What is a fungal nail infection?‍

It is called onychomycosis, an infection of nails caused by a type of germ called a "fungus." It usually happens in the toenails more often than the fingernails, and it also takes longer time to treat with toenails than fingernails.

Who is at risk?‍

🔶 People who swim or whose feet sweat a lot‍

Fungi like to grow in warm and moist places, which may give these people a higher chance of getting an infection.

🔶 Contact with infected household members‍

Fungal nail infection is contagious and can spread to someone else through direct contact or by touching an infected surface. (Shoes, towels, clothing, etc.)

🔶 Dermatologic diseases‍

People with athlete’s foot or psoriasis might have a toenail infection because certain types of fungi can cause both problems.‍

🔶 Comorbidities‍

People who have diabetes or a weakened immune system may have a higher risk of getting toenail fungus.

What are the symptoms of a fungal nail infection?

When an infection happens, it may cause a nail to:

- Turn white, yellow, or brown

- Get thick, change shape, or lift up

- Break off easily

- Hurt

Infection usually starts on the big toe and can affect one or more nails.

How are fungal nail infections treated?

Your doctor will treat you with antifungal medicines, which can be taken by mouth (terbinafine, itraconazole) or put on the nail (efinaconazole, amorolfine, tavaborole, ciclopirox). Being patient and adhering to an entire course of therapy is essential. Before starting any of these treatments, you should know that:

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💡 Fungal nail infections can be challenging to treat.‍

💡 Oral therapy is more effective than topical therapy.

💡 It can take months for your nail to look normal again, and the treatment is more prolonged for toes (12 weeks) than fingers (6 weeks).‍

💡 Treatment failure and disease recurrence are common. If either of these happens, your doctor may try another treatment or send you to a specialist.

How to prevent fungal nail infections?

The purpose is to stop fungi from developing. There are two ways to prevent fungal nail infections:

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🔺Keep your hands and feet clean and dry

- Clean your hands and feet carefully and dry them immediately

- Keep fingernails and toenails short and clean to protect them from injury

- Prepare spare socks (wicking fabric) and shoes. Change them if they become moist from sweat, and it is better to avoid wearing the same shoes every day

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🔺Avoid contacting infected people or things that might infect you

- Do not share the same shoes or towel with infected members

- Do not share your nail tools with others

- Always wear shoes in public areas

- You can apply anti-fungal spray or powder to your shoes or socks or throw away your old shoes

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References:

1. UpToDate: Onychomycosis: Epidemiology, clinical features, and diagnosis

2. UpToDate: Onychomycosis: Management

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