Mee’s Lines
Mees’ lines are narrow white bands that run across the nails, often signaling more than just a cosmetic change. They usually appear after exposure to arsenic, thallium, or other heavy metals, but can also be linked to kidney disease, heart failure, cancer, or severe infections. As the nail grows, the lines move outward, showing when the body faced stress or poisoning.
These lines are not the same as nail ridges or other common nail changes. Instead, they form when something disrupts the nail matrix—the part responsible for nail growth. This makes them an important sign that points to deeper health issues rather than a simple nail injury.
Definition of Symptom
Mees’ lines are transverse white bands that run across the nail plate. They belong to a group of nail changes called leukonychia. Unlike surface injuries, these lines are inside the nail and move outward as the nail grows.
This type of leukonychia is often called leukonychia striata, which means white streaks or bands that cross the nail. While some nail abnormalities are harmless, Mees’ lines usually signal an underlying issue that affects the whole body.
Key Features of Mees’ Lines
- White, horizontal bands across fingernails or toenails.
- Extend from one side of the nail to the other.
- Do not disappear with pressure on the nail.
- Grow out with the nail plate over time.
It is important to distinguish Mees’ lines from other nail abnormalities:
| Condition | Description | Growth Behavior |
|---|---|---|
| Mees’ Lines | White transverse bands in the nail plate. | Grow out with nail. |
| Muehrcke’s Lines | Paired white lines related to blood supply. | Do not grow out. |
| Beau’s Lines | Horizontal depressions in the nail surface. | Grow out with nail. |
| Leukonychia Punctata | Small white spots from minor trauma. | Grow out with nail. |
Mees’ lines often indicate systemic stress, poisoning, or disease, making them a sign that should not be ignored.
Possible Causes/Diseases Condition
Exposure to arsenic poisoning often leads to Mees’ lines. The white bands on the nails may develop weeks after the exposure, reflecting a temporary disruption in nail growth. Other heavy metals, such as thallium and selenium, can also trigger these lines. These substances interfere with normal cell activity, leading to visible changes in the nails.
- Certain systemic illnesses may also be linked to Mees’ lines. Conditions such as kidney failure, congestive heart failure, and Hodgkin lymphoma have been reported in association with this nail finding.
- Chemotherapy drugs like cyclophosphamide, vincristine, and doxorubicin can sometimes cause Mees’ lines by affecting rapidly dividing cells, including those in the nail matrix.
Additional possible causes include carbon monoxide poisoning, leprosy, malaria, and even altitude sickness in some cases. Each condition disrupts the body in a way that temporarily halts normal nail growth.
| Cause Type | Examples | Notes |
|---|---|---|
| Toxins | Arsenic, thallium, selenium | Most common and well-documented. |
| Systemic Illness | Kidney failure, heart failure | Disrupts body function and growth. |
| Cancer/Therapy | Chemotherapy, Hodgkin lymphoma | Affects nail matrix and cell repair. |
| Other Triggers | Carbon monoxide, malaria, leprosy | Less common but reported. |
Other Non-Disease Causes
Not all cases of Mees’ lines come from illness. Certain external factors and temporary stresses on the body can also lead to these white bands on the nails.
- Chemotherapy drugs such as cyclophosphamide, vincristine, and doxorubicin can disrupt nail growth, leaving visible transverse lines. These changes usually fade as the nail grows out and treatment ends.
- Malnutrition can cause Mees’ lines. When the body does not get enough nutrients, nail growth slows or becomes uneven. This stress can show up as Mees’ lines, especially during long periods of poor diet or nutrient deficiency.
- Trauma to the nail plate may also create lines that look like Mees’ lines. For example, repeated manicure errors or physical injury to the nail can leave white streaks. These are localized nail changes, not linked to illness.
Some cases appear after acute stress events, such as severe illness, surgery, or recovery from poisoning. The body temporarily diverts resources away from nail growth, leading to the development of transverse bands.
| Cause | Type | Notes |
|---|---|---|
| Chemotherapy | Treatment | Disrupts nail growth during cancer therapy. |
| Malnutrition | Nutritional | Results from poor diet or lack of key nutrients. |
| Nail Trauma | Mechanical | Manicure errors or physical injury to nail plate. |
| Acute Stress Event | Physiologic | Severe illness, surgery, or recovery from toxic exposure. |
These non-disease factors show how both internal and external stresses can leave temporary marks on the nails.
How It Causes The Symptom
A temporary disruption in nail growth causes Mees’ lines. The nail plate records this event as a white band that moves outward as the nail grows. Exposure to arsenic or heavy metals is a main cause.
These substances build up in nails and interfere with normal nail cell activity. Other conditions, such as kidney failure or certain drugs, can also disturb nail formation and create white bands across the nail. Key triggers include:
- Arsenic poisoning.
- Thallium or selenium exposure.
- Chronic kidney disease.
- Certain medications or toxins.
| Cause | Effect on Nail | Time to Appear |
|---|---|---|
| Arsenic poisoning | Disrupts keratin production | 3–6 weeks |
| Kidney failure | Alters protein metabolism | Variable |
| Drug or toxin exposure | Interferes with nail matrix | Weeks to months |
Unlike surface injuries, Mees’ lines grow out with the nail. This feature helps people tell them apart from Muehrcke lines, which stay in place because they involve blood flow under the nail bed. The appearance of these bands means the body experienced a stressor during the time the nail was forming.
Possible Complications
Mees’ lines do not cause harm, but they often point to deeper health problems. Because they can signal heavy metal poisoning, kidney failure, or other illness, ignoring them may delay the diagnosis of a serious condition. If the underlying cause is not treated, complications may include:
- Organ damage from heavy metal toxicity.
- Chronic kidney disease progression.
- Weakened immune system linked to illness.
- Long-term effects from untreated poisoning or disease.
Some people may also face complications from treatments, such as fatigue or infection risk from chemotherapy. In cases of arsenic or thallium poisoning, complications can include skin changes, nerve damage, or stomach problems. These effects may appear weeks or months after exposure.
Because nail growth is slow, Mees’ lines can remain visible long after the original event. This may cause confusion if new health issues develop while the old lines are still present.
| Possible Cause | Potential Complication |
|---|---|
| Heavy metal poisoning | Organ damage, nerve issues |
| Kidney failure | Fluid imbalance, high blood pressure |
| Chemotherapy | Infection risk, fatigue |
| Systemic illness | Ongoing weakness, poor recovery |
When to Seek Medical Attention
Mees lines can sometimes point to serious health problems. If someone notices new horizontal white bands across several nails without an obvious cause, they should not ignore them. Seek medical care right away if:
- The lines appear suddenly on multiple nails.
- There is a history of possible arsenic, thallium, or other heavy metal exposure.
- The person recently had chemotherapy, severe illness, or unexplained poisoning symptoms.
- Other signs such as fatigue, abdominal pain, or skin changes are present.
Doctors may check blood or urine and ask about your history to look for toxins or underlying health issues. Sharing details about work, travel, and medications helps them figure out what’s going on.
If nail changes happen along with symptoms like shortness of breath, confusion, or ongoing weakness, get checked urgently. These signs may point to a serious illness or poisoning that needs immediate care.
