Ava Monroe
White spots under the nails are a common condition and are usually harmless. They are known as leukonychia, derived from the Greek words leuko, meaning 'white', and onyx, meaning 'nail'. White spots under the nails can be caused by several factors, including injury, infection, or an allergic reaction. In some cases, they may indicate an underlying health condition. Therefore, it is important to consult a healthcare provider if you notice persistent or worsening white spots under your nails.
| Characteristics | Values |
|---|---|
| Medical Term | Leukonychia or Leuconychia |
| Description | White spots or streaks on the nail plate |
| Types | Apparent Leukonychia, Pseudoleukonychia, True Leukonychia, Partial Leukonychia, Total Leukonychia, Hereditary Leukonychia, Acquired Leukonychia, Punctate Leukonychia, Transverse Leukonychia, Striate Leukonychia |
| Causes | Nail biting, trauma or injury, fungal infection, allergies, medications, selenium deficiency, vitamin deficiency, iron deficiency, calcium deficiency, zinc deficiency, heavy metal poisoning, manicures, underlying systemic disease |
| Diagnosis | Visual inspection, biopsy, blood test, mycology, KOH preparation, fungal culture |
| Treatment | Antifungal medication, gentle nail care, avoid irritants or allergens, frequent moisturiser application |
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What You'll Learn
White skin under nails is called leukonychia
There are three main types of leukonychia: true leukonychia, apparent leukonychia, and pseudoleukonychia. True leukonychia is caused by partial or whole nail plate damage, often due to injury to the nail plate or matrix. This type of leukonychia is characterized by trapped air within the nail plate, resulting in a reflection and lack of transparency. Apparent leukonychia occurs when the white spots form on the nail bed, the skin under the nail. This type of leukonychia can be caused by various conditions such as nail bed edema, severe anemia, or certain deficiencies. Pseudoleukonychia, on the other hand, is caused by outside organisms such as fungi, and the white spots appear on the surface of the nail rather than underneath it.
While leukonychia is usually harmless, it can sometimes be a sign of an underlying systemic disease. For example, in rare cases, whitening of all nails could be a sign of hypoalbuminaemia (low albumin), which is associated with nephrotic syndrome, a form of kidney failure. It could also indicate liver failure, protein malabsorption, or protein-losing enteropathies. Therefore, if you notice persistent or concerning nail discolouration, it is recommended to consult a healthcare professional for a proper diagnosis. They may suggest tests such as a biopsy, blood tests, or fungal culture to determine the underlying cause.
The treatment for leukonychia depends on the underlying cause. In many cases, gentle nail care and avoiding irritants are recommended. This includes limiting the use of nail polish, nail glue, and other grooming products that can be allergenic. Keeping nails moisturized can also be beneficial. For cases of pseudoleukonychia caused by fungi, antimycotic therapy may be indicated.
It is important to note that subtle changes in nail colour or texture can sometimes indicate an underlying health condition. Therefore, while leukonychia is often harmless, it is always a good idea to pay attention to any persistent changes in your nails and consult a healthcare professional if you have any concerns.
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It is caused by injury to the base of the nail
White spots under the nails are a common condition and are generally harmless. They are usually caused by an injury to the nail plate or nail matrix, such as bumping or hitting your nails against a hard surface, wearing tight shoes, or biting your nails. Regular manicures can also cause injury to these areas.
In most cases, these white spots will eventually grow out with your nail until you can clip or cut them off. This process can take around 6 to 9 months for a fingernail. During this time, you can try to avoid any behaviours that you suspect are responsible for the damage, such as biting your nails or using harsh chemicals on them. You may also want to try applying moisturizer more frequently.
If the white spots are infrequent and you believe they are related to an injury, you may not need to see a doctor. However, if you notice that the spots are persistent, worsening, or accompanied by other symptoms, it is recommended that you consult a healthcare provider for a proper diagnosis. They may perform a physical examination and take your medical history into account.
Depending on the underlying cause, your doctor may recommend certain treatments or lifestyle changes to address the issue. For example, if the white spots are caused by an injury, you may be advised to avoid any further trauma to the nails and allow them to heal. In the case of a fungal infection, your doctor may prescribe antifungal medication or therapy.
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It can be caused by fungal infections
White skin under the nails can be caused by fungal infections, which are contagious and can be passed from person to person. Fungi thrive in dark, warm, and moist environments, making toenails more susceptible to infection than fingernails. Toenails also have less blood flow, making it harder for the body to detect and prevent the infection.
Fungal nail infections, also known as mycotic nails, can cause the nail to turn white, yellow, green, or black. The nail may thicken, become brittle, and separate from the nail bed. In some cases, the nail may become misshapen, emitting a foul odour. While fungal nail infections may not initially cause pain, they can progress and lead to discomfort when pressure is applied to the affected area.
There are several types of fungal nail infections, including proximal subungual onychomycosis, candidal onychomycosis, and superficial onychomycosis. Proximal subungual onychomycosis typically affects individuals with immune system deficiencies and presents as white spots in the centre of the nail bed, spreading outward as the nail grows. Candidal onychomycosis, caused by yeast, often affects the fingernails, resulting in swollen and inflamed areas around the nails. Superficial onychomycosis originates in the top layers of the nail and gradually moves deeper, causing the nail to turn white.
To diagnose a fungal nail infection, a healthcare provider will visually examine the nail and discuss the patient's symptoms. Additional tests, such as microscopic examination of nail clippings or laboratory analysis, may be conducted to confirm the presence of fungi. Treatment options include antifungal medications and antimycotic therapy. Preventative measures, such as proper nail care and hygiene, are crucial to avoid contracting and spreading fungal nail infections.
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It can be caused by certain medications
White spots under the nails are a common condition and are generally harmless. They often appear after nail biting or bumping your nails, but they may have other causes, including fungi, allergies, and certain medications.
White spots under the nails can sometimes be a side effect of medications. For instance, chemotherapy and some medications used for bacterial and urinary tract infections, including sulfa drugs (sulfonamides), may cause white spots to appear on your nails. Poisoning by toxic heavy metals, such as arsenic and lead, can also lead to white spots.
Additionally, certain medications and personal care products can trigger allergic reactions, resulting in white spots on the nails. Your immune system may interpret products applied to your nails as allergens, causing white spots to form. These products may include nail polish, nail gloss, nail hardener, nail polish remover, and fake nails. If you suspect an allergic reaction, it is advisable to stop using the product and consult a doctor if symptoms persist.
In some cases, white spots under the nails can be associated with underlying medical conditions. While rare, they may indicate systemic diseases such as diabetes, heart failure, HIV, liver cirrhosis, or psoriasis. Therefore, if you are concerned about the appearance of your nails or notice other symptoms, it is recommended to consult a doctor or dermatologist for a proper diagnosis and treatment plan.
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It can be caused by hereditary conditions
White spots on your nails are a common condition and are generally harmless. They often appear after an injury to your nails, like bumping them against a hard surface, hitting them by accident with a tool, or biting them. However, they may also be caused by hereditary conditions, such as certain genetic mutations.
Leukonychia, the medical term for white discoloration appearing on nails, can be caused by a genetic condition. This can include familial cases of leukonychia totalis, which is caused by mutations in the PLCD1 gene on chromosome 3p22.2. This condition results in a whitening of the entire nail and usually occurs on all nails. It is important to note that whitening of only one entire nail is typically not considered leukonychia totalis but rather a result of mechanical trauma.
Additionally, some hereditary conditions that affect your nails, such as Bart-Pumphrey syndrome and Darier disease, may also cause white spots to appear. Darier disease, in particular, has been associated with longitudinal leukonychia, a less common form of leukonychia that features smaller 1mm white lines visible under the nail plate. While these conditions can be inherited from a biological parent, it is always a good idea to consult a healthcare provider for a proper diagnosis if you are concerned about any nail abnormalities.
While hereditary conditions can be a factor, it is worth mentioning that white spots on nails can also be caused by various other factors, including fungal infections, allergies, medications, and physical trauma. In some cases, they may even indicate more serious underlying health issues, such as liver or kidney problems. Therefore, if you notice persistent or concerning nail changes, it is recommended to consult a healthcare professional for further evaluation and appropriate treatment.
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Frequently asked questions
White skin under nails is a condition called leukonychia, which is the whitening of parts of the nail plate in the form of small white dots. It is usually harmless and may be caused by an injury to the base of the nail, nail biting, fungi, allergies, or certain medications.
If you notice persistent or worsening white spots on your nails, it is recommended to consult a doctor or dermatologist. They may perform tests such as a nail biopsy, blood test, or fungal culture to determine the underlying cause and provide an appropriate treatment.
While leukonychia is typically harmless, in rare cases, it may be associated with more serious underlying conditions. For example, whitening of the entire nail, known as leukonychia totalis, can indicate hypoalbuminaemia, nephrotic syndrome, liver failure, protein malabsorption, or protein-losing enteropathies.
