What Do White Toenails Mean? Decoding Common Causes

Decoding Toenail Appearance: What White Toenails Could Mean

Have you noticed white spots or streaks on your toenails? Before you panic, realize there are a few possible causes - some harmless and others that may require treatment. Learning what makes toenails turn white will help you determine if it’s toenail fungus, injury or another condition.

Common Causes of White Toenails

A variety of issues can lead to white toenails. Here are some of the most common culprits:

• Toenail fungus
• Trauma to the nail
• Nail psoriasis
• Skin cancer
• Allergic reaction
• Aging

Let’s explore each of these causes in more detail.

Toenail Fungus

Onychomycosis, more commonly called toenail fungus, is a frequent cause of white toenails. Fungal infections account for 50% of nail disorders.

Toenail fungus thrives in warm, moist environments like swimming pools, showers or sweaty shoes. It begins growing underneath the nail, causing white spots and streaks to appear as it spreads.

If left untreated, the fungus can infect the entire nail and cause thickening, distortion and complete nail plate destruction over time.

Trauma to the Nail

Injuries like stubbing your toe can damage tiny blood vessels under the nail. This allows blood to leak underneath, resulting in red, black or brown bruising.

But over time as bruised areas heal, they may turn white and continue growing out with the nail. These white streaks are harmless and should grow out naturally over several months.

Nail Psoriasis

Psoriasis is an autoimmune condition causing rapid buildup of skin cells. Between 10–55% of people with psoriasis get it in their nails as well.

Signs of nail psoriasis include:

• Pitting, crumbling or grooves
• Discolored nails
• White spots or dots
• Nail separating from the nail bed

If you suspect psoriasis as the cause of white toenails, confirm with a dermatologist. While there is no definitive cure for nail psoriasis, various treatments can help prevent flare-ups and symptom progression.

Skin Cancer

Very rarely, white toenails may indicate subsurface tumors or early signs of melanoma. Around 2-3% of melanoma cases start in the nail matrix, the hidden area under the cuticle.

Additional skin cancer signs affecting toenails include:

• A new pigmented vertical streak down the nail
• Pigmentation spreading to surrounding nail folds
• Nail plate thickening or detachment
• Bleeding around the nail

Catching melanoma quickly leads to better prognoses. Book an appointment with your doctor if you notice any unusual changes in your toenails.

Allergic Reaction

Contact allergies from sources like nail polish, artificial nails or foot soaks can also trigger white spots on nails.

In rare cases, oral medications may be behind mysterious white lines too. Antibiotics, blood pressure drugs, arthritis medication and oral retinoids for acne are occasional offenders.

Review any new medications with your pharmacist. Switching prescriptions often resolves medication-induced leukonychia within a few weeks to months.

Aging Toenails

It’s common for toenails to become thicker, more brittle and develop vertical ridges with age. This can give nails a white-ish opaque hue, especially towards the tip of the nail plate.

While this aging effect is harmless on its own, it makes the nail more vulnerable to fungal and yeast infections.

Practicing good nail hygiene becomes especially important as you get older to keep toenails looking their best.

When to See Your Doctor About White Toenails

In most cases, white toenails are only a cosmetic nuisance requiring no specific treatment. But occasionally it’s wise to seek medical expertise.

See Your Doctor If...

• Discoloration is isolated to one toenail
• The entire toenail turns white rapidly
• Spots start spreading wider or faster
• Nails become thick, brittle or distorted
• You have diabetes or impaired immune system

Diabetics are especially prone to complications from foot disorders. It’s important to identify and treat nail fungal infections early before they can further impair immunity.

Sudden onset of white discolored nails may indicate an underlying health condition requires attention. Getting an accurate diagnosis guides the proper treatment plan moving forward.

Diagnosing the Cause of White Toenails

To identify what’s causing white toenails, a podiatrist can perform certain diagnostic tests:

• Visual exam: Assessing appearance and asking about symptoms/history
• Lab test: Microscopic scrapings or clippings to check for fungus
• Biopsy: Removing a small nail sample for further analysis
• Pathology: Testing tissue samples for abnormal cells signaling disease

Based on a complete evaluation, specialized podiatrists determine the exact reason behind white toenail discoloration. A proper diagnosis paves the way for prompt treatment.

Treatment Options for White Toenails

Treatment varies depending on what’s causing those pesky white streaks or dots on nails. Some options podiatrists may recommend include:

Topical Medications

Mild cases of toenail fungus can be treated using prescription antifungal lacquers, creams and ointments. However, these take up to 12 months to fully resolve infections as nails regrow.

Corticosteroid creams combat nail psoriasis inflammation and related symptoms.

Oral Medications

Oral prescription antifungal pills treat fungal infections lasting over 6 months or affecting multiple nails. They work much faster than topicals with higher success rates.

Oral medications come with more potential side effects though, making them unsuitable for some people.

Nail Removal

When fungal or psoriatic infections are severe, permanently removing the infected nail allows a healthy new one to grow in its place. This also eliminates discomfort in the interim.

Permanent removal options include chemical applications or surgery, both conducted using localized anesthetics. Laser treatments also blast away unwanted nail matter.

Preventing Recurrence

To avoid repeat white toenail issues once cleared, consistency with preventive care is key. Helpful proactive habits include:

• Wear clean, dry socks and rotate shoes daily
• Clip nails straight across to avoid ingrown edges
• Disinfect pedicure tools and avoid cutting cuticles
• Apply antifungal spray or powder preventatively
• See podiatrist regularly to catch problems early

Keeping feet clean and toenails protected blocks infections before they take hold. Developing good foot care routines preserves healthy nails for life.

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.