Health

I have two clients with large white patches on their nails.

October 01, 1995 | Bookmark +

I have two clients who have a similar condition on their natural nails that I have not been able to remedy. On several nails (but not all), there are large white patches that never go away. They do not grow out with the nail, so it seems they must result from something in the nail bed.

When I first remove the polish from the nails, the white patches tend to disappear, but as the natural nail remains exposed to the air for a few minutes, they return. If I apply oil immediately or give a paraffin treatment, the patches tend not to look white, although they can still faintly be seen. But when I prepare the nails for new polish, the nails become dry and white again and the polish tends to peel off more easily. Light buffing of the nail surface does not seem to change the whiteness, which also makes me think this is something in the nail bed and not on the nail plate.

I have been using a base coat for dry nails on both clients after trying all the other base coats we normally use, but the condition persists. Both clients are concerned because they do not feel comfortable without polish since the white areas are so prominent. Can you help us with a diagnosis and a suggestion for clearing up this condition?

Answer

White nails, known as leuconychia, may occur, as you imply, in two forms. First, the problem may be in the nail bed, where the spots tend to remain stationary, or in the nail plate, where they tend to grow out, just as you have stated.

From your description, I am inclined to think it is the nail plate that is affected. I say this because you mention that an oil or paraffin treatment helps diminish the spots’ appearance; then the white spots return and the nails become “dry and white” again. These changes would not occur if the nail bed were affected, but certainly can if it is the nail plate that is affected.

My perception from your description is that your clients’ nails are undergoing a drying-out process and that is what is causing the white spots. As you say, the whiteness disappears briefly when you remove the polish, but returns again when the nails are exposed to air. This is an excellent description of dryness. I recommend frequent moisturizing and periodic rest periods from wearing nail polish. In addition, formaldehyde-free enamels and acetone-free removers are also often beneficial.

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What’s the cause of the pinkish-red oval area on the pad of my client’s toes?

I have a client who has a recurring problem with her fourth toes during the winter months. Both of her “ring finger” toes develop a pinkish-red oval area on the pad. Then a month later, when I see her again, the skin has become dry and hard like a callus, with the layers of skin peeling away to reveal a deeper, dark epicenter.  It’s extremely painful for her and, needless to say, we do not touch it. But it clears up in the summer when she’s wearing open-toed sandals, so I suspect it has to be due to the boots she wears in the winter. Plus she never puts lotion on her feet or uses a foot file in between visits. What do you think causes this?

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What are the big white spots on my natural-nail client’s nails?

I have a client who has been with me for about two years. She used to wear acrylic nails but has been a natural nail client for eight months or so. She has these white spots on her nails — big spots that are dry, but not flaky, right in the middle of the nail. I did try to buff them lightly but they do not come off or grow off. I had a new client come in last week who had the same on her toenails. She said it started after she had a pedicure done at another salon. Can you help?

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