White nails can indicate a variety of conditions, ranging from harmless to more serious underlying health issues. Let’s take a look at some of the possible causes of white nails and when you should see a doctor.
What Causes White Spots on Nails?
Some of the most common causes of white spots or markings on nails include:
- Minor injury or trauma to the nail
- Nail fungus (onychomycosis)
- Vitamin or mineral deficiencies
- Allergic reaction
- Nail psoriasis
- Skin conditions like eczema or lichen planus
- Kidney or liver disease
- Anemia
- Thyroid disease
- Diabetes
- Chemical exposure
Let’s explore some of these causes in more detail:
Nail trauma
Injury to the nail, either from impact or from consistent pressure, can cause white spots or lines. For example, if you hit your fingernail against a hard surface, you may get a bruise under the nail that appears as a white mark. Tight shoes can also cause pressure on toes leading to white lines on toenails.
These white marks from trauma are harmless and grow out with the nail over time. They do not need any treatment.
Nail fungus
One of the most common causes of white, yellow, or brown discoloration along with nail thickening and distortion is a fungal nail infection. Fungus grows well under and inside the nail and feeds on keratin, the protein that makes up your nails.
You are more prone to nail fungus if you have:
- Wet work occupations like dishwashing
- A compromised immune system
- Diabetes, lung disease, or circulatory issues
- Injured nails or artificial nails
- Athlete’s foot
- Walk barefoot in warm, humid places like pools or showers
Prescription oral and topical anti-fungal medications can treat nail fungus. For mild cases, over-the-counter treatments may be effective. Treating nail fungus as soon as you notice symptoms gives you the best chance of clearing it faster.
Nutrient deficiencies
Not getting enough key vitamins and minerals in your diet can show up as white spots on nails. For instance:
- Zinc deficiency – White spots across multiple nails may signal low zinc.
- Calcium deficiency – White bands going across nails horizontally could indicate calcium deficiency.
- Iron or vitamin B12 deficiency – These can cause nails to turn pale or white.
Eating a balanced diet rich in essential vitamins and minerals can often resolve these white discolorations. Your doctor may recommend blood work or supplements depending on the severity of the deficiency.
Allergic reactions
Contact allergies to nail polish, acrylics, gel polish, nail glue, nail hardeners, or other chemical products used on nails can trigger white spots. The spots may appear under the tips of nails first. Allergy to hair dyes can also cause white lines on nails.
When products containing harsh chemicals or allergens are removed, the nails will start to grow out healthy again.
Nail psoriasis
Up to 50 percent of people with psoriasis will get psoriasis of the nails. This causes pitting, loosening, thickening and discoloration of nails. White spots on nails are one manifestation of nail psoriasis. The spots can range from tiny flecks to prominent bands across the nails.
If you have psoriasis on your body, getting white spots on nails could signal nail psoriasis. Treatments like steroid creams and phototherapy may help clear up the spots.
Skin conditions
Chronic skin conditions like eczema and lichen planus that cause inflammation and itchy rashes can also affect nails. People with eczema often have ridges and discoloration like white lines and dots on nails.
Lichen planus causes shiny white lines, dots or patches on nails along with brittle, rough nails. Treating the underlying skin condition with topical medications can help resolve the nail abnormalities.
Kidney and liver disease
Serious medical conditions affecting the kidneys and liver can be associated with white discoloration of nails. For instance:
- Kidney problems can cause nails to become pale, white and dull.
- Liver issues like hepatitis often result in white spots and nails turning white.
- Gout can also cause white islands to appear on nails due to deposits of uric acid crystals.
When white nails appear in conjunction with other symptoms, doctors may run blood tests or do a biopsy to diagnose and treat any underlying kidney or liver disease.
Anemia
Anemia happens when you have a low red blood cell count and your blood cannot carry enough oxygen throughout your body. People with iron, vitamin B12 or folic acid deficiency anemia may notice white lines or bands across nails along with fatigue, pale skin and dizziness.
Doctors can run blood tests to determine the type of anemia. Treatment involves supplements, dietary changes or medication to manage the condition.
Thyroid disorders
Changes in thyroid function from hypothyroidism or hyperthyroidism can affect nail appearance. Along with white spots and stripes, nails can become brittle and dry.
Blood tests help diagnose thyroid disorders. Medications that adjust thyroid hormone levels and regular monitoring of symptoms can restore nail health.
Diabetes
Frequent high blood sugar in diabetes often causes yellowish nails with white bands at the tips. These blood sugar fluctuations damage tiny blood vessels including capillaries that supply nutrients and oxygen to nails.
Getting blood sugar levels under control through medication, diet and exercise helps resolve white discoloration caused by diabetes.
Chemical exposure
Being in frequent contact with industrial chemicals like cleaning solutions, solvents, oils and petroleum products can damage nails. This type of chemical exposure causes white lines, dots and discoloration.
Avoiding further contact with harsh chemicals and protecting hands and feet can help new nail growth come in healthy.
When to See a Doctor
Schedule an appointment with your doctor if you have:
- Pain or soreness around nails
- Nail separation from the nail bed
- Discoloration along with other symptoms like fatigue, trouble breathing, weight changes or rashes
- White spots or nails turning completely white
- No apparent reason for the nail changes
Early diagnosis and treatment help prevent any nail or health issues from becoming more serious.
Diagnosing the Cause of White Nails
To get to the root of what is causing white nails, your doctor will:
- Ask about your medical history and any recent illnesses or injuries
- Find out if you have any underlying medical conditions
- Examine your nails and skin for appearance and texture
- Order blood tests to check for thyroid issues, anemia, diabetes or deficiencies
- Test nail clippings for fungal infections
- Biopsy a nail bed for signs of psoriasis, tumors or other abnormalities
Based on test results and your other symptoms, your doctor can determine if an underlying medical problem is responsible for the white discoloration.
Treatments for White Nails
Treatment depends on the cause behind white nails:
- Nail trauma – No treatment needed; the marks grow out over time
- Fungal infection – Prescription anti-fungal pills or topical medicines
- Nutrient deficiency – Dietary changes and supplements to increase intake of lacking vitamins/minerals
- Allergies – Avoidance of triggers like certain nail products
- Psoriasis – Topical steroids, light therapy, biologics or oral medications to treat the condition
- Skin disorders – Medicated ointments, creams or shampoos to manage eczema or lichen planus
- Systemic disease – Medications or lifestyle changes to regulate thyroid, kidney function, diabetes, etc.
- Anemia – Iron, B12 or folic acid supplements
- Chemicals – Wear protective gloves and minimize exposure
Talk to your dermatologist about the best treatments for your individual case based on the specific cause.
Home Care for White Nails
While getting underlying causes treated, you can try these home remedies to help improve the appearance of white nails:
- Apply a nail hardener or strengthener to bind layers together
- Use a hydrating cuticle oil daily
- Avoid or minimize manicures and use of nail polish/acrylics to prevent damage
- Wear light colored nail polish to camouflage white spots
- Eat a nutritious diet and take supplements as recommended by your doctor
- Avoid picking at nails to prevent splitting and injury
Prevention Tips
You can reduce the chances of white nails by:
- Wearing gloves for wet work and chemical exposure
- Not sharing nail tools to prevent fungus transmission
- Getting manicures from reputable salons with proper sanitization
- Avoiding artificial nails if you have nail psoriasis
- Using moisturizer and sunscreen if you have eczema
- Quitting smoking to improve circulation
- Seeing your doctor regularly to control existing medical conditions
When to Seek Emergency Care
Seek immediate medical attention if you experience:
- Sudden nail detachment or falling off
- Unexplained bleeding from nails
- Red skin, extreme pain or pus around nail
- Nail injury with severed blood vessel
- Rapid worsening of nail discoloration
- Trouble breathing, fainting or chest pain along with white nails
These signs can indicate a nail infection turned severe or an underlying health emergency requiring urgent evaluation and care.
Outlook for White Nails
The prognosis depends on the cause:
- Trauma – Excellent outcome with marks growing out in months
- Fungal infection – Clears slowly over 6 months to 1 year with treatment
- Psoriasis – Manageable with ongoing treatment but can relapse
- Nutrient deficiency – Resolves fully with diet and supplements
- Systemic disease – Variable outcomes depending on management of condition
Mild white spots or lines often resolve on their own as your nails grow out. Seeking timely treatment improves prognosis for fungal and inflammatory causes.
When to See a Dermatologist
Consult a dermatologist promptly if you notice:
- Sudden nail changes without any trauma or chemical exposure
- Severe nail deformity, crumbling or thickening
- Discoloration and texture changes in multiple nails
- Nail abnormalities along with rashes or other skin issues
- Family history of nail disorders
- Frequent nail infections
- No improvement with over-the-counter anti-fungal treatments
A dermatologist can accurately diagnose the specific cause and prescribe medications, phototherapy or nail procedures for effective treatment.
Takeaways
- White spots, bands or nails turning completely white can result from trauma, infections, vitamin deficiencies, kidney disease, skin conditions and other medical disorders.
- See your doctor for persistent or spreading nail discoloration to determine if any underlying illness requires treatment.
- Catching and treating nail issues early provides the best chance for restoring healthy nails.
- Practice good nail hygiene and care to prevent fungus and damage leading to white markings.
- With proper treatment guided by your doctor, white nails often improve gradually as the discolored parts grow out.