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

You asked, we answered: Can toenail fungus spread to other parts of your body?

Question:

If you have toenail fungus, how likely is it to be in your stomach and other parts of your body?

Answer by dermatologist Corey Georgesen, MD:

Toenail fungus is a nail infection usually caused by unique fungi called dermatophytes. These fungi may be found on the skin of humans, animals or in soil. Dermophytes can also cause ringworm and fungal scalp infections. 

Toenail fungus doesn’t usually spread to inside your body, like the stomach. The fungi require keratin, found in your hair, skin and nails. They survive best on the skin.

Is toenail fungus contagious?

Yes, toenail fungus is contagious. 

Typically toenail fungus spreads through: 

• Direct contact with the infected person 
• Common household objects, such as towels or clothing 
• Surfaces, especially damp floors
• Animals, most commonly dogs

Can toenail fungus kill you?

Other types of toenail fungus – caused by nondermatophyte molds or yeast – can spread throughout the body. They can cause death in those without an immune system. These infections are rare. If you’re immunocompromised, seek care quickly if you suspect a toenail fungus.

How to prevent toenail fungus

Prevent toenail fungus by avoiding fungi-friendly places:

1. Do not share towels, combs, clothing or anything else with an infected person.
2. Wear sandals when using public shower facilities and around swimming pools. 
3. Change wet socks after exercise, as fungi thrive in moist, dark environments.  

If you’re prone to skin fungal infections, consider using antifungal cream in your toe web spaces. This area is a natural hiding spot for fungi on the skin.

What toenail fungus cures work?

Toenail fungus can be difficult to treat. The typical treatment for toenail fungus is up to three months, which is why it’s important to start treatment early. Normally it takes six to nine months for a toenail to grow out. 

Treatments for toenail fungus include:

• Topical creams
• Nail lacquer
• Spray
• Oral medications

Which doctor treats toenail fungus?

Dermatologists are trained to diagnose and treat toenail fungus accurately. They can also do laboratory testing if needed. If you have thickening, yellowing or other changes in the toenails, see a certified dermatologist quickly.

You can call 800.922.0000 to make an appointment with a Nebraska Medicine dermatologist.

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Ringworm in humans

Ringworm is a fungal and highly contagious disease caused by fungi Microsporum, Trichophyton, etc. You can become infected with ringworm only through direct contact with the carrier of the fungus – pets, a person suffering from this disease, household appliances, toys. At the same time, in a person who has become infected from an animal, the process of treating ringworm takes much longer, and the disease itself proceeds in a more severe form. Most often, ringworm in humans affects the scalp and scalp. Much less often, the disease appears on the eyelashes, feet and nails. According to statistics, it is children who most often suffer from this disease and are carriers of the fungus.

– appearance of red spots on human skin. Spots, initially covered with a crust or scales, eventually become covered with tiny bubbles. In places where the spots are localized, there is severe itching;
– the appearance of rounded bald spots in the hair. The hair in these places is very thin and short;
– deterioration of hair health in general;
– thickening and delamination of the nail plate;
– with weak immunity, weakness, headache or fever may occur.

Due to the fact that each organism is individual and reacts to the fungus in completely different ways, there are several forms of ringworm in humans :

1. In the papular-squamous form, lichen appears on the chest or face;
2. In the abortive form, the symptoms of the disease are mild. On the skin, only pale foci of localization of the fungus can be observed, which do not have clear boundaries;
3. When the palms and feet are affected, dry plaques are observed, similar in appearance to ordinary corns;
4. The erythematous-edematous form most often occurs in children. Severe inflammation occurs at the site of the spots. Often this form of the disease is accompanied by allergies;
5. When the form is deep, subcutaneous nodes appear on the legs. As a rule, women get sick with this form of lichen;
6. Microsporic onychomycosis affects the nail plate. The nail is covered with dull spots, becomes brittle and collapses over time;
7. Suppurative-infiltrative form is considered the most severe form of the disease. It is characterized by swollen dense plaques, severe itching and purulent discharge.

To combat ringworm in a person, the doctor prescribes medication to the patient with external and internal antifungal drugs with the active ingredient Ketoconazole , Terbinafine , Clotrimazole , Mikoseptin . For deep lesions of the skin, hair or nails, apply Griseofulvin .

As a rule, with complex and correct treatment, the disease recedes after a few weeks. To prevent the occurrence of repeated plaques, it is recommended to complete the entire course of treatment to the end. Also, the patient is prescribed a special diet, including vegetables, meat, fruits, milk and sour-milk drinks.

The material is for informational purposes only. Medicinal products, biologically active supplements and other products are indicated as an example of their possible use and / or application, which in no way constitutes a recommendation for their use. Before using drugs, dietary supplements and medical equipment and other products, be sure to consult a specialist.

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