Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Onychomycosis is an infection of the nail caused by a fungus. The infection occurs more often on toenails than fingernails.

Fungal Infection of the Toenails

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Causes

The fungi that cause onychomycosis thrive in warm, moist environments. Factors that may contribute to onychomycosis include:

  • Injury to the nail
  • Exposure to warm, moist environments, like locker rooms
  • Damp socks
  • Tight fitting shoes
  • Poor nail care

Risk Factors

These risk factors increase your chance of developing onychomycosis. Tell your doctor if you have any of these risk factors:

  • Age: 60 or older—It occurs in half of all people over age 70.
  • Smoking
  • Type 1 or Type 2 diabetes—Onychomycosis occurs in one third of all diabetics.
  • Circulatory disorders, such as peripheral vascular disease
  • Immune system disorders, such as HIV

Symptoms

Onychomycosis can affect one or more nails. It most commonly occurs on toenails.

Symptoms include:

  • Thickened nail that is difficult to cut
  • Brittle or ragged nail
  • Discolored or unsightly nail
  • Pain in the nail when doing ordinary activities

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam. You may need to be referred to a doctor who specializes in skin and nail disorders (a dermatologist). The doctor may scrape or clip the nail to send a sample for testing. Results make take several weeks.

Tests on the nail sample may include:

  • Culture
  • Microscopic examination

Treatment

Since nails grow slowly, it can take up to a year to have a completely clear nail. Onychomycosis can be difficult to treat and may return after treatment. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Medications

  • Prescription antifungal medicine taken by mouth—These medicines may be more effective than other treatments. Some people cannot take antifungal medicine. Tell your doctor about any other medicines that you are taking and your health condition.
  • Creams and ointments
  • Antifungal nail lacquer

Surgery

Surgery to remove the nail is sometimes done in severe cases. A new nail grows in its place.

Prevention

To help reduce your chance of getting onychomycosis, take the following steps:

  • Keep your feet clean. Dry them completely after washing.
  • Keep your hands dry and wear rubber gloves when cleaning.
  • Keep nails short and clean, trimming them straight across.
  • Do not trim or pick at the skin near your nails.
  • Take care to avoid injuring your toenails.
  • Avoid shoes that are too tight.
  • Wear absorbent cotton socks. Change them if they become damp.
  • Avoid walking barefoot around swimming pools, locker rooms, and other public places.
  • Choose a reputable salon for manicures and pedicures.
  • Avoid artificial nails, which can trap moisture.
  • If you smoke, quit .
  • If you have diabetes, see your doctor about steps you can take to better control your blood sugar.