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Nail fungus is a common condition that begins as a white or yellow spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, nail fungus may cause your nail to discolor, thicken and crumble at the edge. It can affect several nails but usually not all of them.
Nail fungus is also called onychomycosis (on-ih-koh-my-KOH-sis) and tinea unguium. When fungus infects the areas between your toes and the skin of your feet, it’s called athlete’s foot (tinea pedis)
Fungal nail infection occurs when a fungus grows in and around your fingernail or toenail.
Fungal nail infection causes
Fungi can live on the dead tissues of the hair, nails, and outer skin layers.
Common fungal infections include:
- Athlete’s foot
- Jock itch
- Ringworm on the skin of the body or head
Fungal nail infections are most often seen in adults. They often follow fungal infection of the feet. Infections occur more often in toenails than in fingernails.
People who often go to public swimming pools, gyms, or shower rooms, and people who sweat a lot often have these infections. The fungi that cause them live in warm, moist areas.
You are at higher risk of getting a fungal nail infection if you:
- Get manicures or pedicures with tools that have been used on other people
- Have minor skin or nail injuries
- Have deformed nail or nail disease
- Have moist skin for a long time
- Have immune system problems
- Wear closed-in footwear
Fungal nail infection symptoms
The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.
A fungal nail infection is usually painless at first, and in most cases it won’t cause any further complications. But if the infection isn’t treated, it may cause pain and discomfort, although this is rare.
If you have pain in the affected toenail, it can eventually make walking and wearing shoes difficult. You may have problems writing if your fingernails are affected.
As the infection progresses you may experience other symptoms, such as the nail becoming brittle, with pieces of nail breaking off and coming away from the toe or finger completely.
If left untreated, the skin around the nail can sometimes become inflamed and painful. White or yellow patches may also be visible on the nailbed, or you may have scaly skin next to the nail.
How do you get a fungal nail infection?
- Spread from a fungal skin infection. For example, athlete’s foot is a fungal skin infection of the toes. This may spread to the toenails if the skin infection is not treated early.
- Fingernail infection may occur after a toenail infection has become established. The fungus may spread to a finger if you scratch your itchy toes and toenail.
- Fingernail infections are also more likely to occur if you wash your hands frequently, or have them in water a lot. For example, if you are a cook or a cleaner. Constant washing may damage the protective skin at the base of the nail. This may allow fungi to enter.
- A nail that has recently been damaged is also more likely to become infected.
- You have an increased risk of developing a fungal nail infection if you have various other conditions. For example: diabetes, psoriasis, poor circulation, a poor immune system (for example, if you have AIDS or are on chemotherapy), or a general poor state of health.
- Nail infections are more common in people who live in hot or humid climates.
- Smoking also increases the risk of developing a nail infection.
- In some cases there is no apparent reason. Fungus germs (fungi) are common and an infection can occur ‘out of the blue’.
Fungal nail infection treatment
Over-the-counter creams and ointments generally do not help treat this condition.
Prescription antifungal medicines that you take by mouth may help clear the fungus.
- You will need to take the medicine for about 2 to 3 months for toenails; a shorter time for fingernails
- Fluconazole griseofulvin, terbinafine, and itraconazole are used to treat this condition.
- Your health care provider will do lab tests to check for liver damage while you are taking these medicines.
Laser treatments may be able to get rid of the fungus in the nails. In some cases, you may need to have the nail removed.