Why Are There White Spots on My Nails

Fill a foot tub with warm water. For every pint of water, add a teaspoon of salt. Soak your feet in the saltwater for about 10 to 15 minutes. Once dry, moisturize your feet, making sure to rub the lotion into your toenails.

5 Things That Can Cause White Toenails (and What to Do About It)

Maybe this sounds familiar: You’re trimming your toenails, contemplating whether to polish them with Relentlessly Ruby or go dark with Black Cherry Chutney, when you notice white spots.

Where did those come from? Discolored, brittle, or thick toenails (and fingernails) can be a sign something isn’t quite right in your body. But that doesn’t mean there’s an immediate cause for concern.

Most of the time, white toenails aren’t a big deal.

The spots might’ve come from bumping your toe or a common toenail fungus that a doctor can easily treat. Although it doesn’t happen too often, white toenails may suggest a more serious matter, like a vitamin deficiency or disease.

Here are some reasons why you might have white toenails and how to prevent and treat them. (Here’s what to know about ingrown toenails.)

It’s not just health insurance premiums, but also deductibles, that keep on rising. In 2018, the average deductible was $3,000 for a gold-tier family plan, $8,000 for a silver-tier family plan and $12,000 for a bronze-tier family plan, according to USC Annenberg’s Center for Health Journalism.

Reasons for white spots on your toenails

There are a bunch of reasons why your toenails may have white spots on them.

You might even notice whitish discoloration after using acetone to remove nail polish.

Pinning down the cause is the first step toward treating your white-spotted toenails. Here are the most common culprits.

Trauma

Sometimes when you stub your toe really hard, the blood vessels under the toenail break and leak blood, causing a bruise.

Other times, trauma might cause a white spot or streak (called leukonychia). This can happen when you bump your toe against a sturdy chair leg or rub it against the inside of a crowded and narrow shoe.

These spots are perfectly harmless.

Toenails are notoriously slow at growing out, so you may have a white spot on your toe for nine to 12 months, but don’t worry: the white discoloration eventually grows out.

Mineral deficiency

White toenails may be subtly trying to tell you you’re not getting enough vitamins and minerals.

“Iron deficiency anemia and zinc deficiency can both cause white nails,” says dermatologist Shari Lipner, MD, an associate professor of clinical dermatology at Weill Cornell Medicine in New York.

With these deficiencies, most of the nail appears white, except for the tip.

If you have an iron deficiency, you’ll probably notice other symptoms first. Those include fatigue and trouble concentrating. If you have a zinc deficiency, there’s a chance you’ll notice a decreased appetite and weight loss before you see a white toenail (or fingernail).

White toenails caused by zinc deficiency are often thin and brittle, breaking easily.

In addition to primarily white toenails, you might notice whitish grooves and double lines on your toenails.

Chronic iron deficiency can lead to other nail symptoms, like a condition called koilonychia, or spoon nails.

With this rare condition, the toenail becomes thin, brittle, and spoon shaped. The abnormal curvature in the middle of the nail is so prominent that the toenail could hold a droplet of water.

Treating mineral deficiencies with vitamin and mineral supplements seems like a no-brainer. But that’s not a safe way to address all your symptoms, and doubling up on vitamins and minerals can be dangerous.

“A mineral deficiency is diagnosed by examining the nails and doing a blood test,” says Dr. Lipner.

From there, your doctor will recommend a safe treatment. For instance, you may take over-the-counter iron supplements or a prescription iron pill that will make up for deficiencies without putting you at risk for a dangerous iron overdose.

Once a deficiency is identified and you’re following a doctor-prescribed treatment, the toenail symptoms should resolve.

But because toenails grow out slowly, the process may take several months.

Nail fungus (onychomycosis)

According to the Mayo Clinic, nail fungus commonly begins as a white or yellow spot under the tip of your nail— so there’s a chance that discoloration could be something more.

There’s a variety pack, if you will, of toenail fungi. They each have a defining trait or two, but for the most part, they all cause discoloration, nail separation, brittleness and thickening of the nail.

Although fungal infections of the toenail are seldom a cause for concern when it comes to our overall health, they rarely go away with over-the-counter treatment.

“Fungal infections of the toenails rarely, if ever, resolve on their own. They almost always require prescription management for resolution,” says dermatologist Joseph Zahn, MD, assistant professor of dermatology at the George Washington Medical Faculty Associates in Washington, D.C.

If you catch and start treating the fungus early, you might not experience some of the pesky symptoms, like crumbly toenails or total loss of the toenail. Unfortunately, the fungus may linger for several months—or as long as it takes the toenail to grow out. You can try a foot soak for toenail fungus to soothe symptoms.

Here are three types of toenail fungus that cause whitish toenails.

Proximal subungual onychomycosis

This toenail fungus is rare in healthy people but very common in immunosuppressed people. Proximal subungual onychomycosis (say that three times fast) differs from other types of toenail infections in that the fungus invades from the proximal skin—the place where the nail meets the toe, behind the cuticle.

“It then progresses distally across the nail, appearing like a diffuse white patch starting at the nail fold,” says Dr. Zahn.

In other words, you’ll first notice white patches developing in the center of the cuticle area.

As the toenail grows, the patches will move outward. Eventually, the toenail will lift from the nail bed, causing total toenail loss.

White superficial onychomycosis

One defining characteristic of white superficial onychomycosis is that it only invades the toenail’s surface—not underneath the nail bed—so it is easier to treat.

The whitish discoloration shows up randomly in the form of small, patchy islands. As the fungus ensues, the nail becomes rough, soft, and crumbly.

Candida infection

Though typically found in the fingernails of people who have their hands in water frequently, this fungus can target the toenails, especially if your feet are routinely in water.

As with other conditions that lead to whitish nails, infection with Candida causes the nails to become whitish and brittle. But the skin around the toenail will appear reddish.

Another clue you’re dealing with Candida: the infection will take a distinct direction on the nail.

“The involvement of the infection is distal and lateral, and there is complete destruction of the nail or partial destruction of the distal nail,” says Dr. Zahn.

In layman’s terms, the infection tends to affect the tip or end of the nail.

Nail psoriasis

“Nail psoriasis is a common inflammatory nail condition, with 80 to 90 percent of patients with psoriasis presenting with nail changes in their lifetime,” says Dr. Lipner.

Healthy nails are smooth, but with nail psoriasis, the toenails are thicker, and the surface is covered with tiny dents, referred to as “pitting.” The toenail may get crumbly and separate from the nail bed.

For mild cases, your doctor may prescribe topical vitamin D, retinoid (vitamin A), cortisone creams, or cortisone injections under the affected nails. Phototherapy (treatment with ultraviolet light) may also be helpful.

More extensive involvement may require systemic psoriasis medications such as biologics (treatments that modulate the immune system).

Diseases and, rarely, poisoning

It’s usually the glaring obvious symptoms (think fever, loss of appetite, and chronic tummy trouble) that lead us to call a doctor, not discolored toenails.

Still, once you’re in the exam room, your doctor may discover evidence of certain diseases or disorders—or even poisoning—that can show up on toenails and fingernails.

Take, for example, Mees’ lines. These white lines run across the nail, parallel to the nail bed, and point to a number of health conditions.

The lines were first described in the early 1900s in patients with arsenic poisoning, but they can also occur with kidney disease, Hodgkin’s disease, heart failure, or sickle cell anemia. You might also spot them if you’re undergoing chemotherapy.

So if you spot horizontal white lines across your nails, know that there are many reasons and conditions that can cause them.

Muehrcke’s lines, which are similar to Mees’ lines, stem from kidney and liver failure. You can tell the two types of lines apart because Muehrcke’s lines disappear temporarily when the nail is pressed.

The white discolorations usually fade or grow out as the specific condition is treated.

How to prevent white toenails

You might not be able to prevent white toenails entirely. After all, the chances of bumping your toenail at some point is pretty high.

And if you have a skin condition such as psoriasis, whitish toenails might be more challenging to fend off.

The wisest move toward reducing white toenails is to keep your eye out for changes in the toenail.

The earlier you notice a change, the better—especially when it comes to toenail fungus, which can spread to other toes and people. Here’s what you can do at home to help prevent white toenails.

Keep your toenails short

It’s much easier to split or break a toenail that is too long. Always cut toenails straight across, rounding slightly at the tips.

Don’t cut the sides of your toenails to shape sharp corners, as it may encourage the nail to grow into the skin, causing a painful ingrown toenail.

Also, don’t share toenail (or fingernail) clippers without sanitizing them first in rubbing alcohol.

Soften toenails, moisturize your feet, and keep them dry

Toenails can be challenging to cut because they are thicker. Try softening the toenails first.

Fill a foot tub with warm water. For every pint of water, add a teaspoon of salt. Soak your feet in the saltwater for about 10 to 15 minutes. Once dry, moisturize your feet, making sure to rub the lotion into your toenails.

Sweaty feet are a breeding ground for germs, so keep your feet as dry as possible by wearing shoes and socks that breathe well.

Prevent toenail fungus by wearing flip-flops in public showers, locker rooms, and around pools.

Be mindful of toenail polish

Don’t wear toenail polish for more than a week or two. It can mask the first signs of fungus or other toenail issues.

Call your doctor

If you have diabetes or circulation problems, or if you’re immunosuppressed, call your doctor at the first sign of pain, redness, pus, or other abnormalities.

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Why Are There White Spots on My Nails?

White spots on your nails are a common indicator of 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 in their lives. In fact, developing them is likely not a sign of a serious medical condition.

The most 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 be responsible for the unusual spots on the nails. Let’s discuss the basics of white spots in the nails and when you may need to talk with your doctor.

Leukonychia is a condition where white lines or dots appear on the fingernails or toenails. This is a very common issue, and it’s entirely harmless.

Leukonychia is classified into two types:

• True leukonychia originates in the matrix of the nail, the part of the nail that’s responsible for nail production.
• Apparent leukonychia is a problem with the nail bed, the portion of the nail that’s 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 is a complete whitening of the nail plate. It usually affects all 20 nails.
• Partial leukonychia 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 white spots may be larger and stretch across the entire nail plate. The spots may affect one nail or several.

Partial leukonychia can appear in a variety of ways. They may look like:

• tiny pen-point–sized dots (punctuate leukonychia), which is the most 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 for the white spots on your nail may dictate 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 include the following.

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 may 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 early in infancy .

In other cases, leukonychia may be the result of rare disorders, including:

• Bart-Pumphrey syndrome, which causes nail abnormalities, knuckle issues, and hearing loss
• Bauer syndrome , which causes leukonychia and skin cysts
• Buschkell-Gorlin syndrome, which causes nail problems, kidney stones, and skin cysts
• Darier disease, which causes 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 4 weeks or more.

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

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 and poisoning

Some medications can cause white spots in nails. These include chemotherapy medications used to treat cancer, and sulfonamides used to treat bacterial infections.

Additionally, 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, see your doctor immediately. A blood test can detect abnormal levels of these elements.

Mineral deficiency

You may notice white spots or dots along your nails if you’re deficient in certain minerals or vitamins. The deficiencies most commonly linked to this issue are zinc deficiency and calcium deficiency.

Your doctor will be able to determine if you are 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. It can be mistaken for whiteness in the nail itself.

Systemic illness

Less common causes for white spots on nails include:

• heart disease
• kidney failure
• pneumonia
• iron deficiency (anemia)
• liver cirrhosis
• diabetes
• hyperthyroidism

While these causes are possible, they are very rare. Your doctor will likely explore a host of 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 never need to see your doctor about the issue.

Just be more careful to avoid injury or stop the behavior you suspect is responsible for the damage.

If you notice the spots are persistent or worsening, it might be time to see your doctor. Most issues that could cause the white spots are easily treated once they’re diagnosed.

At your appointment, your doctor will inspect 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 or heavy metal poisoning

If they’re unsure about the diagnosis, they may request several tests to eliminate possible causes. This is especially true if your 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, your doctor may recommend any of the following treatments.

Avoid allergens and harsh chemicals

Stop using the nail polish, gloss, 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, consult your doctor.

Antifungal medication

Oral antifungal medication is the most common treatment for nail fungus, and many doctors will also prescribe a topical antifungal treatment as well.

The average treatment time is 3 months, and it’s important to use the treatment through the prescribed period of time. Otherwise, you may not fully treat the infection.

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 will disappear entirely.

Cosmetic treatments

If the discoloration of your nails is troublesome, or if you’re seeking a temporary way to cover them up, use nail polish.

Skin tone–colored nail polish is a natural way to hide the spots. And colorful polishes are certainly fun.

If you’ve repeatedly noticed white spots on your nails and wonder what to do, here’s a brief guide:

1. Think, and then protect your nails. Have you recently hit your nails or injured your fingers in any way? Are the spots on the affected digits? Protect your nails as best you can when doing anything where they may be pinched, hit, or smashed. Also, take action to strengthen your nails, so they are more resistant to damage.
2. Take note of symptoms. Do you have any other symptoms, such as changes to your nail color or texture? Are your nails turning yellow or becoming brittle? You may need to see your doctor for treatment.
3. 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, your doctor may offer a diagnosis and prescription.
4. Eat for better nail health. Eat a balanced diet and maintain adequate levels of vitamins to 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 6 months or more to grow out fully. Toenails take longer, up to 18 months for full growth.

For most people, white spots on the nails are nothing more than a bothersome spot. They are rarely signs of bigger problems, and most will disappear on their own without treatment.

If you’ve noticed the spots and are anxious, a quick visit to the doctor can help clear up whatever’s causing the spots and answer any additional questions you have. Most treatments are fast and effective.

Last medically reviewed on March 7, 2022