Fungal infections can affect any part of the body. Fungi are
normally present in and on the body alongside various bacteria. When a fungus
begins to overgrow, you can get an infection.
Onychomycosis, also called tinea unguium, is a fungal infection
that affects either the fingernails or toenails. Fungal infections normally
develop over time, so any immediate difference in the way your nail looks or
feels may be too subtle to notice at first.
Why Does It Develop?
A fungal nail infection occurs from the overgrowth of fungi in,
under, or on the nail. Fungi thrive in warm, moist environments, so this type
of environment can cause them to naturally overpopulate. The same fungi that
cause jock itch, athlete’s foot, and ringworm can cause nail infections.
Fungi that are already present in or on your body can cause nail
infections. If you have come in contact with someone else who has a fungal
infection, it may have spread to you. According to the American
Academy of Dermatology (AAD), fungal infections affect toenails more
commonly than fingernails because your toes are usually confined to your shoes,
where they’re in a warm, moist environment.
If you get a manicure or pedicure at a nail salon, be sure to ask
how the staff disinfects their tools and how often they do it. Tools, such as
emery boards and nail clippers, can spread fungal infections from person-to-person
if they’re not sanitized.
Who Is at Risk for Fungal Infections?
There are many different causes of fungal nail infections, and
each cause has a treatment of its own. Although many of the causes of a fungal
nail infection are preventable, some risk factors increase the likelihood of
developing it. You’re more likely to develop a fungal nail infection if you:
- have diabetes
- have a disease that causes poor circulation
- are over age 65
- wear artificial nails
- swim in a public swimming pool
- have a nail injury
- have a skin injury around the nail
- have moist fingers or toes for an extended time
- have a weakened immune system
- wear closed-toe shoes, such as tennis shoes or
Nail infections occur more often in men than in women, and the
infections are found in adults more often than in children. If you have family
members who often get these types of fungal infections, you’re more likely to
get them as well. Older adults are at the highest risk for getting fungal
infections of the nails because they have poorer circulation and their nails
grow more slowly and thicken as they age.
What Does It Look Like?
A fungal infection of the nail may affect part of the nail, the
entire nail, or several nails.
Visible signs of a fungal nail infection include:
- scaling under the nail, which is called subungual
- white or yellow streaks on the nail, which is
called lateral onychomycosis
- a crumbling corner or tip of the nail, which is
called distal onychomycosis
- flaking white areas on the nail’s surface, which
may include pits in the nail
- the appearance of yellow spots at the bottom of
the nail, which is called proximal onychomycosis
- loss of the nail
Common signs of a fungal nail infection include:
- a distorted nail that may lift off from the nail
- an odor coming from the infected nail
- a brittle or thickened nail
How Do I Know If I Have a Fungal Nail Infection?
Because other infections can affect the nail and mimic symptoms
of fungal nail infection, the only way to confirm a diagnosis is to see a
doctor. They will take a scraping of the nail and look under a microscope for
signs of a fungus. In some cases, your doctor may have to send the sample to a
lab for analysis and identification.
How Is a Fungal Nail Infection Treated?
Over-the-counter products aren’t usually recommended to treat
nail infections because they don’t provide reliable results. Instead, your
doctor may prescribe an oral antifungal medication, such as:
- terbinafine (Lamisil)
- itraconazole (Sporanox)
- fluconazole (Diflucan)
- griseofulvin (Gris-Peg)
You may use other antifungal treatments, such as antifungal nail
lacquer or topical solutions. These treatments are brushed onto the nail in the
same way that you would apply nail polish. Depending on the type of fungus
causing the infection, as well as the extent of the infection, you may have to
use these medications for several months. Topical solutions are not generally
effective in curing toenail fungal infections.
Treatment isn’t guaranteed to rid your body of the fungal
infection completely. In almost half of all cases, the fungal nail infection
will return. Complications from fungal infection are also possible.
Tips to Prevent Fungal Nail Infections
Making a few simple lifestyle changes can help prevent a fungal
infection of the nails. Taking good care of your nails by keeping them well
trimmed and clean is a good way to prevent infections. You should also avoid
injuring the skin around your nails. If you’re going to have damp or wet hands
for an extended amount of time, you may want to wear rubber gloves.
Other ways to prevent fungal infections of the nails include:
- using antifungal sprays or powders regularly
- washing your hands after touching infected nails
- drying your feet well after showering,
especially between your toes
- getting manicures or pedicures from trustworthy
- using your own items for manicures or pedicures
- wearing socks that minimize moisture
- avoiding being barefoot in public places
- reducing your use of artificial nails and nail
For some people, a fungal infection of the nails can be difficult
to cure and the first round of medication might not work. The nail infection can’t
be considered cured until a new nail that’s free from infection has grown in.
Although this indicates that the nail is no longer infected, it’s possible for
the fungal infection to return. In severe cases, there may be permanent damage
to your nail, and it may have to be removed.
The main complications of a fungal nail infection are:
- a resurgence of the infection
- a permanent loss of the affected nail
- a discoloration of the infected nail
- the spread of infection to other areas of the
body and possibly the bloodstream
- the development of a bacterial skin infection
It’s especially important to see your doctor if you have diabetes
and a fungal nail infection. People with diabetes are at greater risk of
developing potentially serious complications caused by these infections. Talk
to your doctor if you have diabetes and think you’re developing a fungal nail