What does it mean when the base of the nail is purple and the upper part is white?

Under normal circumstances, purple discoloration at the base and white appearance at the top of the fingernail may be caused by cold exposure, external pressure, anemia, Raynaud's syndrome, or onychomycosis with infection. It is recommended to seek medical attention promptly, identify the underlying cause, and receive appropriate treatment under a doctor’s guidance. Specific analyses are as follows:

1. Cold exposure: Prolonged exposure of the hands to low temperatures causes constriction of the peripheral blood vessels in the nail bed, leading to insufficient blood supply and a purple hue at the base, while impaired nutrient delivery results in whitening at the top. Immediately soak the hands in warm water for 10 minutes and wear thermal gloves to prevent further cold exposure.

2. External pressure: Trauma such as being pinched in a door or struck by a heavy object can cause blood vessel rupture and bruising at the nail base (appearing purple), while damage to the nail plate leads to whitening at the top. Apply cold compresses within the first 48 hours to control bleeding, followed by warm compresses after 48 hours to promote absorption of the hematoma. Avoid further pressure or impact on the nail.

3. Anemia: Insufficient hemoglobin levels result in reduced oxygen supply, causing the nail tip to appear pale or white, while poor circulation at the base leads to a bluish-purple tint. Patients should take iron supplements such as succinic acid ferrous tablets, ferrous fumarate capsules, or compound ferrous sulfate and folic acid tablets as prescribed, and increase dietary intake of iron-rich foods like lean meat and spinach.

4. Raynaud's syndrome: Blood vessel spasms triggered by cold or emotional stress lead to ischemia at the nail base (causing purple discoloration) and reduced blood flow at the top (resulting in whitening). Medications such as nifedipine sustained-release tablets, diltiazem hydrochloride tablets, or reserpine tablets may be used under medical supervision. Keep hands warm and avoid emotional fluctuations in daily life.

5. Onychomycosis with infection: Fungal infection causes onychomycosis, making the nail plate cloudy and white; secondary bacterial infection leads to dilated blood vessels and purple discoloration at the base. Treatment includes antifungal medications such as terbinafine hydrochloride tablets, itraconazole capsules, or fluconazole tablets, as directed by a physician. In severe cases, surgical nail removal may be performed to eliminate the infected nail and promote healthy regrowth.

To support nail health, avoid using nails to dig or pry hard objects to minimize injury. Maintain clean and dry hands, and wear gloves when handling irritating substances. Follow a regular sleep schedule and balanced diet rich in protein and vitamins to aid in the recovery of healthy nails.