Do you have white spots on your fingernails? The official medical term for these spots is leukonychia punctata – and it’s a fairly common condition. What causes fingernail white spots – and do they ever go away?
White Spots on Your Fingernails: What Are They?
Leukonychia punctata should be distinguished from other types of white nail discoloration. These spots are usually discrete, small in size, and don’t involve all of the fingers or toes. It’s important to distinguish this condition from other types of leukonychia that cause the nails to form white streaks – or even turn completely white. When the entire nail turns white, it can be a sign of a serious health condition such as liver disease, thyroid disease, diabetes, heart failure, or malnutrition.
White streaks that extend across the entire nail and don’t move as the nail grows are called Muehrcke’s lines. These lines disappear if you apply pressure to them, because they come from abnormalities in the blood vessels underneath the nails. Muehrcke’s lines are most often associated with low albumin levels in the blood stream. Albumin is a type of protein that can drop to low levels when a person has kidney disease, liver disease or protein malnutrition.
White Spots on Nails: What Causes Them?
Leukonychia punctata, or fingernail white spots, usually don’t have an ominous cause but appear when there’s injury to the nail matrix. The matrix is a region at the base of the nails that plays a role in determining the shape of the nail and how thick it is. It has the task of making the cells that form the nail plate.
What kind of injury causes the fingernail white spots you see with leukonychia punctata? Not surprisingly, nail biters often have white spots on their nails due to the trauma of their teeth grinding against their nails. People who do heavy labor or use certain types of tools that cause nail injury are also at high risk for leukonychia punctata. Overly aggressive manicures can damage the nail matrix and cause fingernail white spots too.
In rare cases, leukonychia punctata can be caused by a zinc deficiency. If you see white spots on several different nails, this could be the cause. Ask your doctor to check a zinc level.
White Spots on Nails: What Can You Do About Them?
There’s really no way to treat fingernail white spots that come from leukonychia punctata. The good news? They’ll gradually grow out as the nail does. To avoid them in the future, be gentler to your nails – and stop biting them.
Am Fam Physician. 2004 Mar 15;69(6):1417-1424.