7 Causes of White Nail Spots (And When to Be Concerned)

Whether you get your nails done regularly or keep them trimmed nice and short, you may get frustrated if you notice a white spot on your nail. White spots on the nail bed or nails are known as leukonychia. There are many causes of white spots on your nail, ranging from harmless scratches from manicures to signs of serious illness like liver or kidney disease.

Continue reading to learn more about leukonychia, including why white spots on the nails may appear, the causes of white spots on toes, and when you should see a doctor. 

Symptoms of White Spots on Nails

The main symptom of leukonychia is areas of opaque white spots on the nails. This can happen on the fingernails or toenails. Symptoms include:

• One white dot or line
• Many white dots
• White lines running along the nail
• All of the nail turning white

Sometimes the white spot will move as your nail grows, but in other cases, it will remain in one spot.

Types of Leukonychia

There are four different types of leukonychia. They are:

• Leukonychia punctata (true leukonychia): Characterized by a few white spots, this is the most common type of white spots on the nail. 
• Leukonychia partialis: This causes white dots in the nail bed. It can also cause white lines in the nail. 
• Leukonychia striata: This causes white lines that run parallel to the nail bed. 
• Leukonychia totalis: Characterized by the whole nail turning white, this is often a sign of a serious medical issue like liver failure. 

Causes of Leukonychia

There are many different causes of leukonychia. Some of them are minor issues of normal wear and tear, while others are more serious. The most common causes of white spots on nails are:

• Physical trauma: Biting your nails, picking at them, or having a nail bend back due to injury can all leave white marks. Your nails are made of layers of keratin. When injured, these layers can crack or have air trapped between them, leading to white spots. 
• Fungal infections: Sometimes fungus can grow between the layers of keratin, giving your nails a white appearance. One common infection is onychomycosis, a fungal infection of the toenails. 
• Serious health conditions: White nails, particularly leukonychia totalis, can be caused by hypoalbuminemia, or high levels of albumin, a blood protein. Hypoalbuminemia can be a sign of serious diseases including hepatitis, liver cirrhosis, and kidney disease.

Other Causes of Leukonychia

White spots on your nails can also result from:

• Vitamin deficiencies or malnutrition
• Heart disease
• Diabetes

What Medications Can Cause White Spots on the Nail?

Sometimes, people undergoing chemotherapy will develop white spots on their nails. Most often, chemo causes leukonychia striata, lines that run parallel to the base of the nail.

When to See a Healthcare Provider

Having white spots on your nail may seem like a minor condition. If you have an occasional white spot tied to a specific injury like picking your nails or slamming your finger, you likely don’t need to see a healthcare provider. 

However, you should speak with a healthcare provider if you have frequent or widespread leukonychia. White spots or nail color changes can seem harmless, but they might also be a sign of a severe or worsening health condition, like liver disease or diabetes. It’s important that your healthcare provider is aware of the changes to your nail coloring so that they can address the underlying cause of the white spots. 

How to Treat White Spots on the Nails

Most examples of leukonychia are the results of trauma. These areas of white within the nail will grow out as your nail grows. Eventually, they’ll be trimmed off and you won’t notice them anymore. White spots tied to fungal infections can be treated with antifungal medications. 

However, if you have lines running through your nails, many white spots at the bed of your nails, or widespread white areas, you should speak to a healthcare provider. They’ll have to order additional testing based on your health history to identify what’s causing white spots on your nails. When they begin treating the underlying health condition, you’ll likely notice that the white spots on your nails improve. 

Summary

White spots on the nails most often result from a small injury, like biting your nails or jamming your fingertips. These injuries can cause air to get trapped within the nail, giving it a white appearance. Fungal infections within the nail can also cause white spots. 

Yet, in some cases, white spots on the nail are a sign of serious illness, like diabetes, liver disease, or kidney disease. If you have many white spots on your nails, it’s best to see a healthcare provider for evaluation. They can help you identify what might have caused the spots and treat the underlying health condition.