Nail Fungal Infections

Overview

What is a fungal infection?

A fingernail or toenail infection that is caused by a fungus is called onychomycosis (say: "on-ee-koh-my-ko-sis"). Toenails are more likely to become infected than fingernails.

Symptoms

What are the symptoms of a fungal nail infection?

Signs of a fungal nail infection include nails that are:

You may also have pain or discomfort in the affected toes or fingers.

  • Discolored (usually white or yellow)

  • Brittle

  • Crumbly, or have rough, jagged edges

  • Thick

  • Separated from the nail bed

  • Curled up or down, or are distorted in shape

Causes & Risk Factors

Who gets fungal nail infections?

Anyone can get a fungal nail infection, but these infections are more common in adults older than 60 years of age. They are especially common in people who have diabetes or circulation problems. Men are more likely than women to get fungal nail infections.

Why did I get a fungal nail infection?

It may be hard to know where or how you got a fungal nail infection. A warm, wet place is a good place for a fungus to grow. If you often wear heavy work boots that make your feet warm and sweaty, a fungus can grow around your toenails. If you often walk barefoot in locker rooms, you can pick up a fungus from the warm, wet floors.

People whose hands are often wet (for example, dishwashers in restaurants and professional house cleaners) are more likely to get fungal fingernail infections.

Sometimes several people in a family will get fungal infections in their nails at the same time. This can happen because their immune systems aren’t able to fight off the infection very well or because the infection is being passed when they use the same towels.

Diagnosis & Tests

How do I find out if I have a fungal nail infection?

If you think you have a fungal infection in your fingernails or toenails, see your doctor. By looking carefully at your nails, your doctor might be able to tell if you have an infection.

To be sure of what kind of infection you have, your doctor might scrape a little bit of tissue from your nail and send it to a lab. The test can tell if you have a fungal infection or another kind of infection.

Treatment

How is a fungal nail infection treated?

Several medicines can treat a fungal nail infection. Oral antifungal medicines help a new nail grow to replace the infected nail. You might need to take the antifungal medicine for 6 to 12 weeks. It depends on how severe the infection is. Some of these oral antifungal medicines are not safe for people who have liver problems or a history of congestive heart failure. Be sure to let your doctor know if you have one of these conditions. Your doctor will decide which medicine is right for you.

Topical treatments (creams and polish that you apply to the top of your nail) are also available. However, topical medicines alone usually do not cure fungal nail infections.

What can I do to take care of my nails?

Here are some things you can do to take care of your nails if you have a fungal infection:

  • Keep your nails cut short and file down any thick areas.

  • Don’t use the same nail trimmer or file on healthy nails and infected nails. If you have your nails professionally manicured, you should bring your own nail files and trimmers from home.

  • Wear waterproof gloves for wet work (such as washing dishes or floors). To protect your fingers, wear 100% cotton gloves for dry work.

  • Wear socks made of wicking material, which pull moisture away from the skin. Change your socks when they are damp from sweat or if your feet get wet. Put on clean, dry socks every day. You can put over-the-counter antifungal foot powder inside your socks to help keep your feet dry.

  • Wear shoes with good support and a wide toe area. Don’t wear pointed shoes that press your toes together.

  • Avoid walking barefoot in public areas, such as locker rooms.

Questions to Ask Your Doctor

  • My toenail is yellow and brittle. Do I have a fungal infection?

  • What is the best treatment for me?

  • Are treatments usually effective?

  • Are there any side effects of the treatment?

  • If my treatment works, will my nail grow back normally?

  • If I’ve had one fungal nail infection, am I likely to get another?

  • What kinds of shoes should I wear?

  • Should I wear gloves when I get my hands wet?

Citations

  • Treating Onychomycosis by P Rodgers, M.D. and M Bassler, M.D.( 02/15/01, http://www.aafp.org/afp/20010215/663.html)