Caleb Foster
White spots under your nails are usually not a cause for concern and are often the result of a minor injury, like biting your nails or jamming your fingertips. However, in some cases, they may indicate an underlying health condition, such as vitamin or mineral deficiency, inflammatory skin diseases, or even more serious illnesses like liver disease, kidney disease, or diabetes. The medical term for white nails is leukonychia, which can be further classified into subtypes based on the appearance and location of the white spots. Proper nail care and addressing any underlying conditions can help prevent new spots from forming, although it may take several months for the nails to grow out completely.
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Leukonychia
There are several types of leukonychia:
- True leukonychia: This occurs when white spots form at the nail matrix, the beginning edge of the nail located under the skin just before the visible part of the nail. It is caused by damage to the nail plate or matrix, and can be further divided into partial and total leukonychia. Partial leukonychia occurs when only a portion of the nail plate is whitened, and may affect one, a few, or all nails. Total leukonychia is the whitening of the entire nail plate, and can be caused by a more serious injury, often with detachment of the nail plate from the nail bed.
- Apparent leukonychia: This occurs when the white spots form on the skin beneath the nail (nail bed), rather than on the nail itself. This type can be distinguished from true leukonychia as the spots fade when pressure is applied to the nail, and they do not move as the nail grows.
- Pseudoleukonychia: This is caused by a fungus growing on the outside of the nail, causing the upper layers of the nail plate to become scaly.
- Familial leukonychia: This is an inherited form of leukonychia caused by a mutation in the phospholipase C delta-1 gene, resulting in nails that appear milky and porcelain white.
The most common cause of leukonychia is injury to the base of the nail (the matrix) where the nail is formed. This can include nail biting, manicures, knocks, and accidents involving doors or windows. Other causes may include vitamin or mineral deficiencies, fungal infections, or underlying health conditions such as liver disease, kidney disease, or diabetes. In rare cases, leukonychia may indicate ingestion of poisons such as arsenic, thallium, or strontium.
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Injury
White spots under your nails are a common condition and are generally harmless. They often appear after an injury to the nail, such as bumping them against a hard surface, accidentally closing them in a car door, or biting them. This type of trauma can also occur during a manicure or pedicure due to the use of sharp tools, electric files, and aggressive cuticle pushing. Repeated manicures can cause spots even without a significant injury.
In most cases, white spots on your nails will eventually grow out, and you may not need any treatment. However, if the spots are persistent, worsening, or accompanied by other symptoms, it is recommended to consult a healthcare provider. A full physical exam and blood tests may be conducted to evaluate any underlying causes, including potential mineral deficiencies or fungal infections.
True leukonychia, a type of white spot discoloration, originates in the nail matrix, the part of the nail responsible for nail production. It can be further classified into partial leukonychia, which occurs when only a portion of the nail plate is whitened, and total leukonychia, where the entire nail plate is affected. Apparent leukonychia, on the other hand, involves a problem with the nail bed under the nail, and the discoloration disappears when pressure is applied to the nail.
Punctate leukonychia is a specific type of leukonychia that occurs after nail biting, manicuring, knocks, tight footwear, or bangs to the nail. It is characterized by tiny dots speckled across the nail. Striate leukonychia, or transverse leukonychia, may follow more severe damage to the nail matrix, and can result in furrows and ridges on the nail. Total leukonychia can also be a result of more serious trauma, often leading to the detachment of the nail plate from the nail bed and alterations to the nail contour.
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Fungal infection
White spots on your nails are usually harmless and are often caused by minor nail trauma or injury. However, in some cases, they can be a sign of a fungal nail infection, which occurs when a fungus attacks a fingernail, toenail, or the skin under the nail, known as the nail bed.
Fungal nail infections, or mycotic nails, are caused by fungal organisms that invade the nail through small cracks in the keratin or the nearby skin. Dermatophytes are the most common cause of mycotic nails, accounting for 80-90% of cases. Other causes include nondermatophyte molds (2-10% of cases), yeast (2-11% of cases), and various other microorganisms.
Mycotic nails typically cause the nail to turn brown, white, or black, and the nail may also become thick, fragile, and separated from the nail bed. The infection can spread to other parts of the body and can be difficult to treat. It is important to see a healthcare provider if you suspect a fungal nail infection, as they may prescribe oral antifungal medication or, in serious cases, recommend nail removal to allow a healthy nail to grow in its place. Laser treatment is another option for treating nail fungus.
To prevent fungal nail infections, it is recommended to avoid walking barefoot in places where fungus spreads easily, such as gym showers, swimming pools, and locker rooms. Keeping your feet away from others, wearing shoes in communal spaces, and not sharing shower stalls without cleaning them first can also help prevent the spread of fungus.
While white spots on nails are usually harmless, if you notice frequent or widespread leukonychia (white nails) or other nail abnormalities, it is important to consult a healthcare professional. They can help identify the underlying cause and provide appropriate treatment to prevent further nail damage.
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Mineral deficiency
White spots on your nails, also known as leukonychia, are a common condition and are generally harmless. They are often the result of a minor injury to the nail matrix, such as bumping or biting your nails. However, mineral deficiency is also considered a potential cause of white spots on nails.
Some experts believe that a lack of minerals, including iron, calcium, zinc, and magnesium, may lead to leukonychia. The nail plate is made up of various nutrients in specific proportions, and a deficiency in these nutrients can manifest as white spots. Selenium deficiency, in particular, has been reported several times as a possible cause of apparent leukonychia. However, other experts dispute this idea, stating that white spots are more likely due to minor injuries.
If you suspect that your white spots are caused by a mineral deficiency, you should consult a doctor or dermatologist. They may recommend a nail biopsy or blood test to check for any deficiencies or underlying conditions. Treatment for white spots caused by mineral deficiency may involve dietary adjustments or the use of nutritional supplements to improve your mineral intake.
It is important to note that white spots on nails can have various other causes, including fungal infections, allergies, certain medications, manicure treatments, and heavy metal poisoning. In most cases, these spots are not a cause for concern and will disappear over time. However, if you are concerned or if the spots persist, it is always best to seek medical advice.
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Underlying health condition
White spots on your nails are usually harmless and are a common condition. They often appear after minor trauma or injury to your nails, like bumping them against a hard surface, hitting them accidentally with a tool, or biting them. They can also be caused by a fungal infection, which can be treated with oral antifungal medication.
However, in some cases, white spots on the nails can indicate an underlying health condition. These cases are rare, but it is important to be aware of them and seek medical advice if you are concerned. If the white spots are persistent, frequent, or widespread, it is recommended that you consult a healthcare professional for evaluation and treatment.
One possible underlying health condition indicated by white spots on the nails is a vitamin or mineral deficiency. Some experts believe that a lack of minerals, including iron, calcium, and zinc, may cause leukonychia, a condition that results in white spots or streaks on the nails. However, there is ongoing debate among healthcare providers and researchers about whether deficiencies are a true cause of white spots.
In addition, certain skin conditions can cause white spots on the nails. These include alopecia areata, lichen planus, and atopic dermatitis. Psoriasis, in particular, can lead to white spots and often requires systemic therapy for treatment.
More seriously, white spots on the nails can sometimes be a sign of chronic kidney disease. This is especially true if the nails appear half-white and half-pink or red, a condition known as "half-and-half nails." This type of nail discolouration is seen in approximately 10-30% of patients with chronic renal disease.
Furthermore, white spots on the nails have been associated with liver disease, including cirrhosis. In some cases, this may indicate a severe underlying issue such as liver failure. White spots on the nails can also be a symptom of diabetes, although this is less common.
To diagnose and treat underlying health conditions effectively, healthcare providers may use a variety of methods. These can include a physical examination, nail clippings or biopsy, blood tests, and neurological tests.
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Frequently asked questions
White dots under the nails, or leukonychia, are common and usually harmless. They are often the result of a minor injury to the nail or nail bed. In rare cases, they can indicate a more serious underlying health condition such as liver disease, kidney disease, diabetes, or anemia.
Leukonychia can be divided into three types: true leukonychia, apparent leukonychia, and pseudoleukonychia. True leukonychia occurs when the white spots form at the nail matrix, the beginning edge of the nail located under the skin. Apparent leukonychia happens when the white spots form on the nail bed, the skin beneath the nail. Pseudoleukonychia is caused by a fungus growing on the outside of the nail, making the upper layers scaly.
Treating the underlying cause will prevent new spots from forming. White marks caused by injury will usually grow out with the nail and fade over time. Proper nail care can also help prevent new spots from forming. This includes limiting artificial nails and gel manicures, keeping nails trimmed and filed, wearing gloves for wet work, and keeping hands and nails moisturized.
