Nail fungus, or onychomycosis, is an infection of nails with fungal organisms. More toenails than fingernails are affected. It’s more common in elderly people with poor circulation and diabetics. People often have a fungal foot infection (athlete’s foot), along with toenail fungus.
What Causes Nail Fungus?
The most frequent causes are fungi called dermatophytes. People often pick up and spread the infection at public swimming pools and locker rooms, where they walk around barefoot. Conditions there are warm and damp, which are best for fungi to grow. Fungal infections can also spread in families by sharing towels and footwear. Damage to nails can make it easier to get infected.
What Are the Symptoms of Nail Fungus?
Symptoms include change in nail color to yellow, brown, or white; thicker nails with shape changes; brittle and flaky nails, with splits and chips; accumulation of fungus and dirt under nails, leading to a bad smell; separation of nails from toes or fingers; and, rarely, pain.
How Is Nail Fungus Diagnosed?
The doctor makes a diagnosis from an examination of the nails. A scraping of the nail or nail clippings may be taken and sent to a laboratory for study.
How Is Nail Fungus Treated?
Early treatment is best, but getting rid of the fungus may be hard. Untreated, nails may have permanent damage and deformity, leading to problems wearing shoes or walking. Oral antifungal drugs, such as terbinafine, taken for 3 months for toenail fungus and 6 weeks for fingernail fungus are the usual treatment. Some people cannot take these drugs because of their other drugs or medical problems. Antifungal drugs can also be put directly on infected nails (topical treatment) for up to 12 months. These topical drugs don’t usually work very well.
Other treatments, not usually done, include removing the infected nail and scraping the nail to make it less thick. Usually, a foot doctor (podiatrist) does these.