Pale Nails: Causes and Treatment of White Nail Beds

For most people, nails that look unsightly or veer from their “normal” look mean one thing: it is time to get a manicure. Paying close attention to the appearance of your nails can however divulge more than just that; it can say a lot about your health. Pale nails in particular can be a stack pointer to a serious medical problem. Read on to find out more…

Pale Nails Causes

There are numerous possible causes of pale nail beds on fingernails or toenails ranging from less worrying to serious. Although it is best to get proper diagnosis from your doctor, you may want to know some possible underlying factors for your woes. These include:


You can get pale nails after a traumatic injury. This can for example happen when your fingers get caught in a door or a heavy object lands on your nails. Where trauma is involved, the problem only involves the affected fingernails rather than all of them.

Iron Deficiency Anemia

White nail beds may also be a sign of anemia, a blood disorder resulting from having inadequate red blood cells circulating in the body. According to Shilpi Agarwal, MD, a Los Angeles physician, “Anemia resulting from low levels of iron can lead to inadequate oxygen in the blood, which causes the skin and tissues to become pale, particularly the tissues under the nails.”

Pale nails due to iron deficiency anemia may have its root in the following factors:

  • Bleeding in the intestine and stomach as a result of conditions such as ulcers, cancer, and from taking certain medications e.g. Non-steroid anti-inflammatory drugs.
  • Heavy periods.
  • Pregnancy: During pregnancy, extra iron is needed for the developing baby.
  • Low dietary intake of iron rarely causes iron deficiency anemia per se, but it can increase the risk of developing the condition as a result of one or more of the factors mentioned above.

Anemia Treatment

If left to continue unabated, severe iron deficiency can lead to other problems such as dizziness, fatigue, and concave-shaped nails, not to mention heart problems.

Having lots of iron rich foods in your diet such as green leafy vegetables (spinach, kale, broccoli etc.), legumes (e.g. beans), red meat, eggs, nuts, brown rice, and dried fruits (such as apricot, raisin, etc.) may help treat iron deficiency anemia and thus reverse the appearance of pale nail beds.

As for professional treatment, iron supplements are usually administered to boost iron levels in the body. Your doctor will often monitor you until the iron levels return to normal. This usually takes a few months. The factor underlying the iron deficiency will also be addressed.


According to the WebMD, pale or white fingernails may also be a sign of diabetes. This is because diabetes impairs blood circulation. Diabetes is attributed to low levels of insulin – the hormone that regulates the level of glucose in the blood. It can also result from low body cells’ reaction to insulin.

Diabetes can be effectively treated with a combination of dietary changes, medication, and exercise. When diagnosed early, “diet-exercise” approach is often enough to get the condition under control.

If you are diabetic, you should avoid foods with high levels of refined sugars and cards and instead add more vegetables, whole grains, and fibers to your menu. These prevents spikes in blood sugar levels and the associated circulatory damage, says Dr. Agarwal. With the diabetes effectively controlled, those pale fingernails could be a thing of the past.

Thyroid Problems

Your fingernail beds can also turn white because of Thyroid problem. Hyperthyroidism (overactive thyroid glands) is in particular the common culprit.

More common in women than men, hyperthyroidism is usually triggered by factors such as Grave’s disease, thyroiditis (thyroid inflammation), high amounts of iodine, and thyroid nodules among others.

In case the white nail beds are due to hyperthyroidism, your doctor will determine he best treatment course. Among the treatment options available are surgery, oral intake of Radioactive Iodine, beta-blockers, and anti-thyroid medications (to stop thyroid action).

Liver cirrhosis

Pale fingernail beds may also be indicative of liver disease, especially liver cirrhosis (scarring of the liver that reduced the ability of liver to perform its functions). Severe liver damage can eventually lead to complete failure, necessitating liver transplant.

Liver cirrhosis may cause nausea, loss of appetite and skin itching in the early stages but as it progresses, other symptoms such as jaundice, dark stools that look like tar, edema, and vomiting blood may be experienced.

Although there is no cure for cirrhosis, its progression can be slowed down. Your doctor will also treat the underlying causes identified e.g. hepatitis C. It is also important to cut down on drinking and reduce your weight (if obese or overweight).

Heart Failure

It is scary but true. Pale nails may also mean heart failure. According to the Mayo Clinic, heart failure results when your heart muscles fail to pump blood as normal.

Various factors may be to blame for heart failure including coronary artery disease (leading to narrowing of arteries), high blood pressure, heart attack, and cardiomyopathy. Some conditions such as diabetes and obesity are also known to increase risk of heart failure. These factors causes your heart to become weak or stiff over time and thus unable to “fill and pump efficiently”, the Mayo Clinic says.

Treating heart failure requires an integrated holistic approach comprising of prescription medications, exercise (under the guidance of a doctor), dietary changes, and in rare instances, surgical intervention. Heart failure patients are also advised to cut on their salt intake and manage stress.

Kidney Failure

If your fingernail are white on the rear edge but brown near the tip (the detached area that grows out), a condition known as “half-and-half fingernails”, then you could be dealing with a case of kidney failure.

According to the NHS Choices website, it is thought that kidney failure results in chemical changes in the blood that promote the release of melanin into the nail bed. Kidney failure could also likely increase the number of blood vessels in the nail bed.

According to the NHS Choices website, approximately 40 percent of kidney failure patients suffer from “half-and-half” fingernails.

With so many serious medical conditions attributed to pale nails, the condition warrants the attention of a doctor. As they say, it is better to be safe than sorry.


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