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What causes white spots on the nails?

Mar 20, 2025 Source: Cainiu Health
Dr. Liu Wenmin
Introduction
Nail trauma such as impact or compression can cause localized damage to the nail bed, leading to the formation of white spots on the newly growing nail. Generally, no special treatment is required, and the white spots will gradually move out with nail growth. Long-term picky eating habits may lead to deficiencies in trace elements such as calcium and zinc, which can affect normal nail growth.

White spots on the nails may be caused by trauma, deficiency of trace elements, malnutrition, onychomycosis (fungal nail infection), or paronychia (nail fold inflammation), and management should be based on the specific situation. If physical discomfort occurs, it is recommended to seek medical attention at a hospital promptly and follow medical advice for treatment.

1. Trauma: Injury such as bumping or squeezing the nail can damage the nail bed locally, resulting in white spots appearing on the newly growing nail. Usually, no special treatment is required, and the white spots will gradually grow out with the nail.

2. Deficiency of Trace Elements: Long-term picky eating or partial eating habits may lead to deficiencies in trace elements such as calcium and zinc, affecting normal nail growth and resulting in white spots. It is recommended to adjust the diet, consume more foods rich in trace elements, such as milk, nuts, and seafood. Under a doctor's guidance, supplementation with multivitamins and trace element preparations may also be considered to promote nail health.

3. Malnutrition: Long-term inadequate nutritional intake or poor absorption may prevent the body from providing sufficient nutrients for nail growth, leading to white spots on the nails, which may be accompanied by thinning and brittleness of the nails. Patients should ensure balanced nutrition and consume foods rich in protein and vitamins, such as eggs and oranges.

4. Onychomycosis: Fungal infection of the nail, commonly caused by dermatophytes, may lead to fungal growth and reproduction within the nail, damaging its structure and causing white spots. The nail may also become brittle, thickened, and discolored. Patients may use antifungal medications such as amorolfine hydrochloride solution, itraconazole capsules, or fluconazole tablets under medical supervision to eliminate the fungus and improve nail condition.

5. Paronychia: Inflammation occurring in the nail fold area may cause swelling of the surrounding skin, compressing the blood vessels and nerves beneath the nail, thereby affecting normal blood circulation and nutrient supply to the nail. This may lead to loss or abnormality of pigmentation on the nail surface, resulting in white spots. It is recommended to use medications such as ethacridine lactate solution, mupirocin ointment, or aspirin tablets under medical guidance to alleviate symptoms.

In daily life, it is important to protect the nails and wear gloves when engaging in activities that may cause nail injury.

References:

[1] Zhao Chunhua, Qian Xiaoying, Zhou Yu, et al. Observation on the efficacy of licorice zinc granules combined with polysaccharide sulfates ointment in the treatment of nail dystrophy. Chinese Journal of Dermatovenereology Integrated with Traditional and Western Medicine, 2019, 18(02):148-150.

[2] Ding Jiashuo. A case of nursing care for a patient with erysipelas complicated with onychomycosis and tinea pedis with high body weight. In: Proceedings of the 2024 National Academic Annual Conference on Skin Disease Prevention and Treatment, Chinese Association for Leprosy Prevention, 2024:382. Chinese Academy of Medical Sciences, Institute of Dermatology.

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