Overview
Perfect, well-trimmed or manicured nails are not just a girl’s dream; healthy nails are an indicator of your health. You may have noticed white spots on your nails at some point in your life that may have thrown you in disarray. However, developing white marks on nails is usually not a sign of a severe medical condition.
An injury to the nail, usually due to a pinch or strike to your nail, is a very common cause of these white nail spots, termed leukonychia.
However, several other causes may be responsible for the white marks on nails. Let’s discuss the causes of white spots on the nails and if there is a need to inform your doctor about these leukonychia spots.
What Is Leukonychia?
White spots on the nails are referred to as leukonychia. There are multiple causes of white spots on your nail. These can range from harmless scratches from manicures to serious illnesses, namely liver or kidney disease.
You might want to continue reading the article if you want to learn more about leukonychia, including the causes and treatment of white spots on fingernails and toenails.
Leukonychia refers to a condition where white lines or white dots on nails appear on the fingernails or toenails. This is a very prevalent issue and is typically harmless.
Leukonychia is classified into two main types:
- True leukonychia: This arises in the matrix of the nail, the part of the nail that is responsible for the production of the nail.
True leukonychia can be divided into two categories based on the nail’s appearance.
- Total leukonychia: This term refers to the complete whitening of the nail plate and affects all 20 nails.
- Partial leukonychia: This term is used when a part of the nail plate is affected by whitening only. It may affect one or more than one nail.
2. Apparent leukonychia: This problem stems from the nail bed, the portion of the nail beneath the nail.
Types of leukonychia
- Punctate leukonychia: These are small, isolated white spots on the nails.
- Longitudinal leukonychia: These are bands of white lines running through the length of the nail. This is also called Terry’s Nails.
- Transverse leukonychia: These are bands of white that run across the nail. These white lines on nails are also referred to as Muehrcke’s lines.
What Causes White Spots on Fingernails?
There are many different causes of white patches on nails. Some of them are minor conditions, such as normal wear and tear, while others can indicate underlying severe health concerns. Some common causes of white spots on nails include:
1. Injury to the Nail
Biting your nails or a direct injury to the nail can result in white marks. This is because the nails are composed of layers of keratin. In case of an injury, these layers can crack and subsequently have air trapped between them, leading to white marks on fingernails or white spots on toenails. Some injuries show up after 4 weeks or longer.
Nail injury can be caused by:
- accidentally shutting your fingers in a door
- hitting your nails against a desk
- striking your finger with a hammer
Frequent manicures can cause damage and lead to white spots on your nails.
2. Fungal infections
Sometimes, an overgrowth of fungus in between the layers of the nail can give your nails a white appearance. A fungal infection of the toenails is called onychomycosis. Initially, a few small white dots may appear on the nails, but the infection can spread to the nail bed. Resultantly, toenails may become flaky, thick and brittle.
Serious Health Conditions
Abnormal levels of albumin, a blood protein, can lead to white nails. Hypoalbuminemia may be an indication of conditions such as kidney disease, hepatitis or liver cirrhosis.
A few less prevalent causes for white spots on nails include:
- kidney failure
- liver cirrhosis
- pneumonia
- anaemia
- heart disease
- diabetes
- hyperthyroidism
1. Allergic Reaction
An allergy to nail polish or nail polish remover can result in white spots on your nails. Chemicals used when getting acrylic or gel nails can damage your nails and result in white spots.
2. Hereditary Causes
In rare cases, true leukonychia may be inherited. For example, a gene mutation may be passed on by one or both parents to a child can lead to total leukonychia. Such people can present with all-white nails that are apparent at birth or early infancy.
Some rare disorders that can lead to leukonychia include
- Bart-Pumphrey syndrome: Common symptoms include nail abnormalities, hearing loss and knuckle issues.
- Bauer syndrome: This results in leukonychia and the formation of skin cysts.
- Buschkell-Gorlin syndrome: This condition presents with a triad of nail problems, kidney stones, and skin cysts.
- Darier disease: This results in nail abnormalities and wart-like blemishes
What Do White Spots on Nails Indicate?
Some other causes of white spots on nails include:
Medicines and Poisoning
Medications can also be the cause of white spots in nails. Chemotherapy medications mainly used to treat cancer and sulfonamides that are used to treat bacterial infections come under this category.
Moreover, heavy metal poisoning from metals such as lead and arsenic can cause lines to develop on nail plates.
Mineral Deficiency
White spots on nails may be linked to vitamin deficiency. However, the deficiencies are most commonly related to zinc deficiency or calcium deficiency. Sometimes, they may be referred to as calcium spots on nails.
Skin Conditions
White spots on nails may be linked to an autoimmune condition. In addition, some inflammatory skin conditions, including nail psoriasis and hand eczema, may affect the nail and lead to abnormal spots on the nails.
If you think you have calcium deposits or white spots on your nails, you should consult a doctor to determine the cause.
What Medications Can Cause White Spots on the Nail?
Sometimes, individuals taking certain medications develop white spots on their nails. Such medications include:
- Chemotherapeutic medications: Used to treat cancer
- Sulfonamides: Used to treat bacterial infection
Diagnosis
Usually, white spots are harmless and require no treatment. However, if you notice the spots persist, you should visit a doctor for an evaluation. Your doctor will examine the nails on your hands or feet and then make a diagnosis. In some cases, the following tests may be ordered.
- Nail biopsy: A sample of the nail is sent for examination under a microscope.
- Mycology: Fungal or nail clippings are sent for an examination under a microscope.
- Blood test: The blood is tested for any signs of systemic disease or heavy metal poisoning.
Several tests may be done to eliminate possible causes.
How To Get Rid Of White Spots On Nails?
Treatment is advised based on the cause of the white spots.
Time and Rest
Most nail injuries heal with time. The healthy nail grows, and the damage will move up the nail plate. The white spots usually disappear entirely.
Antifungal Medication
Oral antifungal medication is commonly used to treat nail fungus; a topical antifungal treatment is often prescribed alongside.
The average treatment time is three months, and in order to treat the infection fully, it is best to adhere to the treatment.
Avoid the Use of Harsh Chemicals
Stop using nail polish or other products that may have caused damage to your nails. If you continue to have allergic reaction symptoms, consult a doctor.
How to Prevent Reoccurring Spots
Keep track of the following if you have noticed persistent or recurring spots on your nails:
- Keep track of your symptoms. Observe any changes to your nail colour or texture.
- If you are certain that an injury does not cause the white spots on your nails, you can make an appointment with a doctor.
- Eat a balanced diet, maintaining adequate levels of vitamin deficiencies.
It takes quite some time for fingernails and toenails to grow. It may take 6 months or longer for fingernails, and for toenails, it may take up to 18 months to grow.
When to Consult a Doctor
White spots or changes to your nail colour are usually considered harmless. Still, they may be a sign of a worsening health condition such as liver disease, diabetes or an autoimmune disorder. In order to address the underlying cause of the white spots and for the correct treatment, connect with one of our doctors at Your Doctors Online.
FAQs About White Spots on Nails
Leukonychia is typically not an alarming sign. However, it can sometimes be caused by systemic disorders or medical conditions.
Physical or emotional stress may cause white horizontal lines to appear across the nails.
Spoon-shaped fingernails called koilonychia are a symptom of iron deficiency.
The duration of the spots depends on the cause. It takes several months for a nail to grow, so they can last for quite a while.
Calcium, zinc and selenium deficiency can make your nails appear white. However, B-12 deficiency usually causes them to appear hyperpigmented.
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