Overview
White spots on nails, medically known as leukonychia, are small white discolorations that appear on the fingernails or toenails. While often harmless and cosmetic, they can sometimes indicate underlying health issues or nutritional deficiencies.
➤ Leukonychia is common in children and adults, often appearing sporadically.
➤ Most cases are benign and temporary, but persistent or widespread spots may require evaluation.
➤ In Korea, dermatology and internal medicine clinics offer diagnostic evaluation, treatment, and nutritional counseling for nail changes.
Key Facts
► Definition: Small, white, opaque spots or lines on nails due to various causes.
► Prevalence: Frequently observed in otherwise healthy individuals; exact prevalence unknown.
► Associated symptoms: Usually painless, without swelling or redness.
► Risk factors: Nail trauma, fungal infections, nutritional deficiencies, systemic diseases.
► Treatment in Korea: Depends on underlying cause; may include nail care, supplementation, or treatment of systemic conditions.
What Is White Spots on Nails (Leukonychia)?
Leukonychia refers to white discoloration of the nail plate.
➔ True leukonychia arises from abnormalities in the nail matrix, affecting nail growth.
➔ Apparent leukonychia occurs due to changes in the nail bed, such as systemic illness or hypoalbuminemia.
➔ The condition can appear as dots, lines, or diffuse whitening and can involve one or multiple nails.
What Symptoms Are Related to White Spots on Nails?
Symptoms usually include:
→ Small white dots or streaks on fingernails or toenails.
→ Bands or horizontal lines (Mees’ lines) in some cases.
→ Changes in nail thickness or texture if related to trauma or infection.
→ Painless appearance, usually without redness, swelling, or tenderness.
→ Occasional brittle or weak nails when associated with nutritional deficiency.
→ Discoloration spreading to multiple nails may indicate systemic disease.
Causes / Possible Causes of White Spots on Nails
Trauma-Related Causes
➤ Minor injuries or pressure to the nail matrix, often unnoticed.
➤ Frequent manicures, nail biting, or cosmetic treatments.
➤ Tight shoes or stubbing toenails can also trigger leukonychia.
Nutritional and Deficiency Causes
➔ Zinc or calcium deficiency – Can lead to nail discoloration or brittleness.
➔ Protein deficiency – Hypoalbuminemia may cause diffuse whitening.
➔ Vitamin and mineral imbalance – Iron, selenium, or biotin deficiencies sometimes contribute.
Systemic and Medical Causes
→ Fungal infections (onychomycosis) – May cause white patches or powdery appearance.
→ Psoriasis or eczema – Nail changes including leukonychia or pitting.
→ Chronic illnesses – Liver disease, kidney disease, or cardiac disorders may show nail changes.
→ Chemotherapy or medications – Certain drugs may induce temporary leukonychia.
Genetic Causes
➤ Inherited leukonychia – Rare, involves multiple nails and persists over time.
When Should I See My Doctor?
Consult a healthcare provider if:
➤ White spots are widespread, persistent, or increasing.
➤ Associated with changes in nail thickness, color, or shape.
➤ Occurs alongside fatigue, weakness, or other systemic symptoms.
➤ You suspect infection, nutritional deficiency, or systemic illness.
➤ Early evaluation helps identify treatable causes and prevent complications.
Care and Treatment
Lifestyle and Nail Care Measures
► Protect nails from trauma by avoiding biting or aggressive manicures.
► Wear well-fitting shoes to reduce pressure on toenails.
► Maintain good nail hygiene; keep nails trimmed and clean.
► Avoid harsh chemicals or frequent nail polish that may irritate nails.
Medical Treatments
➔ Address nutritional deficiencies – Supplement zinc, calcium, iron, or protein as advised.
➔ Treat underlying infections – Antifungal therapy for fungal leukonychia.
➔ Manage systemic diseases – Treat liver, kidney, or cardiac disorders if indicated.
➔ Discontinue causative medications after consultation with a doctor.
Procedural and Advanced Interventions
→ Laboratory tests – Blood tests to check nutrient levels, liver/kidney function, and protein status.
→ Dermatology evaluation – Skin and nail assessment for psoriasis or eczema.
→ Biopsy in rare cases – To rule out serious nail matrix disorders.
Treatment Options in Korea
Diagnosis in Korea
➤ Visual examination by dermatologists.
➤ Laboratory tests – Blood tests for nutrients, liver, kidney, and systemic disease evaluation.
➤ Fungal cultures or nail microscopy to detect infections.
➤ Dermatology consultation for chronic or unexplained leukonychia.
Non-Surgical Care
► Nutritional counseling and supplementation.
► Topical or oral antifungals for infections.
► Patient education on proper nail care and prevention of trauma.
Advanced Care
➔ Multidisciplinary approach for systemic disease-related nail changes.
➔ Monitoring and follow-up for persistent or recurrent leukonychia.
➔ Cosmetic care or protective nail treatments for cosmetic improvement.
Rehabilitation and Lifestyle Support
→ Education on balanced nutrition and long-term nail care.
→ Monitoring for recurrence after treatment of underlying causes.
→ Support for patients with chronic illnesses affecting nail health.
Korean clinics provide expert dermatology and internal medicine services, combining diagnostic precision, targeted therapy, and lifestyle guidance to manage white spots on nails effectively.
