My Big Fat Greek Leukonychia

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The Geek

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Greek is to language as the Matrix is to the natural nail. It provides the base for most modern day English words (except for oi!, cuppa, and tequila). People of great importance use Greek in everyday conversation and it makes them look, well, simply bad ass.

Could you imagine how silly we would look when a client came up to us asking what those white spots were on their nails and you were to reply, “simple my dear Emily… Whitespottednailplates”. Yup, you would look like a real moron if you couldn’t use the poetic word Leukonychia. Leuko is from the Greek word for white and Onychia is derived from the Greek word for nail (Onyx). Put them together and you have a word that will make you the gas of the next rotary meeting.

Speaking of… What on earth causes Leukonychia? I have heard some real classics that make people saying “Whitespottednailpaltes” sound smart. People believe everything from calcium and zinc deficiencies to excessive amounts of Hellmans mayonnaise on your Tuna and Rye. Heck, at that rate why not chalk it up to alien abductions and be done with it?

Leukonychia is a common nail occurrence which has more myths attached to it than Richard Whitley has bad ties. So where does it come from and what the heck can I do about it aside from trying to pass it off as the latest in nail art craziness?

Punctate what?

There are a few differing forms of Leukonychia however the most common form is Leukonychia spots (or if you insist on being a bad ass Greek; try ‘Punctate Leukonychia’).

The natural nail plate is made up of the keratinization of cells incubated and produced by the matrix. When new baby cells emerge from the matrix, they don’t look a damn thing like a nail plate. Instead, they look more like little round and white squidges. During the keratinization process, these cells ‘flatten’ out and link together to form the natural nail plate. When large areas of these white squidges don’t fully keratinize, the result is an area of the natural nail that still contains unformed natural nail plate, or rather… white squidges.

These spots are most often caused from some type of damage or trauma to the matrix during the incubation or keratinization period. Most miss this aspect though as the portion of the natural nail plate that contains the said spot will generally take up to 6 weeks before it makes its debut from under the eponychium.

Most of the time Leukonychia spots are seen within the natural nail plate instead of on top of it. That is because if they appear in the top portion of the natural nail plate, they usually just flake off, leaving behind small pits where the cells should have getting down and funky (keratinized) with its neighbors. This type of pitting can be frequently seen in clients with psoriasis of the natural nail plate.

Fakeonychia

Another common form of Leukonychia is called Pseudo Leukonychia. Since pseudo means ‘superficial resemblance’. We can put on our detective caps to discover that it means ‘Not really Leukonychia’.

Pseudo Leukonychia is a temporary whitening of the natural nail plate that occurs when an area of the natural nail becomes stripped of oil and moisture.

The natural nail plate is made up of approximately 100-150 layers of densely packed keratin. Though densely packed, there are many voids and channels that run through the natural nail that allow oil and moisture to make the lovely voyage from nail bed to the nail plate surface. Since oil goes with water about as well as tequila goes with milk, oil and moisture move through the natural nail plate in differing ways.

Oil moves through special channels called lipophilic (oil loving) whilst water moves through special channels called hydrophilic (yup, water loving).

When the natural nail plate grows off of the nail bed, it graduates to being dubbed ‘the free edge’. Since this area is no longer attached to the bed, it no longer receives oil and moisture from the body and thus begins to dry out and compress upon itself.
This drying out process makes the natural nail plate turn a whitish coloration and is in fact what the natural nail plate itself actually looks like. The only reason that it appears pink on the bed is because it is made translucent with the oil and moisture and is therefore reflecting the capillaries contained within the nail bed.
Now we have established that once we remove oil and moisture from the natural nail plate it turns whitish in coloration; it is easier to understand what Pseudo Leukonychia actually is.

The real culprit for Pseudo Leukonychia is excessive solvent use. The more a client removes their enamel, the more frequent they will experience the problem. The problem is also more apparent after soaking off a set of enhancements (especially if using pure acetone). Any type of solvent will strip oil and moisture from the skin and the upper most layers of the natural nail plate. Clients with thinner natural nails or nails that are not as densely packed will also see Pseudo Leukonychia more frequently.
The good news is that as oil and moisture starts to reptate back through the natural nail plate, those dehydrated areas become filled once more and turn transparent and healthy looking again.

There are a few other forms of Leukonychia, but these are the two most common (and non serious) forms. Now I suppose we shall have to ditch such silly myths about mayonnaise and calcium deficiencies. Where they came from I shall never know. That’s right… It’s Greek to me (oof, that pun hurts).
 

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Thank you for that wonderfully informative article!
It confirms something i was telling a client only the other day (but better explained!).
 
Thanks for the information Mr Geek.
 
Thank you. Really enjoyed reading this!
 
yep, I always heard leukonychia was caused by an infection in the body somewhere...thank you for the learnin' ;)
 
Really interesting and really well explained, thank you GMG X
 
Brilliant, really well explained. Thank You. Joan
 
Great article, Mr Geek!

Particularly like the technical term "squidges". :green:

:hug:
 
I just read this again and it totally cracked me up. KellyM our very own 'Tulah' should read this!! :)
 
Another great article. Thanks! xx
 
I have a client that has nails just like this one, on most of her fingers. I thought it was her nail drying out, and top layers flaking off, so advised her to oil every day which she does, and always keep a coat of polish on them to protect them a bit more. which she sometimes does. Even though they look alot better its stll not fixing it competely. The 'damaged' part is always towards the middle to free edge, its not as if it grows up from the cuticle / matrix or anything, which is why i thought it was dryness coming from a more external factor.

She has suffered arthritis, and used to be a biter.

any ideas?!

attachment.php
 
I have a client that has nails just like this one, on most of her fingers. I thought it was her nail drying out, and top layers flaking off, so advised her to oil every day which she does, and always keep a coat of polish on them to protect them a bit more. which she sometimes does. Even though they look alot better its stll not fixing it competely. The 'damaged' part is always towards the middle to free edge, its not as if it grows up from the cuticle / matrix or anything, which is why i thought it was dryness coming from a more external factor.

She has suffered arthritis, and used to be a biter.

any ideas?!

attachment.php

I also have a client with nails just like this, in good shape up to the middle of the nail then become whiteish and flaky, she only removes polish once every 2 weeks and it is usually done by me with an acetone free polish remover. Could this be psoriasis? I notice that duing summer her nails are much better, and also get worse when she is more stressed out.
 

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