These plague or flake-like white are usually found dispersed over the nail in many people. Usually our finger-nails and toe-nails are generally pale pink in color, with a paler crescent at the bottom of the nail called lunula. White spots may occasionally appear over nail, then this condition is called leuconychia, i.e., white nails.

Total leuconychia refers to complete nail plate turning milky white. Partial leuconychia is when a part of the nail plate turns white; it is the most common one. There 3 types of partial leuconychia: Punctate leuconychia is the most common of all, it presents as small white spots.

Longitudinal leuconychia which presenting as a white band along the length of the nail. Lastly, striate or transverse leuconychia, one or more milky white lines parallel to lunula. True leuconychia, is when there is damage to the nail plate, and these areas grow along with the nail and do not blanch with pressure. While, apparent leuconychia is when there is damage to the structure underneath the nail plate, these blanch on pressure and do not grow normally along with nail.

The causes of white spots on nails are contrary to the common notion of calcium deficiency. Traumatic insult is the most common cause of white nails, it can range from nail-biting, manicures, nail injuries, constricting footwear or even as minute as nail paint insult.

It can also present with heavy metal poisoning such as lead and arsenic, or mostly with chemotherapy for the treatment of cancer. Fungal disease or infection of the nail or skin disease around the nail can also cause white spots. If none of the above is the causes, it can be rarely due to systemic causes such as, liver cirrhosis, kidney disorders, heart failure, diabetes mellitus, hyperthyroidism, psoriasis and zinc deficiency.

There is no treatment for just white spots on their own. Those that have been caused by trauma will naturally grow out over time. Blood tests can identify the under cause and these can be treated medically.

-Koya Satyasri