Isla Bennett
White nails can be caused by a variety of factors, some harmless and others indicative of underlying health issues. White spots on nails, known as leukonychia, can be caused by injury, infection, or allergic reaction, and are usually harmless. However, if most of the nail has turned white, it may indicate a fungal infection, decreased blood supply to the nail bed (Terry's nails), or other medical conditions such as liver cirrhosis or iron-deficiency anemia. Horizontal white lines, known as Muehrcke's lines, indicate low protein levels, while vertical white streaks, called longitudinal melanonychia, can be a normal variant in darker skin but may also require medical attention. Changes in the colour or size of the lunula, the white half-moon shape at the base of the nail, can also signal underlying diseases, such as Wilson's disease or heart failure. It is important to consult a healthcare professional if you notice any unusual nail changes accompanied by other symptoms.
| Characteristics | Values |
|---|---|
| White spots on nails | Leukonychia |
| Cause of white spots | Stress, injury, infection, allergic reaction, fungal infection, medication, poisoning |
| White lines across nail bed | Muehrcke lines |
| Cause of Muehrcke lines | Low levels of albumin, a protein in the blood |
| White lines across nail plate | Beau's lines |
| Cause of Beau's lines | Severe illness or trauma interrupting normal nail growth |
| White nails | Terry's nails |
| Cause of Terry's nails | Decreased blood supply to the nail bed, liver cirrhosis, iron-deficiency anaemia, kidney disease |
| White lunulae | Could indicate Wilson's disease, a rare inherited genetic disorder |
| White lunulae with red tips | Could indicate heart failure |
| White lunulae with a darker half | Could indicate severe kidney disease |
| White half-moons at the base of the nail | Lunula |
| Change in colour or size of lunula | Could indicate an underlying disease |
| White nails with a thickening of the tissue near the lunula | Clubbing |
| Cause of clubbing | Cardiovascular and pulmonary problems, gastrointestinal problems |
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What You'll Learn
- White nails could indicate an underlying disease
- White spots on nails are usually harmless
- White nails could be Terry's nails, indicating a liver, kidney or heart issue
- White nails could be leukonychia, caused by injury, infection or allergic reaction
- Horizontal white lines on nails could indicate low albumin levels
White nails could indicate an underlying disease
While white spots on nails are usually harmless, they could sometimes indicate an underlying disease. For instance, white lines extending across the nails, known as Muehrcke's lines, indicate low levels of protein in the blood, which may be caused by liver disease or malnutrition. Similarly, Beau's lines, or white horizontal lines across the nail plate, can indicate a severe illness or trauma that interrupted normal nail growth.
White spots on nails could also be a result of leukonychia, which can be classified as true, apparent, or pseudoleukonychia. True leukonychia occurs when white spots form in the area where the nail starts to grow (nail matrix) and appear in the hard part of the nail (nail plate). Apparent leukonychia occurs when white spots form in the skin on which the nails rest (nail bed). Pseudoleukonychia occurs when white spots form on the surface of the nail due to outside organisms like fungi.
Additionally, nails that are entirely or mostly white, known as Terry's nails, can indicate a decreased blood supply to the nail bed and may reflect issues with the liver, kidneys, or heart. They can also be a sign of iron-deficiency anaemia, where there is a reduced number of red blood cells in the body. In some cases, white nails could be a result of nail psoriasis, a long-term skin condition that causes nails to become crumbly and separate from the nail bed.
If you notice any unusual changes in your nails, it is important to consult a healthcare professional. They can evaluate your nails and perform any necessary tests to determine if there is an underlying condition that requires treatment.
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White spots on nails are usually harmless
While changes to your nails can sometimes indicate an underlying health condition, white spots on your nails are usually harmless. These spots are often caused by some sort of stress to the nails, such as an injury, an allergic reaction, or an infection. For example, manicures that involve forceful trimming, buffing, and polishing can cause white spots to appear on your nails. In addition, injuries such as bumping your nails against a hard surface, wearing shoes that are too small, or biting your nails can also result in these spots.
White spots on your nails may also be caused by fungal infections, which can make your nails appear discoloured, thick, or cracked. Outside organisms, such as fungi, can cause pseudoleukonychia, where white spots form on the surface of your nail. If you suspect that your white spots are due to a fungal infection, it is recommended to consult a healthcare provider. They may suggest oral or topical antifungal medications to treat the infection.
In some cases, white spots on your nails can be a side effect of medications or exposure to toxic heavy metals such as arsenic and lead. Additionally, these spots could be a result of an allergic reaction to nail products like nail polish, nail gloss, nail hardener, or fake nails. If you notice other symptoms such as fatigue, shortness of breath, or belly pain alongside the white spots, it is advisable to consult a healthcare professional.
It is important to note that while white spots are usually harmless, they can sometimes be indicative of other conditions. For example, parallel white lines across the nails, known as Muehrcke's lines, can indicate low protein levels in the blood. Horizontal white lines, called Beau's lines, can indicate a severe illness or trauma that interrupted normal nail growth. Moreover, white spots accompanied by other abnormalities, such as dents or pits in your nails, could be a sign of psoriasis or other autoimmune diseases. Therefore, while white spots on their own are typically harmless, it is always a good idea to pay attention to your nails and seek medical advice if you have any concerns.
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White nails could be Terry's nails, indicating a liver, kidney or heart issue
White nails could be Terry's nails, a type of nail discoloration. The nail beds look "washed out", with a thin reddish-brown or pink strip near the tip. Terry's nails are usually a sign of aging, but they can also indicate underlying health issues, particularly liver, kidney, or heart problems.
In the 1950s, Richard Terry observed that more than 8 out of 10 people with severe liver scarring (cirrhosis) also had white nails. This discoloration is due to the opacity of the nail bed, which is caused by a change in nail bed vascularity and the overgrowth of connective tissue. Terry's nails are characterized by ground glass opacification of nearly the entire nail, with a narrow band of normal, pink nail bed at the distal border.
Terry's nails are often associated with liver problems. People with advanced liver illness, cirrhosis, or scarring of the liver are more likely to develop Terry's nails syndrome. It is also a common symptom of chronic renal failure and kidney disease. Additionally, Terry's nails can indicate congestive heart failure and viral hepatitis.
While Terry's nails themselves do not require specific treatment, it is important to address any underlying medical conditions. For example, if liver problems or diabetes are the cause, medication or dietary changes may be recommended. A healthcare provider can give you a treatment plan to help manage the chronic condition.
If you notice that your nails resemble Terry's nails, it is recommended that you visit a healthcare provider for a check-up and further evaluation. They can determine whether your nail discoloration is due to aging or a sign of a more serious medical condition.
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White nails could be leukonychia, caused by injury, infection or allergic reaction
White nails can be harmless and are usually nothing to worry about. However, in some cases, they could be leukonychia, which is caused by stress to the nails. This could be from an injury, such as hitting your nail against a hard surface, or from wearing shoes that are too tight. Regular manicures can also cause leukonychia, as manicurists may use a lot of force when trimming, buffing, and polishing nails.
Leukonychia could also be caused by an infection. Fungal infections, for example, can cause nails to become discoloured, thick, and cracked. They can also lead to white spots and streaks on the nails. In addition, bacterial infections, such as an overgrowth of pseudomonas, can cause green-black nails, especially under loose nails.
Allergic reactions to nail products, such as nail polish, nail gloss, nail hardener, nail polish remover, and fake nails, can also cause leukonychia.
If you notice white nails accompanied by other symptoms, such as fatigue, feeling cold, dizziness, weakness, headaches, a sore tongue, or a fast heartbeat, it is important to consult a healthcare professional.
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Horizontal white lines on nails could indicate low albumin levels
Horizontal white lines on nails, also known as Muehrcke's lines, could indicate low albumin levels. Muehrcke's lines are typically characterised by two or three white lines running across the fingernails. They are caused by an increase in pressure under the nails due to blood vessel abnormalities. This pressure causes the tissue underneath the nails to appear white.
Muehrcke's lines are associated with hypoalbuminemia, a condition characterised by low albumin levels. Albumin is a protein produced by the liver, and its deficiency can be caused by various factors, including nephrotic syndrome and glomerulonephritis. Nephrotic syndrome involves the kidneys releasing too much protein into the urine, while glomerulonephritis is an inflammation of the small parts of the kidneys that filter blood.
Low albumin levels can also be caused by malnutrition, as seen in individuals with inadequate protein or zinc intake. In some cases, Muehrcke's lines may also be present in patients undergoing chemotherapy for cancer, even if their albumin levels are normal.
While Muehrcke's lines themselves are not harmful, they could indicate an underlying health condition or the need for additional treatment for a chronic condition. Therefore, it is important to consult a healthcare provider if you notice these lines, especially if accompanied by other symptoms such as pain or weakness.
In addition to Muehrcke's lines, there are other types of nail abnormalities that can provide insights into potential health issues. For example, Beau's lines are deep horizontal ridges that indicate a temporary cessation of nail growth due to various stressors, including high fever, major surgery, or trauma. Leukonychia, characterised by white spots or streaks on the nails, can result from slight trauma or fungal infection. Moreover, half-white and half-brown nails can be indicative of kidney failure, while blue nails suggest a lack of oxygen to the fingertips, possibly due to respiratory or heart diseases.
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Frequently asked questions
The white part of your nail may be long due to leukonychia, a condition where white spots form in the area where the nail starts to grow. Leukonychia can be caused by stress, injury, infection, or an allergic reaction.
If you have leukonychia, you should monitor your nails for any unusual symptoms and consult a healthcare professional if you are concerned.
Leukonychia is usually harmless and may resolve on its own. However, if it is caused by a fungal infection, your healthcare provider may prescribe oral or topical antifungal medication.
Yes, the long white part of your nail may also be caused by onycholysis, a condition where the nail separates from the nail bed. Onycholysis can be caused by trauma, fungal infections, or other underlying medical conditions.
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