White Spots on Toenails: Causes, Treatment and Prevention
Looking down at your feet and noticing white spots or discoloration on your toenails can be alarming. But while fungal infections are a common cause, there are other possible explanations for white spots on toenails.
By understanding the various reasons toenails can develop white marks, you can get the right diagnosis and find solutions. Learning proper foot care habits can also help prevent many causes of white spots and keep your toenails looking healthy.
Common Causes of White Spots on Toenails
Some typical causes for white discoloration or spots to appear on toenails include:
Onychomycosis (Toenail Fungus)
Fungal infection of the nail, called onychomycosis, is the most common cause of white spots on toes. Fungus thrives in the warm, moist environment inside shoes and socks and enters through cracks in the nail.
Trauma or Injury
Injuries to the toenail like stubbing your toe can cause blood and fluid to build up under the nail, appearing as white spots or streaks. This is called onychomadesis.
Nail Polish
Using nail polish, especially darker shades, can stain the nails once it's removed. These stains may look like white spots or dots on the bare nail.
Psoriasis
The inflammatory skin condition psoriasis can affect toenails and cause pitting, discoloration and white spots on the nails.
Skin Cancer
Rarely, white lines or spots across the nail can be a sign of squamous cell carcinoma, a form of skin cancer usually triggered by repeated UV light exposure.
Less Common Causes
Some other occasional causes of white toenails include:
- Vitamin or mineral deficiencies like zinc or calcium causing brittle nails
- Thyroid disease
- Kidney or liver disease
- Diabetes
- Eczema
- Lichen planus (an inflammatory skin condition)
- Aging
Getting a Diagnosis for White Spots on Toenails
To determine what's causing white spots or discoloration on your toenails, see a dermatologist, podiatrist or primary care physician. Be prepared to describe:
- When you first noticed the spots
- Which nails are affected
- Any other nail changes like thickening or crumbling
- If the spots are painful
- Any related symptoms like toenail odor or debris under nails
- Your health history and any medications
The doctor will examine your feet and nails. They may clip part of the nail to view the nail bed. Other tests that could be ordered include:
- Fungal culture of nail clippings
- Biopsy of nail or nail bed
- Blood tests
Treatment Options for White Spots on Toenails
Treatment will depend on the underlying cause of the white discoloration on your toenails. Some options your doctor may recommend include:
Fungal Infection Treatments
- Oral antifungal pills
- Antifungal nail polish or cream
- Laser therapy
- Nail removal in severe cases
Injury-Related Spots
- Trimming injured part of nail
- Application of urea cream
- Acrylic nail overlay as nail grows out
Psoriasis Management
- Prescription topical steroid
- Oral medication like methotrexate
- Biologics that target immune response
Skin Cancer Treatment
- Surgical excision
- Radiation
- Topical chemotherapy
Properly treating the underlying cause will allow new, healthy nails to grow back over 6-12 months in most cases.
Preventing White Spots and Discoloration on Toenails
Practicing proper nail and foot hygiene and care can help prevent many causes of white toenails, including:
Avoid Fungal Infections
- Wear breathable socks and change frequently if feet sweat
- Use antifungal foot powder inside shoes
- Disinfect nail tools and avoid sharing
- Don’t walk barefoot in public showers or pools
- Treat athlete’s foot promptly
- Keep nails trimmed short
- Avoid prolonged wetness like wearing damp shoes
Prevent Injury
- Wear properly fitted shoes
- Trim nails straight across
- Protect bare feet with shoes or slippers
Support Nail Health
- Take biotin supplements
- Moisturize nails and cuticles
- Avoid harsh nail products
- Treat underlying medical conditions
Limit UV Exposure
- Apply sunscreen to feet
- Avoid prolonged sun exposure
- See a dermatologist for suspicious spots
Seeing a podiatrist or dermatologist yearly can also help catch any nail issues early. Addressing white spots and discoloration on toenails promptly improves outcomes.
When to See a Doctor
Make an appointment with your doctor if you notice any of the following about white spots or discoloration on your toenails:
- Spots spread to multiple nails
- Nail changes don’t go away over several months
- Spots are accompanied by nail thickening, crumbling or odor
- You have pain, swelling or pus
- Spots follow trauma and don’t grow out with nail
- You have a compromised immune system
- Other symptoms like wart-like bumps or darkened skin near nail
While white spots on toenails are often harmless, it’s important to get an evaluation to guide appropriate treatment. Leaving fungal infections or other underlying conditions untreated can lead to permanent nail damage and spread to other nails.
When to Seek Emergency Care
Seek prompt medical attention if you experience:
- Sudden severe toenail pain
- Bleeding under or around the nail
- Signs of infection like redness, swelling, heat, pus or red streaks
- Nail partially or completely torn off
- Trouble walking or standing due to nail pain
These can signal a serious acute nail injury or infection requiring urgent care to prevent complications. Prompt treatment helps prevent permanent nail deformity or loss.
Outlook for White Spots on Toenails
While white spots or discoloration on your toenails may be alarming to notice, the outlook is usually excellent with proper treatment. Fungal infections, minor injuries and many other causes can be resolved without any lasting effects on the nails.
Catching the issue early and seeing a dermatologist at the first sign of any nail changes is key. Practicing good nail hygiene and foot care habits also helps prevent many causes of white toenail spots before they occur.
With proper care and prompt treatment if needed, your toenails can stay healthy-looking and add to your confidence in flip flops or sandals.
FAQs
What causes white spots to appear on toenails?
Common causes include fungal infections, injury or trauma to the nail, nail polish stains, psoriasis, and sometimes skin cancer. Less often, vitamin deficiencies, thyroid disease, kidney issues, diabetes, eczema or lichen planus can be responsible.
How can you tell if white toenail spots are from fungus?
Signs it may be a fungal infection include involvement of multiple nails, nail thickening or crumbling, nail odor and debris under nail. A fungal culture or biopsy can confirm diagnosis.
Is there a home remedy to get rid of white spots on toenails?
For fungal causes, over-the-counter antifungal creams or vinegar soaks may help. But prescription oral medication or laser therapy work better and may be needed for persistent or severe cases. Most other causes require seeing a doctor.
Are white toenail spots preventable?
Practicing good nail hygiene and foot care like washing feet daily, keeping nails trimmed, wearing clean socks and well-fitted shoes can prevent many causes of white discoloration.
When should you see a doctor for white toenail spots?
See your doctor if spots don't resolve after a few months, spread to multiple nails, are accompanied by pain or discharge, follow an injury, or you have other symptoms. Prompt treatment prevents lasting damage.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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