White Spots on Toenails: Causes and Treatments - Dermatology

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Nail leukonychia


Hello doctor, I would like to ask about the white spots on my toenails.
What could this condition be? The white spots vary in size on all my toes except for my big toe and two to three small toes.
They have been getting larger over the past month, and this issue is only on my feet; my hands are completely unaffected.

Niming, 20~29 year old female. Ask Date: 2024/02/18

Dr. Wu Yuxin reply Dermatology


It is necessary to conduct a thorough examination to confirm, as it may also be caused by trauma.

Reply Date: 2024/02/18

More Info


White spots on toenails, medically known as leukonychia, can be caused by a variety of factors, ranging from minor trauma to underlying health conditions. Understanding the potential causes and treatments is essential for addressing this issue effectively.


Causes of White Spots on Toenails
1. Trauma or Injury: One of the most common reasons for white spots on toenails is trauma. This could be from stubbing your toe, wearing tight shoes, or any other injury that affects the nail matrix (the area where the nail grows). The white spots may appear as the nail grows out, and they typically do not indicate a serious problem.

2. Fungal Infections: Fungal infections can also lead to discoloration of the nails, including white spots. Conditions like onychomycosis can cause the nail to become discolored, thickened, and brittle. If you suspect a fungal infection, it is crucial to seek medical advice for appropriate antifungal treatments.

3. Nutritional Deficiencies: Deficiencies in certain vitamins and minerals, particularly zinc and calcium, can manifest as white spots on the nails. Ensuring a balanced diet rich in essential nutrients can help improve nail health.

4. Allergic Reactions: Allergies to nail polish, nail hardeners, or other nail products can cause white spots or discoloration. If you have recently changed your nail care products, consider discontinuing their use to see if the condition improves.

5. Systemic Conditions: In some cases, white spots on toenails can be indicative of underlying health issues, such as psoriasis, eczema, or other skin conditions. If the spots are accompanied by other symptoms, such as pain, swelling, or changes in the skin, it is essential to consult a healthcare professional.

6. Genetic Factors: Some individuals may be genetically predisposed to developing white spots on their nails. This condition is usually harmless and does not require treatment.


Treatments for White Spots on Toenails
1. Observation: If the white spots are due to minor trauma, they may resolve on their own as the nail grows out. Regularly trimming the nails and keeping them clean can help monitor the condition.

2. Topical Antifungals: If a fungal infection is suspected, over-the-counter antifungal treatments may be effective. However, persistent or severe cases should be evaluated by a healthcare provider for prescription-strength medications.

3. Nutritional Support: If nutritional deficiencies are suspected, consider consulting a dietitian or healthcare provider to assess your diet and recommend appropriate supplements.

4. Avoiding Irritants: If you suspect an allergic reaction, discontinue the use of any new nail products and observe if the condition improves. Opt for hypoallergenic products if necessary.

5. Medical Evaluation: If the white spots persist, worsen, or are accompanied by other symptoms, it is crucial to seek medical evaluation. A dermatologist or podiatrist can provide a thorough examination and may perform tests to determine the underlying cause.

6. Nail Care: Maintaining good nail hygiene is essential. Keep your toenails trimmed, clean, and dry. Avoid tight-fitting shoes that can cause trauma to the nails.

In summary, while white spots on toenails can be benign and often resolve on their own, it is important to monitor the condition and seek medical advice if there are concerns about underlying health issues or if the spots do not improve. Regular foot care and attention to any changes in your nails can help maintain overall nail health.

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