Is That White Spot Fungus or Just Dryness?

You just removed your dark red holiday polish, expecting to see clean, healthy nails underneath.

Instead, you are greeted by rough, chalky white patches on your toenails.

Panic sets in. Is it fungus? Did I catch something at the salon? Do I need to hide my feet forever?

Before you spiral, take a breath. While white spots can be a sign of a fungal infection (White Superficial Onychomycosis), they are just as likely to be a harmless reaction to your beauty routine called Keratin Granulations. In this blog, The Foot & Ankle Center of Maryland explains how you can spot the difference (and treat the cause, too).

Keratin Granulations (The "Polish" Problem)

Wearing nail polish nonstop (especially dark colors or gels) dehydrates the nail plate.

  • The Mechanism: Nail polish and remover (acetone) strip the natural oils from your nail. Over time, the top layers of keratin cells dry out and clump together, creating rough, white, chalky patches that scrape off easily.

  • The Look: It looks like dry, peeling skin sitting on top of the nail.

White Superficial Onychomycosis (The Fungus)

This is a specific type of fungus that attacks the top layer of the nail plate.

  • The Mechanism: An organism invades the nail, eating the keratin.

  • The Look: It looks like powdery, soft "islands" of white that can be scraped away, but the nail underneath might feel soft or pitted. Unlike granulations, this will spread and get worse without medication.

The "Texture Test": How to Tell

You can often distinguish between the two at home. Ask yourself:

1.    Is it rough or powdery?

 Granulations feel rough and scaly. Fungus feels powdery and soft.

2.    Does it improve with oil?

Rub cuticle oil or moisturizer on the nail. If the white spots disappear or turn translucent immediately, it’s likely just dryness (Granulations). If the white patch remains distinct even when wet, it’s likely fungus.

3.    Did you wear polish for 6 weeks straight?

 If yes, lean toward dryness.

The Fix: The "Polish Holiday"

If it’s Granulations, you don't need antifungal cream; you need a break.

  • Take 2 Weeks Off: Leave your nails bare. No clear coat, no hardener. Just air.

  • Rehydrate the Keratin: Apply cuticle oil or urea-based cream to the nail plate daily.

  • Buff Gently: You can lightly buff away the rough patches, but don't overdo it, or you will thin the nail!

When to See Us

If you take a 2-week break and hydrate, but the white spots grow, spread, or turn yellow, it is time for a professional culture. We can test the nail to confirm if it’s fungal and prescribe a treatment that actually works (unlike most drugstore lacquers).

Don't guess with your nail health. If you aren't sure, come in for a quick check. We’ll get you clear before sandal season returns!

Do you have questions or concerns about skin or toenail troubles? Contact the office of Dr. Ross Cohen of The Foot & Ankle Center of Maryland in Glen Burnie, MD, at (410) 761-3501 to schedule a visit. We look forward to seeing you!

WPV