White spots on nails, medically called leukonychia, is a common finding and that in most cases, not show any clinical relevance. In general, the spots on nails disappear spontaneously without any treatment.
The presence of white spots on nails is a completely harmless finding, which does not cause symptoms or progress to any other type of problem. The leukonychia is not a disease in itself, only a signal indicating a change in part of the nail structure.
There are more than one type of leukonychia, which are classified according to the appearance of white spots. The illustration on the right shows some of the most common presentations.
The most common form is called leukonychia punctata, consisting of one or more white spots on nails.
Another relatively common presentation is striated leukonychia, which are short white streaks across the nail.
There are still other forms of leukonychia, as the total leukonychia partial leukonychia and cross leukonychia. These forms, however, are much less frequent.
Virtually all people have noticed a small white spot on the nail. In the vast majority of cases, the stain appears and disappears without the patient becomes aware. The leukonychia should only raise some suspicion if it starts to appear with high frequency and if the patient has other symptoms, suggesting that a disease may be behind.
In the vast majority of cases, the white spots on the nail arise by minor trauma, which may include bites, hold your finger on the door or excess pressure in the nail caused by manicure. In general, damage occurs to the nail matrix, where it is formed. In many cases, however, the white spots on the nail arise spontaneously, without the patient is able to remember some recent trauma.
Striated leuconychia and punctatus are the most common forms and do not usually indicate any disease. In some women, white nail patches may arise due to hormonal changes throughout the menstrual cycle or by reactions to the enamel.
The total leukonychia is usually a genetic disorder, an autosomal dominant inheritance. In some cases, the total leukonychia can be acquired throughout life, being related to some diseases such as vitiligo, nephrotic syndrome, leprosy or a side effect of the sulfonamide class of antibiotics such as Bactrim, for example.
The cross leukonychia may arise due to certain conditions, as a side effect of chemotherapy, liver cirrhosis, high fever, tuberculosis or arsenic poisoning.
Despite the white spots can be a sign of disease, in practice they rarely are. If you have leukonychia but has no known disease and shows no other sign or symptom, you need not worry, these patches are clinically irrelevant.
In some cases the nail mycosis, called onychomycosis, white spots may appear. However, these spots are coarser and usually have other nail injuries, not looking like the most common forms of leukonychia.
The leukonychia is not a disease and therefore do not need treatment. In the overwhelming majority of cases the spots on the nails will disappear spontaneously over time.
If you are healthy, your nail looks good and has small white spots without other injuries, no need to seek medical help. Nor are necessary examinations to investigate the diseases mentioned above. In general, the sick patients, leukonychia is just one of several signs that it usually has. No one will suspect cirrhosis, tuberculosis or any other disease only by spots on the nails.
