What Is Nail Fungus?
Onychomycosis, also known as nail fungus, is a fungal infection that occurs underneath the surface of the toenail. Nail fungus can be present for years without any noticeable symptoms or pain. The condition is often characterized by changes in the color and quality of the toenail, which can result in an unsightly appearance.
Nail fungal infections can be mild and may not require treatment. Severe nail fungal infections, however, can cause permanent damage to the toenails. Severe fungal infections can also spread beyond the feet, particularly in individuals with compromised immune systems. Diabetics are especially at risk of developing nail fungal infections.
Nail Fungus Causes and Symptoms
The fungus that causes nail infections lives in warm, moist environments. Given the abundance of such environments in everyday life, everyone is susceptible to this type of fungal infection. Showers, gyms, swimming pools, and nail salons are common sources of nail fungus.
Toenails are especially vulnerable to fungal infection in damp areas where people may be walking barefoot, such as showers and locker rooms. Cracks in the nails or cuts in the skin may make one more susceptible to a fungal infection.
Trauma to a toenail may also predispose one to nail fungus as this can cause separation of the nail from the underlying skin, giving opportunity for fungus to thrive.
Chronic underlying health conditions such as diabetes, autoimmune diseases, or circulatory problems can also increase the risk of nail fungus, as can a history of athlete’s foot or excessive sweating. Nail fungus is also more common in older adults. Nails become more dry and brittle with age, leading to cracks that allow fungus to enter.
Symptoms of nail fungus include:
- Thick nails.
- Nail discoloration that is whitish to yellow-brown.
- Brittle, crumbly, or ragged nails.
- Nails that are distorted in shape.
- Foul-smelling nails.
Nail fungus can also affect fingernails but is more common in toenails.
Forms of Nail Fungus
Nail fungus can be caused by various fungal organisms. The most common is a group of fungi known as dermatophytes. These fungi require keratin, which is a structural protein found in hair, nails, and skin. Nail infections can also be caused by yeast and molds.
Nail Fungus Diagnosis and Treatment
To properly diagnose a fungal infection, the podiatrist may take some nail clippings or debris from the nail for lab testing. Identifying the exact organism that is causing the infection is necessary to determine the best course of treatment. Lab analysis is also necessary to rule out other conditions that can mimic a fungal infection, such as psoriasis or eczema.
Treatment will depend on the severity of the infection and the type of fungus. Certain fungal infections can be difficult to treat, and even if treatment is successful, repeat infections are common.
Treatment for nail fungus may include:
- Antifungal medication—medication may be required for 6–12 weeks, but the full results won’t be seen until the nail grows. Eliminating an infection through the use of oral medication may take four months or longer. Antifungal medications have better success rates in adults under 65.
- Medicated nail cream—these creams, which are rubbed into the nails after soaking, often work better if the nails are first thinned. This allows the medication to penetrate the nail and reach the underlying fungus. Nails can be thinned using a nail file or a nonprescription lotion containing urea.
- Medicated nail polish—these can be applied to the infected nails and surrounding skin once a day.
In some cases, the affected nail may need to be removed to apply an antifungal treatment directly to the underlying infection.
Individuals who suspect they are suffering from a nail fungal infection should consult a podiatrist as soon as possible.