Key takeaways
- White spots on your nails are often the result of a nail injury called leukonychia.
- Other potential causes of white spots in your nails include allergies, fungal infection, mineral deficiency, or heavy metal poisoning.
- Your treatment options will depend on the cause of the white spots and may include medication, eliminating exposure to irritants, or giving your nails some time to heal.
You may notice white spots on your nails at some point in your life. This discoloration isn’t usually a sign of a serious medical condition.
A common cause of these spots is an injury to your nail matrix. White spots that occur due to an injury are called leukonychia. These injuries can occur if you accidentally close your finger in a car door or strike the tip of your finger with a hammer.
In addition to nail injury, several other causes may trigger the formation of white spots. This article reviews all potential causes of white spots on your nails and when to seek treatment from a doctor.
Leukonychia is an injury to your nail matrix. This is the base of your fingernail that produces the nail plate. An injury to this area can cause white spots on your nail as it grows.
However, because of the time it takes for your fingernails to grow, you may not remember or associate the injury with the white spots on your nails. Symptoms of leukonychia may not show up for
What are the different types of leukonychia?
Leukonychia may be classified into two
- True leukonychia: This type originates in the matrix of the nail, the part of the nail responsible for nail production. True leukonychia is further divided into two categories based on how the nails look:
- Total leukonychia is a complete whitening of the nail plate. It usually affects all 20 nails.
- Partial leukonychia occurs when just a portion of the nail plate is whitened. It may affect one nail, a few, or all.
- Apparent leukonychia: This type of leukonychia involves a problem with the nail bed under the nail, not the nail itself.
What does leukonchia look like?
For some people with leukonychia, the white spots may appear as tiny dots speckled across the nail. For others, the spots may be larger and stretch across the entire nail plate. The spots may affect one nail or several.
Leukonychia may also look like:
- tiny pen-point–sized dots (punctuate leukonychia), which is a
common form - larger “lines” across the nail (longitudinal leukonychia)
- larger individual dots or horizontal bands that are parallel to the base of the nail (striate or transverse leukonychia)
In addition to leukonychia, a number of other potential causes may form white spots on your nails, such as:
- an allergic reaction
- fungal infection
- hereditary mutations or rare disorders
- frequent manicures
- medications
- heavy metal poisoning
- mineral deficiency
- skin conditions
- systemic illnesses
Keep reading to learn more about each of these potential causes.
Allergic reaction
An allergy to nail polish, gloss, hardener, or nail polish remover may cause white spots on your nails.
Chemicals used in the application and removal of acrylic or gel nails can also badly damage your nails and cause these spots.
Fungal infection
A common nail fungus called white superficial onychomycosis can appear on your toenails. The first sign of the infection may be a few small white dots on your nails.
The infection can grow and spread to your nail bed. Toenails may appear white and flaky at first and then become thick and brittle.
Hereditary mutations or rare disorders
True leukonychia may be an inherited condition, but it’s very rare.
A gene mutation causes it, and one or both parents can pass it to their child. Typically, people born with true leukonychia caused by a hereditary issue experience total leukonychia, and the all-white nails show up at birth or in infancy.
In other cases, leukonychia may result from rare disorders, including:
- Bart-Pumphrey syndrome, which can cause nail abnormalities, knuckle issues, and hearing loss
- Bauer syndrome, which may cause leukonychia and skin cysts
- Buschkell-Gorlin syndrome, which can cause nail problems, kidney stones, and skin cysts
Darier disease (keratosis follicularis ), which can cause nail abnormalities and wart-like blemishes
Frequent manicures
Frequent manicures may also cause damage that results in these white spots on your nails. Pressure applied by the manicurist may damage the nail beds or nail matrix.
Medications
Some medications can cause white spots on nails. These include chemotherapy used to treat cancer and sulfonamides used to treat bacterial infections.
Heavy metal poisoning
Heavy metal poisoning from arsenic and lead can cause lines to develop on nail plates. If you’re exhibiting other symptoms of heavy metal poisoning, consider getting medical attention immediately.
A blood test can detect abnormal levels of these elements.
Mineral deficiency
You may notice white spots along your nails if you’re deficient in certain minerals or vitamins. The deficiencies most commonly linked to this issue include zinc deficiency and calcium deficiency.
A doctor can determine if you’re at risk for any mineral deficiency.
Skin conditions
Inflammatory skin diseases, like nail psoriasis and hand eczema, can affect the nail matrix. This can lead to abnormal spots in the nail plate.
Leukoderma causes white patches under the nail. Some people may mistake it for whiteness in the nail itself.
Systemic illness
In some cases, white marks on your nails
While these causes are possible, they’re rare. If you have persistent white spots on your nails or other nail abnormalities, a doctor may explore other conditions before considering these more serious issues.
If your white spots are infrequent, and you think they’re likely related to injury, you may not need to see a doctor. Instead, you can try to avoid the behavior you suspect is responsible for the damage, such as not using nail polish remover or other harsh chemicals on your nails.
If you notice the spots are persistent or worsening, it might be time to talk with a doctor. The issues that could cause the white spots may be easily treated once you receive the correct diagnosis.
At your appointment, a doctor typically inspects the nails on your hands or feet. Based on their observations, they may make a diagnosis and offer a prescription.
To help understand the underlying issues, doctors may perform one or more tests, including:
- Mycology: where they send your nails with the fungal infection or nail clippings for study under a microscope
- Nail biopsy: where they send a sample of your nail or skin tissue for study under a microscope
- Blood test: where they examine blood for evidence of systemic disease, heavy metal poisoning, or a mineral deficiency
If they’re unsure about the diagnosis, a doctor may request several tests to eliminate possible causes. This is especially true if a doctor suspects that a vitamin or mineral deficiency is responsible for the white spots on your nails.
Treatment depends on the cause of the white spots. Once you’ve received a diagnosis, a doctor may recommend any of the following treatments.
Avoid allergens and harsh chemicals
If caused by an allergic reaction, you may want to stop using the nail polish or other product you think may be responsible for your allergic reaction. If you continue to have symptoms of an allergic reaction after you stop using the products, consider consulting a doctor.
Antifungal medication
Doctors typically recommend oral antifungal medication (medication that you take by mouth) for nail fungus, and some may prescribe a topical antifungal treatment (medication that you apply on the skin/nail) as well.
Treatment may take
Time and rest
Most nail injuries just need time to heal. As the nail grows, the damage will move up the nail plate. Over time, the white spots may disappear entirely.
Cosmetic treatments
If the discoloration of your nails is not getting better, or if you’re seeking a temporary way to cover them up, you can try nail polish, as long as that is not the cause of the spots in the first place.
Nail polish that matches your skin tone may help hide the spots.
If you’ve repeatedly noticed white spots on your nails and wonder what to do, here are some prevention and next-step tips:
- Protect your nails: Have you recently hit your nails or injured your fingers in any way? Protect your nails as best you can when doing anything that may cause them to be pinched, hit, or smashed. You can also strengthen your nails so they’re more resistant to damage.
- Take note of new symptoms: Do you have any other symptoms, such as changes to your nail color or texture? If so, you may need to see a doctor for treatment.
- Talk with a doctor: If you think the white spots on your nails are not caused by injury, make an appointment with a doctor. They can diagnose your condition and recommend a treatment plan.
- Eat for better nail health: Eating a balanced diet and maintaining adequate levels of vitamins may prevent mineral deficiencies, which can cause white spots on your nails.
Fingernails and toenails grow slowly, so it may take some time for the white spots or lines to disappear entirely. Fingernails typically take
For most people, white spots on the nails are rarely signs of bigger problems. They often result from injury and go away as the nail grows out.
However, if the spots appear with other symptoms or continue to develop, this may indicate another health condition, such as an allergic reaction.
A doctor can diagnose your condition and recommend treatment.