Leukonychia: main causes, treatment and prevention

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Together with specialist Christina Tsvigun, we’ll figure out what leukonychia is, what causes it, and how a pedicurist can work with the pathology.

How to distinguish leukonychia during work and determine what it entails? What to do if a pedicurist suspects this pathology in a client? Is it possible to apply gel polish to nails with leukonychia and how to help the client in this case? Our expert answers all these relevant questions for the master.

Kristina Tsvigun , a specialist in pedobarographic diagnostics of the foot and posture at the Healthy Foot Podology Center, has been actively involved in scientific medical work since 2012, speaker at scientific and practical conferences, author of publications in medical journals and newspapers, winner of the scientific and practical conference “Scientific Poten - progress of medicine of the future", pediatrician, neonatologist, intensive care of newborns, KZ ENT LOKL (Lvov)

What is leukonychia and how can a pedicurist determine it?

Leukonychia is pathological changes on one or more nail plates in the form of stripes or white spots that occur as a result of a disruption in the keratinization process of the nail.

Under the influence of various factors, changes can occur in the functioning of the nail matrix - that part of the nail that is responsible for its formation and growth. Subsequently, such disorders cause incomplete maturation of the cells of the nail plate, lack of their keratinization and the formation of white spots on the nail, namely, a layer of air appears in the thickness of the nail plate, which is replaced by fat and water. It is these substances, and not the white pigment, that cause the white color of such spots.

There are dotted, stripe-shaped and total leukonychia.

Possible causes of pathology

Exogenous - these are mainly causes that cause injury to the nail plate. On the feet it is most often:

  • tight shoes, incorrectly chosen shape or size;
  • excessive pressure and stress on the toes due to foot deformation;
  • deformation of the fingers themselves (hammer or claw fingers);
  • carelessly performed pedicure, which damages the superficial, sometimes deep layers of the nail plate;
  • exposure to household chemicals, fertilizers, paints and other substances.

Endogenous - often the appearance of leukonychia may indicate a person’s health status and has a number of reasons:

  • metabolic disorders (for example, impaired absorption of calcium);
  • diseases of internal organs (liver, intestines, stomach);
  • infectious diseases that may affect metabolism;
  • fungal diseases of the nail plate, as well as the body as a whole;
  • nervous system disease;
  • stress factor, depression, neuroses (sometimes, under the influence of neurotic conditions, a person intentionally injures the nail, which can also cause leukonychia, but this disease will be called onychotillomania);
  • heavy metal poisoning;
  • deficiency of vitamins and micro- and macroelements.

How should a manicurist work with such nails?

Working with such nails depends on the location of the lesion, the condition of the entire nail plate and the spread of the process.

Dotted leukonychia is usually one or two areas in the form of dots formed as a result of trauma. Be sure to check that the patient's shoes are not too tight and fit correctly. This can be done very simply by removing the insole from the shoe the patient is wearing and asking him to stand on it - it should be in the shape of the foot: oval or square, male or female. This is important because there is a 1cm width difference between them. The insole of the shoe should not only fit the shape, but also have a margin that is approximately equal to the width of the client’s index finger (everyone has a different finger width).

It is important to pay attention to whether there is deformation of the fingers and the foot itself, which in turn can disrupt biomechanics and create excessive pressure (flat foot, hollow foot, plano-valgus foot), deformation of the fingers (Hallux valgus, Morton's finger, claw or hammertoes).

Stripe-shaped lesions of the nail plate can occur due to the influence of a fungal infection, deficiency of micro-macroelements, or chemical poisoning. The work consists of referral to a dermatologist to take a scraping and rule out a fungal infection.

Total damage to the nail plate indicates a severe disorder in the whole body and requires detailed examination and treatment. We need consultations with a dermatologist, endocrinologist, therapist, infectious disease specialist and other specialists as necessary.

Should you prescribe treatment yourself?

Considering all of the above, it is important to set the limits of your own competence and be able to differentiate leukonychia from other pathologies. If the cause of the formation of leukonychia is trauma, then by eliminating the factor, the pedicurist will achieve a quick result, for example, replacing the right shoes, or after a “diligent” pedicure, give time for the restoration of the nail plate.

A combination of several causes for the formation of leukonychia is possible, so additional consultation with specialists and a detailed examination will always be required to determine the cause.

Is it possible to cover nails with leukonychia with gel polish?

Gel polish on the legs is not recommended at all; in the case of leukonychia, absolutely not. This can put excessive pressure on the nail and cause injury. You can cover your nails with regular varnish if you remove it in a timely manner and monitor the condition of the nail plate.

You also need to monitor the affected nail to see if leukonychia is increasing in area or color. A change in color may indicate the growth of a tumor or the addition of an infectious factor.

What is the prevention of leukonychia?

I recommend that you take care and appreciate your feet, select only high-quality shoes that fit properly, and if you have problems with your feet, contact tax specialists and do not self-medicate.

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