White spots on the nails of fingers and toes: what does it mean?

The appearance of the nail plates is pinkish, smooth and strong enough, indicating the absence of health problems. But the appearance of any pathological changes indicates possible trouble. Including white spots on the nails (leukonychia) should attract attention and make you think about the reasons for their appearance. Point, striped, irregularly shaped spots appear in places where air accumulates in the nail plate. So how and why does it get there?

Causes white spots on the nails

Modern medicine is not ready to give a detailed answer to the question of why white spots appear on nails. A number of reasons may contribute to the abnormal development of the nail plate structure. It is normally tightly folded like tiles from many miniature porous plates and consists mainly of protein. Most researchers support the hypothesis that air bubbles between insufficiently keratinized cells appear as a result of a disruption in the functions of nail formation in the matrix (its root) under the influence of various factors. Histological examination of a nail sample with leukonychia reveals normally keratinized and parakeratotic (non-keratinized) cells.

The most common cause of leukonychia is considered to be nail trauma. This can be blows, cuts, scratches of the nail bed, exposure to chemicals contained in detergents, cleaning agents, nail polish. The most common traumatic cause of white spots on nails in adults is a trim manicure, in which the cuticle and eponychium are removed, exposing areas of incomplete keratinization. The situation is aggravated by regular coating of nails with decorative varnish, as well as other cosmetic tricks, for example, gluing on false acrylic nails. It is not for nothing that many women note that they have white spots on their nails after varnish, although in fact the starting point was an injury to the matrix during cuticle trimming.

Keratinization anomalies in the form of leukonychia are found in diseases of the liver, digestive and excretory organs, hyperthyroidism, since they are accompanied by metabolic and trophic disorders, intoxication, hypoalbunemia (protein deficiency), which is considered the most common cause of total leukonychia.

The alimentary factor is mentioned among the reasons that link white spots on the nails and a deficiency of vitamins, minerals or protein in the body. The risk group includes vegetarians, athletes, pregnant and lactating women, elderly people who require increased consumption, mainly zinc, as well as vitamins and other microelements that actively participate in the synthesis of albumins and their absorption.

Hereditary predisposition (dominant trait) leads to familial forms of total leukonychia.

White spots on the nails have been reported as an occupational pathology in workers exposed to brine.

Other risk factors for the appearance of white spots on the nails include severe systemic infections, congestive heart failure, diseases of the nervous system, lymphomas and leukemia, intoxication with carbon dioxide, thallium or arsenic compounds, as well as drugs from the sulfonamide and anthracycline groups.

Subtotal infiltration of the nail with air is a secondary symptom of some nail diseases – onychogryphosis, psoriasis.

Partial white spots on nails and fungus are closely related. The so-called false leukonychia is one of the main symptoms of nail trichophytosis. With the normotrophic type of mycosis, only the color of the nail changes.

The pathogenesis of leukonychia has not been fully identified. It is often a symptom of various diseases and is considered within the framework of the mechanism of their development.

The most common is the point form, the main pathogenetic link of which is considered to be injuries to the nail matrix. White spots in this case change their location along the growth of the nail and in the absence of new mechanical damage safely disappear.

Pathogenesis

In the pathogenesis of striped white spots, both injuries and trophic disorders, and intoxication with toxic substances are considered.

Partial persistent whitening of the nail plate, as well as diffuse (total) is caused mainly by serious endogenous causes - genetic, severe hypoalbunemia, lymphoproliferative pathologies. Although sometimes the causes of any form of leukonychia remain unknown. Nails acquire a uniformly white matte color, the same as the lunula, which is explained by a decrease in the number of blood vessels in the epithelium of the nail bed and the proliferation of connective tissue.

The real statistics of the appearance of white spots on nails is unknown. Nail injuries are very common in childhood, almost always children's nails are decorated with white spots and stripes. Adults also regularly encounter punctate or striped leukonychia of traumatic genesis. White spots are more noticeable on the fingernails of women, because women's hands are in an aggressive environment, as a rule, more often than men's. At least - in everyday life. People rarely go to the doctor with such problems. Unless pathological changes in the nail plate stubbornly do not go away, but, on the contrary, become a hindrance and cause discomfort.

Fungal nail infections account for approximately a third of all nail plate diseases, with 10 to 20% of the world's population directly affected. In the vast majority of cases (70 to 95%), the causative agents are fungi of the Trichophyton rubrum species, and in the rest, other representatives of the same species.

White spots on the nails of various shapes and distribution on the nail plate, from stripes to total whitening, almost always (in 80% of cases) accompany chronic diffuse liver damage. A similar phenomenon is observed in patients with other systemic diseases - toxic goiter, diabetes mellitus, lymphoproliferative diseases, alimentary dystrophy and others.

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Symptoms

A change in the color of the nails can be both an innocent consequence of a blow or scratch to the nail plate, and evidence of serious pathological changes in the body. And if in the first case, white dots or stripes on one or more nails disappear on their own as the nail grows, then in others, the appearance of persistent defects, as well as an increase in their number, can be interpreted as the first signs of the disease. Moreover, in most cases, nail defects are not the only symptom of the disease.

So, what can white spots on fingernails signal? They definitely attract more attention, and are noticed on fingers sooner than on toes. Spots of traumatic genesis are more often noted on the nails of the thumb, index and middle fingers than on the ring and little fingers, although this is also possible. Dots and stripes that appear after injuries are usually located on the nail of one or several fingers, but not on all. If all nails are affected and there are many white spots on the nails, this is already a reason to think. Unless you have a habit of biting or otherwise regularly injuring your nails.

Traumatic lesions can manifest themselves as white spots on toenails. If you notice such defects and nothing else bothers you, you should analyze how comfortable your shoes are. White spots on toenails can appear in people who prefer narrow-toed shoes. Traumatic leukonychia, especially in this localization, can easily be confused with onychomycosis. Diagnostics are essential for differentiation.

In addition to injuries, many white spots on the nails of people experiencing the effects of severe or prolonged stress. In this case, neurological symptoms are added, the patient may show signs of depressive disorder. Many spots, both single and merging into stripes, may indicate vitamin deficiency, slight protein deficiency, and be a consequence of dietary nutrition, malnutrition or metabolic disorders, uremia, in which the necessary substances are not absorbed or intensively excreted from the body. Usually, in addition to the presence of spots and stripes on the nails, the patient also has symptoms of systemic malaise (fatigue, poor health, dizziness), pain in the side with kidney disease. If you do not pay attention to such symptoms, the disease will develop - white spots will appear on the toenails, the size of the spots will increase.

Types of leukonychia correspond to certain specific diseases and may indicate their stage of development. Dots and stripes consisting of them indicate that the disease is still developing, more extensive lesions of the nail plate indicate the duration of the chronic process or the severity of the acute one. In this case, in addition to white spots on the nails, patients have additional symptoms. The most harmless type of leukonychia is punctate. Stripes consisting of dots can probably be attributed to this type.

However, there are stripes related to subtotal (partial or limited) leukonychia. These are persistent white stripes that occupy approximately 40 to 80% of the nail plate surface. They are also subdivided into types.

Mess lines are fairly clear white stripes that run across the nail and move as it grows. There may be one or more stripes, and they are present on all fingers. Such nails may indicate poisoning with carbon dioxide, thallium salts, arsenic compounds, anthracycline antibiotics, and sulfanilamide drugs. Patients with lymphogranulomatosis (Hodgkin's disease), as well as with congestive heart disease, may develop the same pattern on their nails.

In patients with poisoning, the severity of intoxication symptoms is dose-dependent - general weakness, dyspeptic symptoms, jaundice, symptoms of damage to the nervous system. In lymphogranulomatosis, the primary symptom is an increase in peripheral lymph nodes, most often cervical and supraclavicular, however, there may be other localizations. At the onset of the disease, the general condition of the patient is normal.

The first signs of congestive heart failure are not specific - they include weakness, rapid pulse, shortness of breath, and nails that take on a bluish tint.

Muehrcke's lines are a white spot at the base of the nail, almost reaching its middle, present on all fingers. They are typical for patients with mild degrees of protein deficiency (hypoalbunemia). The protein component in the blood is less than 35 g / l. The main symptom is edema. This condition can accompany many diseases of vital organs - digestion, excretion, lungs, diabetes, extensive injuries, adherence to strict diets.

Muehrcke's lines are sometimes observed in severe neurological conditions, stress and depression.

A white spot at the base of a nail, one or two or three, on the hands or feet may be the first sign of mycotic leukonychia (white superficial onychomycosis). Characteristic of HIV infection. Then all nails are affected and the defect spreads to the entire surface of the nail plate. White spots on the nails have a surface resembling a fine powder scattering.

White spots with a fungal infection can turn yellow, the nail becomes thickened, delamination and an unpleasant odor appear. Nails become brittle and begin to crumble. Approximately the same picture can be observed with psoriasis and eczema.

White-yellow spots may be present in smokers with leukonychia. This category of patients is also likely to have vitamin deficiency, hypoproteinemia and the development of chronic pathologies. Leukonychia in combination with poor-quality nail polish can also lead to the appearance of yellow-white spots. Other dystrophic processes after severe infections and stress can provoke the appearance of white-yellow spots on the nails.

White and black spots on the nails are also called Terry's nails or half-nails. The section at the root of the nail (proximal) is painted white, the upper (distal) part is dark, in the same part there is usually a pinkish or brownish transverse stripe. This coloring is typical for patients with liver cirrhosis, uremia, congestive heart failure and is physiological in old age.

Total leukonychia - whitening of more than 80% of the surface of the nail plate can accompany quite severe stages of hypoproteinemia (the content of the protein component in the blood is less than 20 g / l), congenital hereditary pathologies (manifested from birth or in childhood), severe stages of congestive heart failure, hyperthyroidism, indicate the development of lymphoma or leukemia. Sometimes the reasons for whitening of nails even after a thorough diagnosis remain unknown, however, only a doctor can answer the question: why white spots appeared on the nails of an adult after a detailed examination.

White spots on nails during pregnancy occur for the same reasons. Individual white spots or stripes on several nails are usually of traumatic origin. Pregnant women do housework, coming into contact with aggressive substances, take care of their hands - doing manicures and nail extensions.

During pregnancy and breastfeeding, the mother's body needs complete nutrition, rich in proteins, vitamins and microelements. White spots may indicate an insufficient amount of nutrients in the mother's diet.

Also during pregnancy, diseases that have been latently maturing in the body may worsen and manifest themselves. If white spots are present on all fingers or almost the entire nail plate, fingernails and toenails are affected, it is necessary to draw the doctor's attention to this and undergo an examination in order not to neglect the disease, to bear and give birth to a healthy child.

White spots on a child's nails, even if they are quite numerous, usually appear as a result of injuries. If a child has a habit of biting his nails, then the spots on his fingers simply do not go away. However, all other reasons for the appearance of this defect for a child are not excluded.

Thus, an alimentary factor may manifest itself - it is necessary to analyze the child's diet. Stressful situations, kidney and liver diseases, recent infections, fungal infections, lymphoproliferative diseases - all this can happen in childhood, so if the defect is long-term, it is worth visiting a doctor. If total leukonychia is observed in an infant, then this may be a symptom of congenital pathology.

Diagnostics white spots on the nails

The presence of leukonychia is determined visually and does not present any difficulties. However, determining the cause of whitening of the nail plates requires a number of diagnostic measures.

Blood tests may be required - clinical to determine its composition, biochemical, liver function tests, testing for thyroid hormones. General urine analysis, special tests, for example, according to Nechiporenko, are done to assess kidney function. Scraping for fungus and its microscopic examination to exclude mycosis. The type of tests prescribed will depend on the suspected diagnosis.

For the same purpose, appropriate instrumental diagnostics will be carried out.

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Differential diagnosis

Based on the results of the examinations, differential diagnostics are carried out, which should put an end to and determine the cause that caused the defect.

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Treatment white spots on the nails

Single dotted spots usually do not bother their owners. Massive and constant lesions of the nail plates, multiple stripes and dots on each finger attract attention, cause concern, and the question arises: how to get rid of white spots on nails?

The consequences of minor and unnoticed injuries do not require treatment, the nails grow back - white dots and lines are cut off as the nail grows. In this case, preventive measures can be recommended: put on household gloves when planning work with the possibility of nail injury, mechanical or chemical; switch to unedged manicure, change the master to a more careful and conscientious one, do not use aggressive nail polishes and liquids for removing them, eradicate bad habits - biting nails, injuring them in any other way. You can visit a beauty salon for medical and cosmetic procedures or use folk experience to strengthen nails.

A large number of white stripes, subtotal and total leukonychia most often occur due to hypoalbunemia (protein deficiency). This condition can be the result of nutritional errors, as well as various diseases that lead to increased excretion or decreased synthesis and absorption of protein in the body. Basically, it requires diagnostics. If the cause of the deficiency is an alimentary factor, then dietary adjustments are sometimes sufficient. Sometimes complex treatment is required, including both dietary nutrition and vitamin and mineral complexes.

Hypoalbunemia is often caused by zinc deficiency in the body, one of the symptoms of which is leukonychia. Deficiency of this chemical element occurs for various reasons and with pronounced clinical signs, dietary adjustments may not be enough. Zinc for white spots on nails can be prescribed in dosage forms, for example, Zinketral tablets. Zinc deficiency disrupts the enzymatic activity of more than two hundred enzymes and negatively affects all metabolic processes. To compensate for the deficiency, patients over four years of age are prescribed one tablet of the drug once a day one hour before meals. After eating, it is necessary to pause before taking at least two hours. With this scheme, the bioavailability of Zinketral is the highest. Adults can be prescribed two tablets at a time or one in the morning and one in the evening. The duration of administration is determined by the doctor. An overdose is possible, especially with parallel intake of vitamin and mineral complexes with zinc. During the course of therapy with the drug, the consumption of alcohol, coffee and strong tea is limited. When taking the drug for a long time, it must be combined with copper preparations.

Some associate the appearance of leukonychia with anemia, and iron preparations and B vitamins are effective in this case. Balanced vitamin and mineral complexes, especially during periods of increased nervous and physical stress, after infections and stress, will help the body cope with the resulting deficiency or prevent it. For example, the vitamin and mineral preparation Centrum, containing vitamins A, E, K, C and D, a full range of B vitamins, as well as 15 minerals, will help restore proper metabolism, boost immunity and restore the healthy appearance of nails.

For nail growth regeneration, the doctor may recommend Revalid, which contains vitamins A, E, D, group B, zinc and silicon, copper and iron; Pantovigar, which has a similar composition; Doppelherz Active - 13 vitamins and 14 elements of the periodic table, compensating for nutritional errors, increased mental and physical stress.

In case of hypoalbunemia caused by diseases of internal organs, the doctor prescribes treatment for the underlying disease in addition to drugs that replenish the detected deficiency.

Detection of a fungal infection involves identifying its type and conducting a course of treatment with external antifungal drugs, sometimes it is necessary to connect systemic therapy. Pharmacies offer a wide range of products: varnishes, gels, solutions, ointments, tablets. Self-medication may be ineffective, will only worsen the situation and contribute to the spread of infection.

Externally, Lotseril varnish is used for nail fungus. Its active ingredient, amorolfine hydrochloride, belongs to the newest generation of antifungal agents that affect the cellular sterols of fungi. It has an antimycotic effect on a wide range of fungi that parasitize human nails. When applied to nails, the active ingredient penetrates well into hard-to-reach places and is able to destroy fungi in the nail bed. The systemic effect of the varnish is minimal. It is effective for mycotic lesions without affecting the root of the nail. Regularly applied to nails that have been cleaned with the file supplied in the kit and degreased until the symptoms disappear. Usually, a course of continuous treatment takes from six months to a year.

In cases of poisoning, organopathies, polyneuropathies, lymphoproliferative, hereditary and other diseases, the doctor prescribes appropriate therapy in combination with vitamins, as well as physiotherapy.

Physiotherapy is a serious alternative to drug treatment of fungal nail diseases. Short-spectrum ultraviolet rays completely destroy spore formation. Ozone therapy and laser therapy are also used in the treatment of onychomycosis, they have a local effect, unlike the previous method, so they can be prescribed to patients with diseases of internal organs for whom systemic physical action is contraindicated.

Iontophoresis, vitamin phonophoresis, and heating with high-frequency currents have a general strengthening effect on the nail plate.

Surgical treatment is usually not resorted to, however, in case of serious injuries, radical intervention is performed – removal of the nail.

Folk remedies

To strengthen and improve the health of the nail plates with minor manifestations of leukonychia, as well as in addition to the drug treatment, you can use traditional medicine recipes. Of course, white spots from such procedures will not go away until the nail grows, but nail care will not remain ineffective.

The simplest procedure for strengthening fingernails and toenails is baths with sea salt. A regular course of fifteen daily procedures will make nails stronger and cleaner. Sea salt is diluted in water at a temperature of about 40-45℃ in proportions: a teaspoon per liter. Duration of the procedure is about a quarter of an hour.

After this, you can rub garlic juice into your steamed nails; it has bactericidal properties and will provide local nourishment of the nail plate and the skin around it with vitamins and microelements.

It is good to rub your nails with the inner part of lemon, grapefruit or orange peel. Don't forget to do this when you drink lemon tea or eat citrus fruits.

Before any procedure, it is better to steam your nails, you can simply use warm water, or salted water.

After this, warm vegetable oil mixed with lemon juice is applied to the nails with a brush (a couple of drops of lemon juice are squeezed into a tablespoon of oil). You can rub in fish oil or an oil solution of vitamins A and E, or mix them as a fat base with lemon juice.

It is recommended to use so-called home-made nail polish at night: add five drops of iodine and the same number of capsules of an oil solution of vitamins A and E to 3.5 tablespoons of vegetable oil, preferably olive oil.

In case of nail injuries, after a trim manicure, it is recommended to make baths with an infusion of medicinal herbs. Herbal treatment promotes healing and disinfection of microtraumas, as well as improving blood circulation, vitaminization and nutrition.

For baths, oak bark, chamomile and calendula flowers, succession grass, St. John's wort, yarrow are used, both separately and in mixtures.

You can brew the following composition: equal parts of dried milkweed leaves, onion peel, string, St. John's wort, yarrow are mixed and a tablespoon is brewed per 200 ml of boiling water. After a quarter of an hour, dip your fingers into the unstrained infusion for about 20 minutes. Do not wipe, but lightly blot your hands.

It is recommended to do all procedures before going to bed for three weeks; it is good to wear simple thread gloves at night.

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Homeopathy

In case of pathological processes in the body that affect the condition of the nails, various homeopathic preparations are used. Most often, when white spots and transverse stripes appear, Silicea is used; Arsenicum album may be prescribed. If the patient is prone to nail biting, Arum triphyllum may be prescribed. Yellowish nail color suggests the use of Conium; in case of nail fungus, the drugs of choice are Antimonium crudum, Fluoricum acidum, Thuja. However, the condition of the nails is not the only sign that determines the choice of the drug. Homeopathy involves a comprehensive approach and takes into account many factors. Therefore, in order for the treatment to be effective, you should consult a professional.

Complications and consequences

In the vast majority of cases, injured nails grow back, the spots disappear and there are no negative health consequences. This usually concerns punctate leukonychia on individual fingers. On the feet, the nail can also be injured, for example, during a pedicure.

Striped, subtotal and total leukonychia are often symptoms of quite serious pathologies, so they should not be ignored. Advanced diseases and deficiency states are much more difficult to treat.

In addition, a white spot even on one nail can be a symptom of onychomycosis, as a result of which the infection can spread to other nails. Nail plates affected by fungus not only have an unaesthetic appearance, but also cause serious discomfort. In addition, the affected nail can even be lost.

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Prevention

You can prevent the appearance of white spots and stripes on your nails by following simple recommendations: eating well, getting quality rest, and being less nervous. In short, the same old tired healthy lifestyle.

In addition, injury prevention includes following basic rules for safe work with aggressive substances (gloves), wearing comfortable shoes, and choosing high-quality and professional nail care.

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Forecast

White spots on nails themselves are not dangerous to life and health, however, they may indicate the presence of serious pathological processes. If the whitening of nails is diffuse and all nails are affected, it is necessary to find out the cause of this condition, and the prognosis will entirely depend on the diagnosis.

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What do white spots on nails mean? Signs

The ineradicable desire to predict one's future has always been inherent in man. Everything was used, including, special attention was paid to temporary marks. It was impossible to ignore such noticeable spots and white lines, appearing from time to time on fingernails.

Unlike modern doctors, who call minor damage to the matrix of the nail plates the most harmless cause of leukonychia, most popular beliefs about “blooming” nails are much more optimistic.

Whitish spots and streaks were interpreted as the appearance of new items in the wardrobe, and the number of supposed new items corresponded to the number of defects that appeared.

In a more global sense, the appearance of leukonychia was interpreted as upcoming positive changes in life; for patients, they promised a quick recovery. Moreover, they tried not to cut their nails so that the spot would remain until the wish came true.

The spots on each finger had their own meaning, although not all sources interpret these meanings in the same way. For example, spots on the nail of the thumb in almost all sources promise pleasant changes - new clothes, gifts, a new profitable business that will bring a good income, but you will have to work hard for it, and also - winning at cards, at the races, in the lottery.

Things were much worse when white spots appeared on the nail of the index finger. This promised sad events, the appearance of some annoying concern, ill-wishers. It was interpreted as a sign to stop, wait, catch your breath.

But a white spot on the nail of the middle finger foreshadowed a joyful event, at the very least – a successful purchase, globally – great luck, good earnings, personal happiness.

Not everything is clear with the nail on the ring finger, there are diametrically opposed interpretations. Some sources claim that white spots on the ring finger are a sign of misfortune, others - of the appearance of new things. For married couples, the appearance of spots on this nail promised grand scandals leading to a breakup and, at the same time, consoled with the imminence of a new relationship.

A white spot on the nail of the little finger promised love, for young girls - a quick marriage, interesting travels, creative success. However, spots that appeared on the nails of the little fingers of both hands warned of a possible theft.

The more spots there were, the more happy events or fuss and worries they predicted. Size also mattered and was interpreted proportionally to the expected events, however, a large spot on the entire nail predicted neither more nor less, but imminent death.

Blooming nails in children have always been interpreted as a good omen, regardless of their location on the fingers.

The localization of the spot indicated the speed of the event. The closer to the edge of the nail, the sooner the omen would come true. Therefore, people tried to cut the nail with the spot that promised trouble, and thus prevent the event or, on the contrary, did not cut it for a long time, expecting joy, happiness, gifts.