White spots on your nails often result from injury but can also happen due to other causes, including fungus, mineral deficiency, and heavy metal poisoning.
Many healthy adults will notice spots on their nails at some point. Developing them is typically not a sign of a serious medical condition.
A common cause of these white nail spots, called leukonychia, is an injury to the nail matrix. These injuries can occur if you pinch or strike your nail or finger.
Several other causes may trigger these spots to form. We’ll discuss the basics of white spots on the nails and when you may need to talk with a doctor.
Leukonychia is a condition where white lines or dots appear on the fingernails or toenails.
Leukonychia is classified into
- True leukonychia: This type originates in the matrix of the nail, the part of the nail responsible for nail production.
- Apparent leukonychia: This is a problem with the nail bed under the nail and not the nail itself.
True leukonychia can be further divided into two categories based on how the nails look.
- Total leukonychia: This is a complete whitening of the nail plate. It usually affects all 20 nails.
- Partial leukonychia: This occurs when a portion of the nail plate is affected by the whitening. It may affect one nail, a few, or all.
For some people, 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.
Partial leukonychia may 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)
The cause may affect how the spots appear. A nail injury may cause a large white dot in the middle of the nail. An allergic reaction may cause several dots all over the nail.
The appearance of the white dots or lines may be different on each nail.
You may also have additional symptoms, depending on the cause of the white spots.
White spots or dots on your nails are common, and a variety of factors can cause them. Possibilities can include:
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 white spots.
Fungi
A common nail fungus called white superficial onychomycosis can appear on the toenails. The first sign of the infection may be a few small white dots on the nails.
The infection can grow and spread to the nail bed. Toenails may appear flaky and then become thick and brittle.
Hereditary causes
True leukonychia may be an inherited condition, but it’s very rare.
It’s caused by a gene mutation that can be passed by one or both parents to a 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
Injury to the nail
An injury at the matrix, or base of your fingernail that produces the nail plate, can cause white spots or dots on your nail as it grows.
However, because of the time it takes for your fingernails to grow, you may not recall the injury. Some injuries won’t show up for
Common sources of injuries to nails include:
- shutting your fingers in a door
- striking your finger with a hammer
- hitting your nails against a counter or desk
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 matrix.
Medicines
Some medications can cause white spots on nails. These include chemotherapy used to treat cancer and sulfonamides used to treat bacterial infections.
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
- heart disease
- kidney failure
- pneumonia
- iron deficiency (anemia)
- liver cirrhosis
- diabetes
- hyperthyroidism
While these causes are possible, they’re rare. A doctor may explore other conditions if you have persistent white spots on your nails or other nail abnormalities 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 about them.
You can try to prevent injury or avoid the behavior you suspect is responsible for the damage.
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 diagnosed.
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 them understand the underlying issues, doctors may perform one or more tests. These include:
- mycology, where fungal or nail clippings are sent for study under a microscope
- nail biopsy, where a sample of the nail or skin tissue is sent for study under a microscope
- blood test, where blood is examined for evidence of systemic disease, heavy metal poisoning, or a mineral deficiency
If they’re unsure about the diagnosis, they 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 will vary depending on the cause of the white spots. Once you have 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 for nail fungus, and some may prescribe a topical antifungal treatment 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 troublesome, 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.
Skin tone–colored nail polish may help hide the spots.
If you’ve repeatedly noticed white spots on your nails and wonder what to do, here’s a brief guide:
- Think, and then 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 where they may be pinched, hit, or smashed. You can also take action to strengthen your nails so they’re more resistant to damage.
- Take note of 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 your doctor: If you think the white spots on your nails are not caused by injury, you can make an appointment with your doctor. After an examination, a doctor may offer a diagnosis and treatment plan.
- Eat for better nail health: Eating a balanced diet and maintaining adequate levels of vitamins may prevent side effects like 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 can 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.
But if the spot appears with other symptoms or spots continue to develop, it may indicate another health condition, such as an allergic reaction.
Treatment can depend on the cause of the white spots.
