Fungal nail infections are way more common than you think. A fungal nail infection occurs when a fungus invades a fingernail, a toenail, or the skin under the nail (nail bed). But, it is more common in toenails. If you have a fungal infection such as on your foot, the fungus can spread to one or more of your nails. The nail can become discolored, thick, and more likely to crack and break. A fungal infection of the nail is also called onychomycosis.
Fungi (plural of fungus) are tiny organisms you can only see through a microscope. Fungus is normally present on the body, but if it overgrows, it can become a problem. A fungal nail infection usually isn’t painful unless it becomes severe. But it may look bad, hurt, or damage your nail or nail bed.
A fungal nail infection could lead to more serious problems if you have diabetes or a weak immune system. Most infections are caused by the same fungus that causes athlete’s foot. You can get infected by walking barefoot in public showers or pools or from sharing personal items, such as towels or nail clippers.
What causes a nail fungal infection?
Fungi can attack your nails through small cuts in the skin around your nail or through the opening between your nail and nail bed. Fungal nail infection can develop in people at any age, but it’s more common in older adults. As the nail ages, it can become brittle and dry. The resulting cracks in the nails allow fungi to enter.
Fungal nail infections can be caused by many different types of fungi (yeasts or molds) that live in the environment. The fungus lives in wet, dark conditions. The fungus grows when your feet are in warm, sweaty environment (socks, work boots). If you have athlete’s foot, the fungus can spread from your skin to your nails.
Anyone can get a nail infection. Some people may be more likely than others to get a fungal nail infection, including older adults. You’re more likely to get a fungal nail infection if you:
- don’t keep your feet clean and dry
- are older than 60 years
- sweat heavily
- have blood circulation problems
- wear shoes that cause your feet to get hot and sweaty
- have minor skin or nail injury
- walk around barefoot in places where fungal infections can spread easily, such as communal showers, locker rooms and gyms
- have a weakened immune system
- have certain other health conditions, such as diabetes
What are the symptoms?
A fungal nail infection may start as a white or yellow spot under the tip of the finger or toenail. As it spreads, the infected nail will change appearance.
Common symptoms of a fungal nail infection includes:
- Discolouration – white or yellow patches may appear and spread, usually at the tip of the nail
- Nail becomes thick, rough, or brittle
- Crumbling or jagged edges
- Nail splitting from the skin beneath
There may be also be:
- scaling under the nail
- yellow or white streaking
- yellow spots at the bottom of the nail
- infected nails may separate from the nail bed
- they may even emit a foul odor.
Treating a Fungal Nail Infection
The key to treating a fungal nail infection is to ensure you get to the source of the infection which in the majority of cases is underneath the nail.
Fungal nail infections can be difficult to cure. Also, they typically don’t go away without antifungal treatment. The best treatment for a fungal nail infection is usually prescription antifungal pills taken by mouth. In severe cases, a doctor might remove the nail completely.
There are also topical ointments and alternative therapies. Over the counter creams and ointments are also available, but they have not proved very effective.
Oral medications for nail fungus infection include:
- terbinafine (Lamisil)
- itraconazole (Sporanox)
- fluconazole (Diflucan)
These typically take up to 4 months before fully replacing the infected nail with uninfected nail.
It can take several months to a year for the infection to go away. Even after successful treatment of the fungal infection, the nail may not look completely normal. There is a 1 in 4 chance that the fungal infection will come back.
Prevention of Fungal Nail Infections
The following habits can help prevent nail fungus or reinfections and also athlete’s foot, which can lead to nail fungus:
- Wash your hands and feet regularly. Wash your hands after touching an infected nail. You can also moisturize your nails after washing.
- Trim nails straight across, smooth the edges with a file and file down thickened areas. Disinfect your nail clippers after each use.
- Wear sweat-absorbing socks or change your socks throughout the day.
- Choose shoes made of materials that breathe. Also, let your shoes dry for 24 hours before you wear them again.
- Discard old shoes or treat them with disinfectants or antifungal powders.
- Don’t walk barefoot in areas such as locker rooms or public showers.
- Choose a nail salon that uses sterilized manicure tools for each customer.
- Give up nail polish and artificial nails.