Fungal nail infections, also known as onychomycosis, can affect both toenails and fingernails, but toenail infections are more common.
Signs and Symptoms of fungal nail infections
- white or yellow spots or streaks under the tip of the nail
- thickening and roughness
- brittle, crumbling nail edges
- nail discoloration (nails may turn white, yellow or brown)
- separation of the nail from the nail bed
- and pain and tenderness
Fungal nail infections are caused by a fungus penetrating into the nail bed. Different types of fungi can infect nails (including dermatophytes, some forms of moulds and yeasts). This makes there appearance vary greatly and minimises treatment results. The fungus is able to infect a nail when it is compromised such as if broken or injured, or may spread to the nail from a nearby skin infection (e.g. athlete’s foot). Fungal infections can be picked up by walking barefoot in damp environments such as public changing rooms, pools, and showers. Anywhere warm and moist where the public walk barefoot is an ideal environment for the fungus to spread from person to person.
Who is at risk?
There are several factors that can put you at increased risk of developing a fungal nail infection. These include:
- poor circulation
- compromised immune system
- being older than 60
- wearing footwear that is closed-in, has poor ventilation, and doesn’t absorb sweat
- working in a humid or moist environment
- excessive sweating
People involved in sporting activities such as running may be at increased risk of getting a fungal toenail infection because they often damage their toenails, which provides an opening for infections to get under the toenail. Also, wearing running shoes means that the feet are often exposed to warm, moist conditions, which are ideal for the development of a fungal infection. Diagnosis To confirm a fungal nail infection a scraping or clipping of the nail can be taken and sent to a pathology laboratory for testing. This also identifies the exact type of fungus involved, which helps guide treatment.
Early treatment is important and may prevent damage to or loss of the nail. Treatment at any stage may reduce discomfort and improve the nail’s appearance. However, fungal nail infections can be difficult to treat, and can reoccur even after successful treatment. Because toenails grow slowly, it can take up to a year for the appearance of the nail to return to normal, even if treatment is successful. Treatments vary depending on the severity and type of fungal infection present. They range from simple application of topical ointments to anti-fungal medications prescribed by your GP. When medical treatments don’t work, another option is to remove the nail, either surgically or with chemicals. A new nail should grow back in its place.
In addition to anti-fungal treatments, you can help manage a fungal nail infection (and prevent further infections from developing) by: keeping your nails short; filing down any thick areas; thoroughly drying your hands and feet, including between the fingers and toes, after washing; and using a separate pair of nail scissors for any infected nails. If a toenail is affected, wear open-toed shoes or shoes with plenty of room for your toes. Always wear clean, dry socks that absorb moisture, especially if your feet sweat a lot, and change your socks when they are damp from sweat. And remember not to walk barefoot in public change rooms, pools or showers; wear thongs.