White spots or discoloration is a frequently reported complains in individuals of all age group and mostly develops around the cuticle of finger nails or toe nails. Often times when we bump our fingers or toes on a hard surface, the force of impact causes minor injury to the root of nail leading to whitish area that disappears when the nail grows out.

However, in some cases white discoloration or spots under nails is a result of a much grave problem like fugal nail infection. If discoloration in your nail does not disappear, grows into even bigger spots or is associated with changes in the texture of nails (like thickening, yellowing, splitting or separation from nail-bed), you should consult a healthcare provider for assessment of fungal nail infection.

Causes of White Spots on Toenails

Apart from fungal nail infections, there may be a variety of conditions in which a person may develop white spots on toenails or finger nails. A few common ones are listed below:

1. Nutritional Deficiency

Deficiency of certain nutrients (especially micronutrients) is very strongly associated with changes in the texture of nails, skin, and hair. White spots on toenails are reported quite frequently in deficiency of calcium, an essential mineral that is associated with strong bones. In addition, zinc deficiency is also associated with changes in nail and skin.

2. Fungus Infection

Individuals who wear shoes for long periods of time in hot humid environment are prone to develop fungal infections. The three important fungi that are most commonly reported in the setting of fungal nail infections are dermatophytes, molds and yeast. In most cases, white spots appear on the tip of toenails instead of the root can lead to changes in the texture of nails like flaking, tearing and splitting of nail.

3. Toenail Injury

Persistent and frequent injuries to the nail as a result of sub-optimal trauma can present in the form of white toe nail spots. Gardeners, plumbers, construction workers and domestic workers are most vulnerable to this form of injury leading to nail changes that are not permanent.

4. Allergy

Allergy to cosmetic products like nail enamels, thinners, nail polish removers and nail hardeners can also lead to appearance of white spots on toenails as a result of irritation or inflammatory reaction due to allergens. The allergic response may be limited to nails or may involve skin surrounding nail surfaces or root.

5. Improper Footwear

Improper footwear (use of improper size, either too big to too small) can pose extra stress or strain on the anterior aspect of feet that includes the nails, leading to injury that may lead to development of white spots.

Remedies for White Spots on Toenails

In most cases, no treatment is needed and white spots on the toenails disappear without causing any long term complication or problem; however, in cases where toe nail discoloration is due to a well-established pathology, a more schematic treatment approach is needed in order to manage the symptoms. Following treatment modalities are most commonly employed to manage the symptoms.

1. Medications

Topical medications are generally helpful in managing superficial fungal infections. In this regard Fungoid Tincture is the most helpful remedy. In cases where fungal infection is deep and unresponsive to topical treatments, systemic anti-fungal medications are needed to manage the symptoms. This includes itraconazole and terbinafine hydrochloride. Both of these systemic medications are FDA (Food and Drug Administration) approved and may be consumed for a period of 12 to 16 weeks (or according to prescription of your healthcare provider). Since systemic anti- fungal medications are excreted by liver, it is imperative to periodically monitor liver function tests.

2. Home Remedies

Home remedies require long term administration and are slow to exert action, but are nevertheless much safer and cheaper than systemic or topical anti fungal medications. Moreover, herbal and home remedies can be consumed effectively for extended periods of time as a preventive strategy to decrease the risk of recurrence. Clinically proven and most effective home remedies to manage white spots on toenails due to fungal infection include:

• Vinegar Soaks

The acetic acid is the active ingredient of vinegar that is responsible for its anti- fungal properties. You can mix the vinegar with water to prepare a 1:1 solution. Soaking your feet for just 30 minutes once daily can help in decreasing the fungal or microbial growth and helps in improving the complexion of the skin. Moreover, the weak acid also helps in returning natural luster and shine of your nails that is destroyed by the long standing fungal infection.

• Tea Tree Oil

The most active ingredients of tea tree oil that is responsible for its anti-fungal properties are 1.8-cineole and terpinen-4-ol. In addition to resisting the growth of fungal agents, tea tree oil and its active ingredients are also helpful in managing the growth of other microbial agents without causing any damage to nails or surrounding skin. You can use 100% tea tree oil as a topical herbal agent that can be applied 3 to 4 times a daily after scraping the fungal lesions.

• Ointments

Local ointments that contain camphor or methanol are extremely helpful in killing fungal growth and also preventing the spread of fungi to other nails or tissues. You can also use nasal decongestants like Vicks locally to achieve fruitful results.

• Diet for Nail Health

In order to keep your nails healthy, shiny and strong, you need a lot of macro and micro-nutrients that help in promoting blood circulation to nails and also helps in maintaining the shine and luster of nails. For healthy nails, consume optimal amounts of vitamins, minerals and macronutrients. Consume healthy dietary sources of Vitamin A, B, C, D and E in addition to zinc, calcium and magnesium.

3. Preventing Fungus Spreading

It is as important to prevent the spread of fungus as it is to control the fungal growth and this can be achieved by frequent washing of hands and feet with soap and warm water. It is also very important to dry your feet with a clean towel and avoid sharing the use of personal items like towels, pedicure kits and nail clippers. For better maintenance, keep your toenails short and clean. Until you get clear of fungus fully, make sure to continue your therapies along with home remedies.