5 Things That Can Cause White Toenails (and What to Do About It)
White patches, lines, or spots on your nails have several causes, from trauma to fungal infections.
Why are my toenails white?
Maybe this sounds familiar: You’re trimming your toenails, contemplating whether to polish them with Relentlessly Ruby or go dark with Black Cherry Chutney, when you notice white spots.
Where did those come from? Discolored, brittle, or thick toenails (and fingernails) can be a sign something isn’t quite right in your body. But that doesn’t mean there’s an immediate cause for concern.
Most of the time, white toenails aren’t a big deal.
The spots might’ve come from bumping your toe or a common toenail fungus that a doctor can easily treat. Although it doesn’t happen too often, white toenails may suggest a more serious matter, like a vitamin deficiency or disease.
Here are some reasons why you might have white toenails and how to prevent and treat them. (Here’s what to know about ingrown toenails.)
Reasons for white spots on your toenails
There are a bunch of reasons why your toenails may have white spots on them.
You might even notice whitish discoloration after using acetone to remove nail polish.
Pinning down the cause is the first step toward treating your white-spotted toenails. Here are the most common culprits.
Sometimes when you stub your toe really hard, the blood vessels under the toenail break and leak blood, causing a bruise.
Other times, trauma might cause a white spot or streak (called leukonychia). This can happen when you bump your toe against a sturdy chair leg or rub it against the inside of a crowded and narrow shoe.
These spots are perfectly harmless.
Toenails are notoriously slow at growing out, so you may have a white spot on your toe for nine to 12 months, but don’t worry: the white discoloration eventually grows out.
White toenails may be subtly trying to tell you you’re not getting enough vitamins and minerals.
With these deficiencies, most of the nail appears white, except for the tip.
If you have an iron deficiency, you’ll probably notice other symptoms first. Those include fatigue and trouble concentrating. If you have a zinc deficiency, there’s a chance you’ll notice a decreased appetite and weight loss before you see a white toenail (or fingernail).
White toenails caused by zinc deficiency are often thin and brittle, breaking easily.
In addition to primarily white toenails, you might notice whitish grooves and double lines on your toenails.
Chronic iron deficiency can lead to other nail symptoms, like a condition called koilonychia, or spoon nails.
With this rare condition, the toenail becomes thin, brittle, and spoon shaped. The abnormal curvature in the middle of the nail is so prominent that the toenail could hold a droplet of water.
Treating mineral deficiencies with vitamin and mineral supplements seems like a no-brainer. But that’s not a safe way to address all your symptoms, and doubling up on vitamins and minerals can be dangerous.
“A mineral deficiency is diagnosed by examining the nails and doing a blood test,” says Dr. Lipner.
From there, your doctor will recommend a safe treatment. For instance, you may take over-the-counter iron supplements or a prescription iron pill that will make up for deficiencies without putting you at risk for a dangerous iron overdose.
Once a deficiency is identified and you’re following a doctor-prescribed treatment, the toenail symptoms should resolve.
But because toenails grow out slowly, the process may take several months.
Nail fungus (onychomycosis)
According to the Mayo Clinic, nail fungus commonly begins as a white or yellow spot under the tip of your nail— so there’s a chance that discoloration could be something more.
There’s a variety pack, if you will, of toenail fungi. They each have a defining trait or two, but for the most part, they all cause discoloration, nail separation, brittleness and thickening of the nail.
Although fungal infections of the toenail are seldom a cause for concern when it comes to our overall health, they rarely go away with over-the-counter treatment.
“Fungal infections of the toenails rarely, if ever, resolve on their own. They almost always require prescription management for resolution,” says dermatologist Joseph Zahn, MD, assistant professor of dermatology at the George Washington Medical Faculty Associates in Washington, D.C.
If you catch and start treating the fungus early, you might not experience some of the pesky symptoms, like crumbly toenails or total loss of the toenail. Unfortunately, the fungus may linger for several months—or as long as it takes the toenail to grow out. You can try a foot soak for toenail fungus to soothe symptoms.
Here are three types of toenail fungus that cause whitish toenails.
Proximal subungual onychomycosis
This toenail fungus is rare in healthy people but very common in immunosuppressed people. Proximal subungual onychomycosis (say that three times fast) differs from other types of toenail infections in that the fungus invades from the proximal skin—the place where the nail meets the toe, behind the cuticle.
“It then progresses distally across the nail, appearing like a diffuse white patch starting at the nail fold,” says Dr. Zahn.
In other words, you’ll first notice white patches developing in the center of the cuticle area.
As the toenail grows, the patches will move outward. Eventually, the toenail will lift from the nail bed, causing total toenail loss.
White superficial onychomycosis
One defining characteristic of white superficial onychomycosis is that it only invades the toenail’s surface—not underneath the nail bed—so it is easier to treat.
The whitish discoloration shows up randomly in the form of small, patchy islands. As the fungus ensues, the nail becomes rough, soft, and crumbly.
Though typically found in the fingernails of people who have their hands in water frequently, this fungus can target the toenails, especially if your feet are routinely in water.
As with other conditions that lead to whitish nails, infection with Candida causes the nails to become whitish and brittle. But the skin around the toenail will appear reddish.
Another clue you’re dealing with Candida: the infection will take a distinct direction on the nail.
“The involvement of the infection is distal and lateral, and there is complete destruction of the nail or partial destruction of the distal nail,” says Dr. Zahn.
In layman’s terms, the infection tends to affect the tip or end of the nail.
“Nail psoriasis is a common inflammatory nail condition, with 80 to 90 percent of patients with psoriasis presenting with nail changes in their lifetime,” says Dr. Lipner.
Healthy nails are smooth, but with nail psoriasis, the toenails are thicker, and the surface is covered with tiny dents, referred to as “pitting.” The toenail may get crumbly and separate from the nail bed.
For mild cases, your doctor may prescribe topical vitamin D, retinoid (vitamin A), cortisone creams, or cortisone injections under the affected nails. Phototherapy (treatment with ultraviolet light) may also be helpful.
More extensive involvement may require systemic psoriasis medications such as biologics (treatments that modulate the immune system).
Diseases and, rarely, poisoning
It’s usually the glaring obvious symptoms (think fever, loss of appetite, and chronic tummy trouble) that lead us to call a doctor, not discolored toenails.
Still, once you’re in the exam room, your doctor may discover evidence of certain diseases or disorders—or even poisoning—that can show up on toenails and fingernails.
Take, for example, Mees’ lines. These white lines run across the nail, parallel to the nail bed, and point to a number of health conditions.
The lines were first described in the early 1900s in patients with arsenic poisoning, but they can also occur with kidney disease, Hodgkin’s disease, heart failure, or sickle cell anemia. You might also spot them if you’re undergoing chemotherapy.
So if you spot horizontal white lines across your nails, know that there are many reasons and conditions that can cause them.
Muehrcke’s lines, which are similar to Mees’ lines, stem from kidney and liver failure. You can tell the two types of lines apart because Muehrcke’s lines disappear temporarily when the nail is pressed.
The white discolorations usually fade or grow out as the specific condition is treated.
How to prevent white toenails
You might not be able to prevent white toenails entirely. After all, the chances of bumping your toenail at some point is pretty high.
And if you have a skin condition such as psoriasis, whitish toenails might be more challenging to fend off.
The wisest move toward reducing white toenails is to keep your eye out for changes in the toenail.
The earlier you notice a change, the better—especially when it comes to toenail fungus, which can spread to other toes and people. Here’s what you can do at home to help prevent white toenails.
Keep your toenails short
It’s much easier to split or break a toenail that is too long. Always cut toenails straight across, rounding slightly at the tips.
Don’t cut the sides of your toenails to shape sharp corners, as it may encourage the nail to grow into the skin, causing a painful ingrown toenail.
Also, don’t share toenail (or fingernail) clippers without sanitizing them first in rubbing alcohol.
Soften toenails, moisturize your feet, and keep them dry
Toenails can be challenging to cut because they are thicker. Try softening the toenails first.
Fill a foot tub with warm water. For every pint of water, add a teaspoon of salt. Soak your feet in the saltwater for about 10 to 15 minutes. Once dry, moisturize your feet, making sure to rub the lotion into your toenails.
Sweaty feet are a breeding ground for germs, so keep your feet as dry as possible by wearing shoes and socks that breathe well.
Prevent toenail fungus by wearing flip-flops in public showers, locker rooms, and around pools.
Be mindful of toenail polish
Don’t wear toenail polish for more than a week or two. It can mask the first signs of fungus or other toenail issues.
Call your doctor
If you have diabetes or circulation problems, or if you’re immunosuppressed, call your doctor at the first sign of pain, redness, pus, or other abnormalities.
- Shari Lipner, MD, dermatologist, associate professor of clinical dermatology at Weill Cornell Medicine in New York
- Joseph Zahn, MD, dermatologist, assistant professor of dermatology at the George Washington Medical Faculty Associates in Washington, D.C.
- National Institutes of Health: "Iron"
- National Institutes of Health: "Zinc"
- National Center for Biotechnology Information: "Spoon Nails"
- Goldman's Cecil Medicine: "Diseases of Hair and Nails"
- Dermatological Signs of Internal Disease: "Nail Signs of Systemic Disease"
- Urgent Care Dermatology: Symptom-Based Diagnosis: "Nail Disorders"