Leukonychia is a white discoloration of the fingernail. It may cover the whole nail in leukonychia totalis, or it may appear in the form of stripes or spots on the nail. There are a number of reasons why people can develop leukonychia. Sometimes it is entirely harmless, while in other cases it may be a sign of an underlying medical problem. Sudden changes in the color of the nails may be cause for a doctor's appointment or a phone consultation with a doctor or nurse practitioner to determine whether or not an appointment is necessary.
In many people, these white spots are perfectly harmless. Some appear to be hereditary in nature. Others have to do with problems which occur during keratinization, the process of making new fingernail material at the base of the nail in the area known as the matrix. Air bubbles can cause leukonychia and damage to the nailbed can also lead to the development of white spots. Sometimes the spots don't show up immediately, in which case the marks may be startling, but they are still not a cause for concern.
Sometimes leukonychia is a sign of a more serious problem such as a nutritional deficiency. Changes in nail color are also associated with ill health, especially circulatory conditions like heart failure, although usually the condition has already been diagnosed so the leukonychia is not a diagnostic sign. It can also be evidence of a bacterial, fungal, or viral infection in the nail, or of exposure to toxins such as arsenic.
If someone in otherwise good health develops leukonychia and risk factors such as recent trauma to the fingers, receiving a manicure, or attending a gym, where people can commonly pick up fungal infections, are not in evidence, it may be a sign of a nutritional deficiency or another medical problem. A doctor can provide an evaluation to check for conditions which might be causing leukonychia but going otherwise unnoticed and make treatment recommendations. For onychomycosis, a fungal infection of the nail, for example, antifungal medications can be prescribed.
Leukonychia may be aesthetically undesirable. Painting the nails can conceal the white spots, and sometimes making dietary changes can help to resolve the spots. Eating a well balanced diet with lots of vitamins and minerals can promote healthy nail growth, which can resolve the spots as the nails grow out. Others choose to embrace the small spots as normal variations.
