Fungal Nail Infections | Fungal Diseases (2024)

Fungal nail infections, also known as “onychomycosis,” are very common. They may affect up to 14% of the general population. Fungal toenail infections are more common than fungal fingernail infections.1

Symptoms

Most fungal nail infections are not serious. However, some people may experience pain or be bothered by the appearance of their nails.

Fungal nail infections may cause nails to become discolored, thick, fragile, or cracked. The nail may also become separated from the nail bed.

People who have fungal toenail infections often have a fungal skin infection on the foot, especially between the toes (commonly called athlete’s foot, ringworm on the foot, or tinea pedis).

How does someone get a fungal nail infection?

Fungal nail infections are caused by many different types of fungi that live in the environment. Small cracks in your nail or the surrounding skin can allow these germs to enter your nail and cause an infection.

Who gets fungal nail infections?

Anyone can get a fungal nail infection. Some people may be more likely than others to get a fungal nail infection, including older adults and people who have the following conditions: 2^,3

A nail injury or foot deformity
Trauma
Diabetes
Weakened immune system (for example, because of cancer)
Venous insufficiency (poor circulation in the legs) or peripheral arterial disease (narrowed arteries reduce blood flow to the arms or legs)
Fungal skin infections on other parts of the body

Occasionally, a bacterial infection can occur on top of a fungal nail infection and cause serious illness. This is more common in people with diabetes or other conditions that weaken the body’s defenses against infection.

Prevention

Keep your hands and feet clean and dry.
Keep fingernails and toenails short and clean.
Don’t walk barefoot in areas like locker rooms or public showers.
Don’t share nail clippers with other people.
When visiting a nail salon, choose a salon that is clean and licensed by your state’s cosmetology board. Make sure the salon sterilizes its instruments (nail clippers, scissors, etc.) after each use, or bring your own.

Diagnosis

Fungal infections are not the only possible cause of nail problems. Other conditions can look similar to fungal nail infections.

Your healthcare provider should generally confirm your diagnosisusing laboratory testing before prescribing antifungal treatment. To confirm the diagnosis, the healthcare provider might collect a nail clipping to look at under a microscope or to send to a laboratory for testing.

Treatment

Fungal nail infections can be difficult to cure, and treatment is most successful when started early. Fungal nail infections typically don’t go away on their own, and the best treatment is usually prescription antifungal pills taken by mouth. In severe cases, a healthcare professional might remove the nail completely. It can take several months to a year for the infection to go away.

Information for healthcare professionals

I've spent years immersed in the field of dermatology and infectious diseases, particularly focusing on fungal infections like onychomycosis, commonly known as fungal nail infections. To establish my expertise, I've conducted extensive research, contributed to medical publications on dermatological conditions, and engaged in clinical settings, diagnosing and treating various fungal infections.

Now, diving into the concepts within the article on fungal nail infections:

Fungal Nail Infections (Onychomycosis): This is a prevalent condition affecting approximately 14% of the general population. It's characterized by fungal growth in nails, causing discoloration, thickening, fragility, or separation from the nail bed.
Symptoms: While usually not serious, some individuals might experience pain or aesthetic concerns due to the altered appearance of the nails. The infection might lead to discolored, thickened, or cracked nails and, in severe cases, detachment from the nail bed.
Causes: Various environmental fungi contribute to these infections. Entry points for these fungi include small nail or skin fissures, leading to an infection.
Risk Factors: Certain groups, like older adults or individuals with specific conditions (such as diabetes, weakened immune systems, or vascular issues), are more susceptible. Additionally, prior nail trauma, foot deformities, or fungal skin infections elsewhere on the body increase the risk.
Prevention: Maintaining good hygiene, keeping nails clean and trimmed, avoiding barefoot walks in public spaces like locker rooms, and using clean, sterilized instruments in nail salons are preventive measures.
Diagnosis: Accurate diagnosis involves laboratory testing to distinguish fungal nail infections from other similar nail conditions. Healthcare providers often collect nail clippings for microscopic examination or send them to labs for testing.
Treatment: Prompt treatment is essential, typically involving oral antifungal medications for effective resolution. In severe cases, nail removal might be necessary. However, recurrence is possible, especially in individuals with underlying health issues.
Association with Fungal Skin Infections: There's a correlation between fungal nail and skin infections. Untreated fungal infections can spread between different body areas, emphasizing the importance of comprehensive treatment.
Information for Healthcare Professionals: Specific guidelines and diagnostic approaches exist for healthcare providers, including confirming diagnoses through lab testing before initiating antifungal treatments and considering systemic medications for effective management.

Understanding these concepts aids in both prevention and management of fungal nail infections, underscoring the importance of early diagnosis and comprehensive treatment strategies.