What
is a fungal nail infection?
A fungal nail infection (onychomycosis,
or ringworm of the nail) occurs when fungi invade a fingernail or
toenail and/or the skin underneath the nail. Toenails are more
commonly affected than fingernails, because they grow very slowly,
allowing the fungi more time to develop. As a result, toenails
require longer treatment time than fingernails do.
The most common fungal nail infection
is distal subungual onychomycosis,
 Fungal nail infections are common.
Worldwide, 2% to 18% of the population have a fungal nail infection
at any given time. They are most common in people older than 60 and
rare in children, affecting less than 1% of children at any given
time.
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Symptoms
Symptoms of fungal nail
infections vary. An infection can cause discomfort but is usually
not painful. Athlete's foot is often present.
Distal subungual onychomycosis, the
most common fungal nail infection, is caused by dermatophytes. It
affects both the nail and the skin underneath the nail (nail bed).
Dermatophytes cause 90% of all fungal toenail infections. Symptoms
include:
- Yellow streaks in the nail bed and
on the underside of the nail.
- Buildup of bits and pieces of skin
and nail fragments (debris) under the nail.
- A discolored and thickened nail
that may separate from the skin under the nail.
- A brittle, broken, and thickened
nail.
 
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What
Increases Your Risk
The risk of getting a fungal nail infection depends on your
susceptibility to fungal infection.
Risk factors include:
- Susceptibility to fungal infection or a history of fungal
infections.
- Impaired immune system .
- Poor blood circulation.
- Age. People older than 60 are more likely to have a fungal
nail infection.
- Being male.
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Prevention
After your fungal nail infection has been
successfully treated, take steps to prevent the infection from
recurring.
- Before bed, thoroughly wash and
dry your feet, and apply a topical antifungal, such as
terbinafine (Lamisil) or ciclopirox (Penlac), directly to your
skin or nail. Use the topical medication for 1 year.
- Keep your feet dry. Dry feet are
less likely to become infected. Apply powder to your dry feet
after you take a shower or bath.
- Wear dry cotton socks and change
them 2 or 3 times a day if necessary.
- Wear dry shoes that allow air to
circulate around your feet. Avoid tight, enclosed shoes. Injury
to the tips of the toes because of tight shoes may be the
biggest single factor that leads to a fungal nail infection
returning.
- Wear shower sandals or shower
shoes when using a public pool or shower; allow them to dry
between uses.
- Don't share shoes, socks, nail
clippers, or nail files with others.
- Avoid injuring your nail. Cutting
nails too short is a common cause of nail injury. If you decide
to get artificial nails or have a manicure, go to a salon that
uses sterile instruments. Nail manicure and certain nail
products can damage the nail or cuticle, making the nail more
susceptible to infection.
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