What are the common symptoms of fungal nail infections. How do fungi invade nails and cause infections. What are the most effective treatments for onychomycosis. How can you prevent fungal nail infections from occurring or recurring.

Understanding Fungal Nail Infections: An Overview

Fungal nail infections, medically known as onychomycosis, are a widespread condition affecting millions of people worldwide. These infections occur when fungi invade the nail bed, leading to various symptoms that can impact both the appearance and health of the nails. While toenails are more commonly affected, fingernails can also fall victim to fungal infections.

Onychomycosis is estimated to affect up to 14% of the general population, making it one of the most prevalent nail disorders. The condition is more common in older adults and individuals with certain predisposing factors. Understanding the nature of fungal nail infections is crucial for proper diagnosis, treatment, and prevention.

Types of Fungal Nail Infections: Identifying the Culprits

There are several types of fungal nail infections, each with its own characteristics and causative organisms. The four main types include:

1. Distal or lateral subungual onychomycosis
2. Proximal subungual onychomycosis
3. White superficial onychomycosis
4. Candidal onychomycosis

Distal or lateral subungual onychomycosis is the most common type, typically caused by dermatophytes. It begins in the nail bed and spreads from the edges of the nail, resulting in a yellowish discoloration.

How do different types of fungal nail infections manifest?

Each type of fungal nail infection presents with slightly different symptoms and patterns of spread. For instance, proximal subungual onychomycosis starts at the base of the nail and moves outward, while white superficial onychomycosis affects the top layers of the nail plate. Candidal onychomycosis is often associated with chronic mucocutaneous candidiasis and typically affects fingernails.

Recognizing the Symptoms: Tell-Tale Signs of Fungal Nail Infections

Fungal nail infections can manifest through various symptoms, which may vary in severity depending on the type and extent of the infection. Common signs include:

• Discoloration of the nail (yellowing, browning, or whitish)
• Thickening of the nail plate
• Brittleness or fragility of the nail
• Distortion of nail shape
• Separation of the nail from the nail bed (onycholysis)
• Accumulation of debris under the nail
• Foul odor

In some cases, individuals may experience pain or discomfort, particularly when pressure is applied to the affected nail. It’s important to note that these symptoms can also be indicative of other nail conditions, highlighting the need for proper diagnosis by a healthcare professional.

Can fungal nail infections cause pain?

While many fungal nail infections are painless, some individuals may experience discomfort or pain, especially if the infection has led to significant thickening of the nail or separation from the nail bed. In severe cases, walking or wearing shoes may become uncomfortable if toenails are affected.

Unveiling the Causes: How Fungal Nail Infections Develop

Fungal nail infections are caused by various types of fungi that thrive in warm, moist environments. These organisms can enter the nail through small cracks in the nail or surrounding skin. Several factors can increase the risk of developing a fungal nail infection:

• Exposure to environments where fungi thrive (e.g., public swimming pools, locker rooms)
• Poor foot hygiene
• Wearing tight, non-breathable footwear
• Nail trauma or injury
• Chronic health conditions like diabetes or circulatory problems
• Weakened immune system
• Advanced age

Understanding these risk factors is crucial for both prevention and management of fungal nail infections. By addressing these underlying causes, individuals can reduce their likelihood of developing or experiencing recurrent infections.

Why are toenails more susceptible to fungal infections than fingernails?

Toenails are more frequently affected by fungal infections due to several factors. Feet are often confined in shoes, creating a warm, moist environment ideal for fungal growth. Additionally, toes have less blood flow compared to fingers, making it harder for the immune system to detect and fight off infections in this area.

Diagnosis and Treatment: Combating Fungal Nail Infections Effectively

Accurate diagnosis is crucial for effective treatment of fungal nail infections. Healthcare providers typically confirm the diagnosis through laboratory testing, which may involve examining nail clippings under a microscope or culturing the nail material.

Once diagnosed, treatment options for fungal nail infections include:

1. Oral antifungal medications
2. Topical antifungal treatments
3. Combination therapy (oral and topical)
4. Laser therapy
5. Nail removal (in severe cases)

Oral antifungal medications are often considered the most effective treatment, particularly for more severe or resistant infections. However, treatment can be prolonged, often lasting several months to a year, and may require regular monitoring due to potential side effects.

How effective are over-the-counter treatments for fungal nail infections?

While over-the-counter antifungal treatments are available, their effectiveness for nail infections is limited. These products may be more suitable for mild cases or as a preventive measure. For established nail infections, prescription-strength medications prescribed by a healthcare provider are typically necessary for successful treatment.

Prevention Strategies: Keeping Fungal Nail Infections at Bay

Preventing fungal nail infections involves a combination of good hygiene practices and protective measures. Key prevention strategies include:

• Keeping hands and feet clean and dry
• Trimming nails regularly and keeping them short
• Wearing breathable footwear and moisture-wicking socks
• Using antifungal powders or sprays in shoes
• Avoiding walking barefoot in public areas like locker rooms or swimming pools
• Not sharing nail care tools with others
• Choosing reputable nail salons that properly sterilize their equipment

For individuals prone to recurrent infections, incorporating these preventive measures into their daily routine can significantly reduce the risk of future occurrences.

Can dietary changes help prevent fungal nail infections?

While there’s no direct evidence linking diet to fungal nail infections, maintaining a balanced diet that supports overall immune function may help reduce susceptibility. Some studies suggest that probiotics and foods rich in antifungal compounds (like garlic and coconut oil) may have beneficial effects, but more research is needed to confirm their efficacy in preventing nail infections.

Complications and Associated Conditions: Beyond the Nail

While fungal nail infections are often considered a cosmetic concern, they can lead to more serious complications in some cases. Potential complications include:

• Spread of infection to other nails or skin areas
• Secondary bacterial infections
• Chronic pain or discomfort
• Permanent nail damage

Furthermore, fungal nail infections can be closely associated with other fungal skin conditions, particularly athlete’s foot (tinea pedis). Treating one condition without addressing the other can lead to recurrent infections.

Are there any systemic health risks associated with untreated fungal nail infections?

In most cases, fungal nail infections do not pose significant systemic health risks. However, for individuals with compromised immune systems or chronic conditions like diabetes, untreated infections can potentially lead to more serious complications. These may include cellulitis (a bacterial skin infection) or, in rare cases, systemic fungal infections.

Special Considerations: Fungal Nail Infections in High-Risk Populations

Certain groups of individuals are at higher risk for developing fungal nail infections or experiencing complications from them. These high-risk populations include:

• Elderly individuals
• People with diabetes
• Individuals with compromised immune systems
• Athletes and frequent gym-goers
• People with chronic nail trauma (e.g., due to ill-fitting shoes)

For these groups, early detection, prompt treatment, and rigorous preventive measures are particularly important. Regular foot and nail examinations, along with proactive management of underlying conditions, can help mitigate the risks associated with fungal nail infections.

How should diabetics manage fungal nail infections?

Diabetics should be especially vigilant about foot care, including monitoring for signs of fungal nail infections. Due to potential complications related to poor circulation and neuropathy, diabetics should seek professional medical care for any nail abnormalities. Treatment may need to be more aggressive, and close monitoring is essential to prevent secondary infections or other foot-related complications.

Fungal nail infections, while common, can be challenging to treat and may significantly impact an individual’s quality of life. Understanding the causes, symptoms, and available treatment options is crucial for effective management of this condition. By implementing proper hygiene practices and preventive measures, individuals can reduce their risk of developing fungal nail infections and maintain healthy, attractive nails.

As research in this field continues to evolve, new treatment modalities and preventive strategies may emerge, offering hope for more effective and efficient management of fungal nail infections in the future. Always consult with a healthcare professional for personalized advice and treatment options tailored to your specific situation.

Fungal Nail Infections | Fungal Diseases

Fungal nail infections, also known as “onychomycosis,” are very common. They may affect up to 14% of the general population. Fungal toenail infections are more common than fungal fingernail infections.¹

Symptoms

Most fungal nail infections are not serious. However, some people may experience pain or be bothered by the appearance of their nails.

Fungal nail infections may cause nails to become discolored, thick, fragile, or cracked. The nail may also become separated from the nail bed.

People who have fungal toenail infections often have a fungal skin infection on the foot, especially between the toes (commonly called athlete’s foot, ringworm on the foot, or tinea pedis).

How does someone get a fungal nail infection?

Fungal nail infections are caused by many different types of fungi that live in the environment. Small cracks in your nail or the surrounding skin can allow these germs to enter your nail and cause an infection.

Who gets fungal nail infections?

Anyone can get a fungal nail infection. Some people may be more likely than others to get a fungal nail infection, including older adults and people who have the following conditions: ^2,3

• A nail injury or foot deformity
• Trauma
• Diabetes
• Weakened immune system (for example, because of cancer)
• Venous insufficiency (poor circulation in the legs) or peripheral arterial disease (narrowed arteries reduce blood flow to the arms or legs)
• Fungal skin infections on other parts of the body

Occasionally, a bacterial infection can occur on top of a fungal nail infection and cause serious illness. This is more common in people with diabetes or other conditions that weaken the body’s defenses against infection.

Prevention

• Keep your hands and feet clean and dry.
• Keep fingernails and toenails short and clean.
• Don’t walk barefoot in areas like locker rooms or public showers.
• Don’t share nail clippers with other people.
• When visiting a nail salon, choose a salon that is clean and licensed by your state’s cosmetology board. Make sure the salon sterilizes its instruments (nail clippers, scissors, etc.) after each use, or bring your own.

Diagnosis

Fungal infections are not the only possible cause of nail problems. Other conditions can look similar to fungal nail infections.

Your healthcare provider should generally confirm your diagnosis using laboratory testing before prescribing antifungal treatment. To confirm the diagnosis, the healthcare provider might collect a nail clipping to look at under a microscope or to send to a laboratory for testing.

Treatment

Fungal nail infections can be difficult to cure, and treatment is most successful when started early. Fungal nail infections typically don’t go away on their own, and the best treatment is usually prescription antifungal pills taken by mouth. In severe cases, a healthcare professional might remove the nail completely. It can take several months to a year for the infection to go away.

Fungal nail infections can be closely associated with fungal skin infections. If a fungal infection is not treated, it can spread from one place to the other. Patients should discuss all skin concerns with their healthcare provider to ensure that all fungal infections are properly treated.

Even after treatment, fungal nail infections can come back. This is more common in people who have conditions like diabetes that make them more likely to get a fungal nail infection. If you suspect an infection has returned, contact your healthcare provider.

Information for healthcare professionals

Symptoms Causes, Treatment, and Prevention

Written by Stephanie Booth

Medically Reviewed by Poonam Sachdev on May 10, 2023

• What Is a Fungal Nail Infection?
• Types of Fungal Nail Infections
• Fungal Nail Infection Symptoms
• Fungal Nail Infection Causes 
• Fungal Nail Infection Treatment
• Fungal Nail Infection Prevention
• Fungal Nail Infection Complications
• More

A fungal nail infection is a common condition that can leave you with brittle, discolored nails, usually on your toes.

Its formal name is onychomycosis, and it’s a lot like athlete’s foot. But instead of affecting the skin on the bottom of your feet or between your toes, it invades your nails.

Fungi are tiny organisms you can only see through a microscope. Many different types can cause a nail infection. Sometimes they live on your skin and don’t make any trouble. But if you have a lot in one area, you might get infected.

Don’t be embarrassed if you have toenail or fingernail fungus. It’s way more common than you think.

There are 4 main kinds of fungal nail infection. Each looks slightly different:

• Distal or lateral subungual onychomycosis. This is the most common kind. It results from a fungus called a dermatophyte. You can get it in your fingernails or toenails. It starts in the nail bed, underneath the nail. You’ll see a yellowish colored area that spreads from the edges of the nail to the center, and places where it comes apart from the nail bed.
• White superficial onychomycosis. This is less common and only affects the nail surface, mainly on your toenails. It starts as white spots, which become powdery and cause the nail to crumble.
• Proximal subungual onychomycosis. This appears first as white spots in the center of the nail bed at the cuticle. They move outward as the finger or toenail grows. It’s rare and usually affects people who have immune system problems, like HIV infection.
• Candidal onychomycosis. Yeast causes this infection that usually affects your fingernails. The area around the nails is often swollen and inflamed, and the nails may come off entirely. It tends to happen to nails that have been damaged by an injury or another infection.

Symptoms are different, depending on which type of fungal nail infection you have. They usually start mild and get more serious.

• At first, you may only see a white or yellow spot under your nail. Over time, this spreads and can turn your whole nail white, yellow, green, or black.
• The nail may thicken and could be hard to trim. 
• It may start to curl up or down or loosen from the nail bed. 
• Your nail could become brittle and crumble when you touch it.
• Your nail may become misshapen.
• You may notice a bad smell.

It’s easy to ignore fungal nail infections at first, since you may not have any pain. But if you don’t treat them, it can hurt to put any pressure on the area. If an infection gets bad enough, it could even become hard to walk.

You get an infection when a crack in your nail or the skin around it allows fungus to get inside and grow.

Since fungus thrives in dark, warm places, your toenails are more likely to be affected than your fingernails. Your toes also have less blood flow than your fingers, which makes it harder for your body to pick up on and prevent an infection.

You’re more likely to get a fungal nail infection if you:

• Are a man
• Are older, since nails become more brittle and likely to crack as you age 
• Have a weak immune system or ongoing health problems like diabetes
• Wear shoes that make your feet hot and sweaty
• Walk barefoot through gym showers, swimming pools, and locker rooms –places where fungus spreads easily 
• Live with someone who has a fungal infection
• Have athlete’s foot, as the fungus that causes it can spread to your nails 
• Recently had an injury or surgery on your nail, or had a previous infection
• Wear plastic gloves or keep your hands wet for long periods 

See your doctor if you think you have nail fungus. You may need a prescription to treat it, whether that means taking a medicine by mouth or using a special cream. In serious cases, your nail may need to be removed so a healthy new one can grow in its place. Doctors can also use lasers to treat nail fungus.

See your doctor if you think you have nail fungus. It can be tough to get rid of, and you’re more likely to have success with a prescription. Treatments include:

• Oral antifungals. The doctor may give you a pill to kill fungus in your whole body. This is usually the best way to get rid of a nail infection. Treatment may last 2 months for an infection in your fingernails, or 3 months if it’s in your toenails. 
• Topical antifungals. You rub or brush these medicines onto your nails. They may work for a mild infection, but they can’t get deep enough into the nail to cure a more serious one. You might use a topical treatment in combination with a pill.  
• Surgery. If other treatments don’t work, the doctor may need to remove your nail entirely and let a healthy one grow back in its place. The new nail could also get infected.
• Laser or photodynamic therapy. Doctors are studying newer treatments that use special light to try to kill the fungus.

To prevent an infection, wash your hands and feet often. Use soap, and make sure you get between your fingers and toes. Also:

• Keep your fingernails and toenails short and trimmed straight across.
• Wear socks that wick away (absorb) moisture. If your feet sweat a lot, change your socks once or twice a day, or take off your shoes and let your feet cool when you have the chance.
• Use antifungal powder or spray on your feet as well as in your shoes. Throw away old pairs of closed-toe shoes since fungi might be living in them.
• If you get manicures at nail salons, visit only the ones that disinfect tools after each client. You can also bring your own file and clippers from home. Ask that your cuticles not be cut, since this can cause tiny breaks in the skin that let germs in.
• Don’t share towels if someone else in your family has nail fungus. This will pass around the infection.

It can take a year or more for your nails to look like they did before the infection. And you may continue to have problems: 

• The fungus can come back.
• Your nails may be permanently discolored or misshapen.
• The infection may spread to other parts of your body.

It’s especially important to take care of a fungal nail infection if you have diabetes. You’re at greater risk of getting a serious skin infection. 

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Onychomycosis (nail fungus) – causes, symptoms, diagnosis, treatment and prevention

The incidence of fungus in recent years has the character of an epidemic. Every 5 inhabitant of the planet is infected with a fungus. After 60 years, every second. Once having had a fungus, a person remains at risk for life.

Nail fungus symptoms

As soon as the spores penetrate the nail plate, the active stage of the disease begins, the nails begin to change and the infection becomes obvious to the patient.

There are three main signs of damage to the nail plate:

• color change,
• appearance of uncharacteristic stripes and spots,
• thickening, deformation,
• partial or complete separation from the nail bed.

Nail fungus is often preceded by a fungal infection of the skin of the feet, which manifests itself in dryness, cracked heels and interdigital folds, smell, and is often perceived as a cosmetic defect. The usual pedicure using nourishing creams and oils in this case does not lead to an improvement in the condition of the skin and nails. It brings only a temporary effect, and soon causes a return of the problem and worsening of symptoms, as it feeds the parasite.

Azarova Evgenia Sergeevna

Podiatrist (podiatrist), mycologist

Treatment of foot fungus takes about 1 month with proper therapy.
The defeat of the nails in a neglected form takes several months.
Therefore, in all cases of initial changes in the skin of the feet or nails, the appearance of the nail: the disappearance of shine, discoloration, thickening – you should immediately contact a podiatrist!

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Azarova E.S., podiatrist (podiatrist), mycologist, dermatocosmetologist, orthopedic traumatologist.

Which doctor should I contact with a disease of the nails and feet? All about podology.

Diagnosis and treatment of nail fungus in the center of podology ON CLINIC

Treatment of fungal infections of the nails is a complex and lengthy process that requires an integrated approach. Fungal diseases can be defeated if the pathogen is correctly identified and effective therapy is started. The fungus is often combined with an infectious lesion of the skin and nails by bacteria. A preliminary diagnostic method is a study in the rays of a Wood’s lamp. Laboratory methods for diagnosing infections of the nails and skin of the feet include scraping, sowing of nail and skin scales for parasitic fungi, CMS.

In the arsenal of a podologist doctor: antifungal drugs, nail plate growth stimulants, ointments, laser treatment, photodynamic disinfection “RAST therapy”.

Regular instrumental and hardware treatment of the nail plate helps to reduce the time and enhance the effectiveness of the treatment of onychomycosis, as a result of which the affected part of the nail is painlessly removed – a medical hardware pedicure.

Azarova Evgenia Sergeevna

Podiatrist (podiatrist), mycologist

No need to self-medicate. Only a doctor can prescribe the necessary diagnostics and draw up an individual treatment plan for the fungus, as well as an action plan to prevent re-infection.

Remember that the fungus is a contagious, infectious disease that, if ignored, can become a family ailment!!!

Take care of the health and beauty of your feet and the feet of your loved ones!

causes, diagnosis and treatment of nail detachment in Moscow

Onycholysis, having appeared once, can progress over time. Rarely is an independent disease of the nail apparatus, more often it is a symptom of various diseases of the body.

The initial stage of the disease is partial (marginal) onycholysis. This is peeling off only part of the nail. The progressive stage is total onycholysis. In this case, the entire nail plate is affected.

Onycholysis can affect one or more fingers.

Prolonged lack of treatment can lead to a serious infection of the nail.

Symptoms

At first, the nail plate can move away from the nail bed only in the lateral sections and from the side of the free edge. Due to the discharge, a cavity is formed and the color of the nail changes to whitish-gray. In the future, subungual hyperkeratosis is formed, and if a fungus or bacterial flora enters the subungual cavity, then an unpleasant, putrefactive odor and discoloration will be added to the main symptoms. With an infectious or bacterial nature of the disease, the nail may darken, turn yellow, turn green.

Causes

In podology, it is customary to distinguish several types of onycholysis, which are directly related to the causes of the disease:

• Bacterial – the cause of the development of the pathological process is associated with the addition of a secondary infection.
• Fungal – develops as a result of the settlement of colonies of fungi. Mycotic infection does not always destroy the structure of the nail, while the bed is affected, a focus of secondary onycholysis is formed.
• Traumatic – the cause of the pathology lies in chemical, thermal or physical effects, prolonged wearing of tight and uncomfortable shoes, orthopedic pathology.
• Systemic – develops against the background of current chronic pathologies of the gastrointestinal tract, endocrine disorders, dermatological lesions.
• Allergic – provoked by detachment of the nail by certain drugs, against which photosensitizing reactions develop. Also, the development of onycholysis is sometimes observed with prolonged contact with household chemicals, aggressive substances, as well as exposure to ultraviolet radiation. Nails are particularly sensitive to chemical attack, so sometimes a destructive condition is observed when using low-quality varnishes and coatings such as Shellak.
• Dermatological – the nail bed can be deformed as a result of prolonged dermatoses, which cause the development of an inflammatory focus.

Most often, onycholysis on the toes appears due to foot injuries, mycosis and allergies. If there was a blow, then in this case both the nail and the bed suffer at the same time. There is a subungual hematoma. The nail is deformed, the vessels are compressed, which disrupts the nutrition of the plate, weakens the connection between it and the bed, peeling begins.

With an allergic reaction, the regeneration process slows down, hypersensitization of the skin is observed, which ultimately exacerbates the developing process of deformation. Symptoms of an allergic nature are similar to manifestations of inflammation. Therefore, it is necessary to contact the ON CLINIC podiatrist to clarify the diagnosis and assess the degree of deformity.

Azarova E.S., podiatrist (podiatrist), mycologist, dermatocosmetologist, orthopedic traumatologist.

Which doctor should I contact with a disease of the nails and feet? All about podology.

Diagnostics

A podologist reveals the clinical manifestations of onycholysis during visual diagnostics. But a simple inspection is not always enough. It is necessary to differentiate the disease from other pathologies of the feet, in particular, with a fungus, lichen planus, psoriasis, etc.

Diagnostics in ON CLINIC:

• Microelement composition of nail plates
• Examination of small vessels of the nail bed (pulse oximetry, onychoscopy, capillaroscopy)
• Scraping and inoculation for fungus
• Osipov XMS plates
• UAC
• OAM
• TANK
• X-ray of the nail phalanges of the toes

You will receive individual recommendations and appointments after a personal consultation.

Treatment of onycholysis

The choice of treatment method depends on the cause of development. It should be borne in mind that in one day or even one week this disease cannot be cured. An integrated approach is needed – and only if the patient strictly observes all the recommendations of the podiatrist, you can count on a complete cure. Otherwise, secondary onycholysis may develop.

Basic treatments

Medical manicure or pedicure

It is necessary to remove the affected part of the nail, prescribe local and systemic treatment aimed at combating the cause of onycholysis, restoring the nail plate. In the future, to ensure the prevention of ingrowth and re-onycholysis.

If an infection is suspected, it is necessary! conduct a study of the nail plate for parasitic fungi and bacteria. And also to conduct a basic laboratory study of blood and urine.

If the disease has a laboratory-confirmed mycotic or bacterial nature, the affected nails, hosiery and shoes should be regularly treated with special disinfectants, antibacterial and antimycotic drugs.

Vitamin therapy

If the reason lies in a change in the chemical composition of the plate, in this case, the lack of vitamins and trace elements should be eliminated first. In some cases, joint treatment is carried out with doctors of related specialties.

With onycholysis, it is recommended to exclude prolonged contact with water. Foot baths, compresses and other folk procedures should be carried out only as prescribed by a doctor. It is better to stop using varnishes for a while. If aesthetics is important to you, ON CLINIC offers vegan polishes. They are safe, non-toxic, free of animal fats. These coatings provide aesthetics and protection of the nail from external influences, as well as restoration of nails.

ON CLINIC successfully treats onycholysis, reveals and treats diseases that lead to it. If you notice external deformation, detachment or external change in toenails, immediately contact a podiatrist.

Azarova Evgenia Sergeevna
Podiatrist (podiatrist), mycologist, dermatocosmetologist, traumatologist-orthopedist

Onycholysis can develop at any age, and more often women come to see me.