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Small white spots or streaks on the nails are seen in most people. These white spots usually appear on the fingernails or toenails and this condition is called leukonychia, a very common issue that is pretty harmless. In this article, we will discuss what is leukonychia, its causes, symptoms and how it can be treated.
What Causes White Spots On Nails ( Leukonychia)
It is a condition where white spots develop on the nail plate. It occurs due to an allergic reaction, nail injury, fungal infection, or mineral deficiency  .
Allergic reaction - An allergic reaction to nail polish, nail gloss or nail polish remover may cause white spots on nails. Using excessive acrylic or gel nails can damage your nails badly and may cause white spots.
Nail injury - An injury to the nail bed may also cause white spots on the nails. These injuries include shutting your fingers in a door, hitting your nails against a table, striking your finger with a hammer  .
Fungal infection - Nail fungus can also cause small white dots on the nails, resulting in flaky and brittle skin  .
Mineral deficiency - If your body is lacking in certain vitamins or minerals, you may notice white spots or dots on your nails. The most common deficiencies are zinc deficiency and calcium deficiency  .
Additional causes of white spots on nails are heart disease, kidney failure, eczema, pneumonia, diabetes, liver cirrhosis, psoriasis, and arsenic poisoning.
Types Of White Spots On Nails ( Leukonychia)
Punctate leukonychia - It is a type of leukonychia, in which one or more white spots develop on the nails. It often occurs as a result of injury to the nail, such as nail-biting or smashing the nail  .
Longitudinal leukonychia - It is a less common type of leukonychia, which has a lengthwise band of white nail  .
Striate or transverse leukonychia - It is characterized by one or more horizontal lines that appear across the nail  .
Symptoms Of White Spots On Nails (Leukonychia)
- Tiny small dots
- Larger dots
- Larger lines across the nail
Diagnosis Of White Spots On Nails (Leukonychia) 
If you notice that the white spots on the nails are appearing and disappearing on their own, then you needn't worry. But, make sure that your nails aren't getting injured.
However, if you notice that the spots are still there and becoming worse, it's time to consult a doctor. The doctor will ask about your medical history and perform some blood tests to rule out what's causing them.
Nail biopsy is also done where the doctor removes a small piece of tissue and sends it for testing.
Treatment Of White Spots On Nails (Leukonychia) 
The treatment varies depending on the causes of leukonychia.
- Treating allergies - If you are noticing that the white spots are caused due to nail paints or any other nail products, stop using them immediately.
- Treating nail injuries - Nail injuries don't require any kind of treatment. As the nail grows, the white spots will move up to the nail bed and over time, the spots will go away completely.
- Treating fungal infection - Oral anti-fungal medications will be prescribed for treating fungal nail infections and this treatment procedure may take up to three months.
- Treating mineral deficiency - The doctor will prescribe you multivitamin or mineral supplements. These medicines may be taken along with other supplements to help the body absorb the mineral better.
Prevention Of White Spots On Nails (Leukonychia)
- Avoid contact with substances that cause irritation
- Avoid excessive use of nail polish
- Apply moisturiser on the nails to prevent drying
- Cut your nails short
-  Grossman, M., & Scher, R. K. (1990). Leukonychia: review and classification.International journal of dermatology,29(8), 535-541.
-  Piraccini, B. M., & Starace, M. (2014). Nail disorders in infants and children.Current opinion in pediatrics,26(4), 440-445.
-  Sulzberger, M. B., Rein, C. R., Fanburg, S. J., Wolf, M., Shair, H. M., & Popkin, G. L. (1948). Allergic eczematous reactions of the nail bed.J. Invest. Derm,11, 67.
-  Seshadri, D., & De, D. (2012). Nails in nutritional deficiencies.Indian Journal of Dermatology, Venereology, and Leprology,78(3), 237.
-  Arnold, H. L. (1979). Sympathetic Symmetric Punctate Leukonychia: Three Cases.Archives of dermatology,115(4), 495-496.
-  Mokhtari, F., Mozafarpoor, S., Nouraei, S., & Nilforoushzadeh, M. A. (2016). Acquired Bilateral Longitudinal True Leukonychia in a 35-year-old Woman.International journal of preventive medicine,7, 118.
-  SCHER, R. K. (2016). Evaluation of nail lines: color and shape hold clues.Cleveland Clinic journal of medicine,83(5), 385.
-  Howard, S. R., & Siegfried, E. C. (2013). A case of leukonychia.The Journal of pediatrics,163(3), 914-915.
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