual hair growth too, like steroids or some immunosuppressants. 

Sometimes doctors can’t pinpoint a cause, but it might be worth a conversation if you’re concerned about body hair. (The University of Maryland Medical Center has a good overview of hirsutism.)

Mysterious moles

Once called “beauty marks”, moles come in many shapes, sizes and colours — and most of them are harmless. However, unusual moles could be a sign of skin cancer. How can you spot trouble? Remember your ABCDE’s: asymmetry, irregular borders, uneven colour, large diameter and evolving.

What about other suspicious lumps and bumps? They could be the sign of a less serious form of non-melanoma skin cancer known as basal cell carcinoma. Luckily, BCC doesn’t spread and can usually be treated by a dermatologist. (See Skin cancer: recognizing the trouble spots for more details.)

Of course, if you notice any of the above warning signs, don’t panic — remember, the cause is often benign — but do talk to your doctor. We know it’s tempting to cover up or mask any issues that affect how we look, but getting the right treatment can make a lasting difference.

Additional sources: The British Liver Trust, The Canadian Liver Foundation, Health.com, University of Maryland Medical Center

Photo ©iStockphoto.com/ Stefano Lunardi

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