Now, if you have been busy bashing around in the kitchen over the festive period you may have a few of these white spots on your nails.
A friend of mine also once asked me if I thought she suffered from a vitamin deficiency. She was worried as she had noticed small white spots on her nails and thought that maybe these were because she was deficient in some sort of vitamin.
Now, the dermatological term for white spots on the nails is leukonychia. The nail plate (which is the hard bit most of us refer to as the nail) is seated on and attached to the nail bed underneath. The nail plate grows from the proximal nail fold (which is were the cuticle is).
What causes leukonychia?
Leukonychia can occur because the nail plate is discoloured, so called true leukonychia, or the nail plate can look whitish-pale because of a problem with the nail bed underneath, so called apparent leukonychia.
What is apparent leukonychia?
Apparent leukonychia is generally because there is a problem with the blood supply to the nail bed or fingers for some medical reason and that is why the nail bed (and hence the nail plate) looks pale.
What is true leukonychia?
True leukonychia can have several causes.
Firstly, there is an inherited form where all the nails look milky, porcelain white but it would be unusual to only be noticed in adult life.
Secondly, drugs (such as chemotherapy drugs or poisons) and general infections in the body which affect nail growth can cause horizontal white lines across the nail. These are called Mees’ lines and grow along with the nail as it grows out. They form a sort of arc across the nail, similar in form to the little half-moon found near the cuticle (called the lunula).
Thirdly, little white spots on the nail, called punctate leukonychia can be found. These are mostly due to trauma to the nails from general wear and tear. Occasionally they can be seen in people who suffer from a hair loss condition called alopecia areata.
Thankfully, I was able to reassure my friend that her nail condition was not due to a vitamin deficiency but was this banal condition called punctate leukonychia which was probably due to general mild trauma to the nails. She looked suitably impressed at the long latin name of her diagnosis yet relieved it was nothing worse, both at the same time!
Sandy
Dr Sandy Flann, Consultant Dermatologist
