Nail Fungus (Tinea Unguium/Onychomycosis)

Fungal nail infections are common. Things that increase your risk for getting this infection include a history of foot fungus or athlete’s foot, warm moist places (pool or locker room), having wet nails for a long time (occupational), or being in contact with someone with the fungus. Some people, however, are genetically more susceptible to developing this infection and often have family members with it. Because of the genetic risk, it is likely that it will recur even after successful treatment of the fungus.

Things that increase your risk of developing nail fungus:
◦ Athlete’s foot (or another skin infection caused by fungus).
◦ Cancer and are receiving chemotherapy.
◦ Diabetes.
◦ Had a nail infection.
◦ Injured a nail or recently had nail surgery.
◦ People in your family frequently get nail infections.
◦ Poor circulation.
◦ Psoriasis.
◦ Received an organ transplant.
◦ Weakened immune system due to a disease like human immunodeficiency syndrome (HIV).

Most people see some nail discoloration. The nail may have a white spot. Some nails turn yellow, brown, or green. As the infection worsens, infected nails can thicken, lift up from the finger or toe, or crumble. Some nails become thinner.

Signs of a nail fungal infection:
◦ Part of a nail turns white, yellow, brown, or another color. At first, you may just see a spot of discoloration at the tip of your nail. Without treatment, this discoloration may spread, covering more of the nail.
◦ Debris builds up under the nail.
◦ A nail begins to lift up, so it’s no longer firmly attached to the finger or toe.
◦ A nail turns white, and the surface of the nail may feel soft, dry, and powdery. The nail also thins, so you may be able to scrape off the nail.
◦ Nails thicken and turn yellow or brown, often this affects all of the fingernails.
◦ A nail splits or crumbles.
◦ Usually painless, but if left untreated for a long period of time, can become uncomfortable.

Treatment is important and can prevent the infection from causing more damage to your nails. After getting a fungal nail infection, people who have diabetes have an increased risk of developing sores that do not heal. It’s important to see a dermatologist (or other doctor) at the first sign of a nail problem. A dermatologist can tell you whether you have a nail infection or something else.

Treatment:
◦ To find out if a patient has nail fungus, a dermatologist examines your nails and nearby skin. The doctor may take a sample from your nail and send it to the lab for evaluation to confirm the diagnosis.
◦ Treatment usually begins you trimming your infected nail(s) and keeping them short.
◦ If you have a mild infection, a medicine that you apply to your nails may get rid of the infection. This treatment helps keep new fungus out while the nails grow. Fingernails typically grow out in 4 to 6 months. Toenails take longer, usually takes 12 to 18 months.
◦ If you need more-aggressive treatment, your dermatologist may prescribe antifungal pills. These have a higher cure rate than medicine you apply to your nails., but they also have more potential side effects.
◦ Antifungal pills also work more quickly than medicine applied to the nails. Taking antifungal pills for 2 months can cure an infection under the fingernails. Usually 3 months of treatment cures a toenail fungal infection.
◦ Nail fungus can return even after antifungal pill treatment, therefore it is important to continue preventive foot care.
◦ Spray an antifungal spray into your shoes before you put them on and after taking them off.
◦ Allow your shoes to air out for 24 hours before you wear them again.