What are Mees lines?

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Last updated: June 10, 2025View editorial policy

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From the Research

Mees lines are white horizontal bands that appear on the fingernails or toenails, typically indicating systemic illness or poisoning, and are most commonly associated with arsenic poisoning, but can also occur with other heavy metal poisonings, severe infections, chemotherapy, heart attack, kidney failure, or other serious systemic conditions. These lines develop when nail growth is temporarily disrupted, causing abnormal keratinization that appears as transverse white lines across the nail plate 1. Unlike Beau's lines, which are depressions in the nail, Mees lines are not palpable and don't cause nail surface irregularities. They move outward as the nail grows, allowing clinicians to roughly estimate when the toxic exposure or illness occurred. Some key points to consider about Mees lines include:

  • They can be caused by a variety of factors, including heavy metal poisoning, severe infections, and chemotherapy 2, 3, 4
  • Treatment focuses on addressing the underlying condition or removing the source of poisoning rather than treating the nail changes themselves, as the lines will eventually grow out with the nail 5
  • Medical evaluation is recommended to identify the underlying cause, which may require toxicology screening, especially if heavy metal poisoning is suspected
  • Chelation therapy may be used to treat heavy metal poisoning, and has been shown to be effective in removing toxic metals from the body 2, 3, 4

References

Research

Heavy metal toxicity: An update of chelating therapeutic strategies.

Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS), 2019

Research

The role of chelation in the treatment of arsenic and mercury poisoning.

Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2013

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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