Patient Education

White Toenails

Description

Nails can be pretty useful things. You use your fingernails to pry apart otherwise impossible packaging, and your toenails do an awfully good job of protecting the ends of your toes. (And you’ve got to admit that painted toenails can look pretty darn cute in a pair of trendy sandals.) Your nails also perform nicely in the role of a body barometer. Not literally, of course. They don’t tell you how intense the atmospheric pressure in your colon is, for instance. But, they do serve as indicators when something else is wrong with your body.

Illness, injury and certain kinds of infections can cause your toenails to become distorted, develop ridges, pits or bumps, or become discolored. White toenails, for instance, may be caused by several things. Dropping something heavy on your toe (like a huge antique barometer) can make a white spot appear under your toenail. (Although if blood vessels get broken in the impact, your nail may turn black.) Repetitive stresses on the toenail, such as when your toes get repeatedly jammed into the front of your shoe during running or other activities, can cause white lines to appear. In fact, white streaks and spots in the toenail even has a fancy name: leukonychia. (If you mention the term casually to your podiatrist, he or she will probably be pretty impressed.)

Fungal infections may also cause your toenail to appear white (if the infection is in an outer layer of the nail, it’ll appear bright white), as can arsenic poisoning, although with the poisoning, you’re likely to notice white lines and horizontal ridges on your nail. Fun stuff, right?

Or, the white area on your nail may only be the lunula, a normal white spot next to the nail fold (where your nail grows out of your toe). This spot is completely innocuous, and the size varies from person to person, so don’t be distressed if yours is larger than others’.

However, if you notice white spots, streaks, or lines that weren’t there before, it’s definitely a good idea to see your podiatrist, who can diagnose the problem for you.

Symptoms

White toenails may be only one of your symptoms. If you have a fungal infection, for instance, you may also notice an unpleasant odor coming from the nail, debris under the nail plate, and your nail will also probably thicken, making it more difficult to trim. If severe enough, or left long enough, fungal infections may impair your ability to walk or wear shoes.

Nail trauma (such as dropping something heavy on your foot) is usually accompanied by hopping up and down on one foot, and swearing.

Diagnosis

Your podiatrist is kind of like a meteorologist for your body. (Or is that carrying the analogy too far…?) He or she can discover what your body’s trying to say through your nail color and other symptoms. In order to find out what’s causing your white toenails, your podiatrist will need to ask you about your symptoms. He or she will ask you about the color and texture of your toenail, as well as other qualities, such as luster (how shiny it is), brittleness, and possible deformities or ridges. You’ll also want to tell your podiatrist whether your toenail has undergone some injury recently (such as the hop-on-one-foot variety), or if you have any other symptoms.

Diagnostic tests may be used, such as nail scraping (to test for fungal infection), blood tests, or X-rays to determine the cause of your white toenails.

Treatment

How your podiatrist opts to treat your white toenails will depend on what’s causing them. Fungal infections are treated with anti-fungal medications. These can be applied topically to the nail itself, or may be taken orally. In severe cases, the nail may need to be removed in order to apply the medication directly to the nail bed.

It’s always a good idea to wear shoes that fit properly and have plenty of room in the toe box. Avoid walking barefoot in wet public areas (like around pools or public showers), and keep your nail care instruments disinfected. And, keeping your feet clean and dry certainly won’t hurt. You’ll also want to pay attention to your nails. When they tell you something’s wrong, it’s NOT the time to sit back and do nothing; you should see your podiatrist, who can help bring your body’s issues under control.