Your client wants to know what the white spots are on her nails, and you know they may have been caused by something you did. How do you respond?
White spots are nearly as common to nail techs as dry cuticles. Known medically as leukonychia, the spots are usually harmless, but, in rare occasions, can indicate a larger problem. Most likely, they are a result of a minor trauma to the nail matrix, such as biting the nails, hitting them against something hard, or, on the toes, wearing the wrong footwear. Techs can also cause trauma. Pushing the cuticle back with too much pressure or being too aggressive while removing salon products (such as gel-polish) can result in a white spot. When a client comes in with white spots, evaluate her nails. If you suspect the spots are from something other than trauma, refer her to a doctor. The conversation may sound something like this:
Client: I have these white spots on my nails. Do you know what they’re from?
You: Oh, yes, I’ve seen them. They are so common, I don’t even think to mention them. Do you know how long they’ve been there?
Client: I don’t know. I’ve had them forever. They sort of come and go.
You: There are a few different reasons for white spots. They actually have a medical name called leukonychia. They can be caused from nearly any type of small trauma on your nail, even something as simple as banging your nail on something. It’s hard to know exactly what caused it because it might be from trauma to the matrix, which lies here below the cuticle. That means it would take months to grow to the point where we see it in the middle of the nail. By then, we don’t remember even banging it. They can also show up on the toes if your shoes are too tight. They could be from biting the nails or even from tapping the nail too hard. Certain medications and health conditions can also cause them.
Client: Health conditions? That doesn’t sound good. Are they dangerous?
You: Typically, they aren’t dangerous at all. They just grow off the nail and that’s the end of it.
Client: So, just leave them alone?
You: Yes, from a maintenance perspective, we leave them alone. Nail polish covers them, but even when a person wears clear polish, they aren’t that noticeable because they are so common to everyone. However, if you notice other health problems, such as heart or kidney problems, other skin conditions — even on your face or other areas of your body — or if you’re excessively tired, call your doctor. When you’re with your doctor, point out the white spots on your nails. Our nails are the window to our body, so internal issues often come out through indicators on our nails.
Client: Now you’ve scared me! Do you think it could be from something larger?
You: When it’s a systemic issue rather than just a micro trauma, white spots will be on multiple nails and grow out at the same level. That’s not happening here. Your nails have only a few white spots on them. Most likely, you banged your nail without realizing it. I could have pushed your cuticle back with some pressure, or it could have happened when you picked off your polish. I wouldn’t worry about it unless you notice other health problems. Let’s give you a beautiful mani and get you looking beautiful.