Fungal nail infections often start after a fungal infection on the feet. They occur more often in toenails than in fingernails. And they are most often seen in adults as they age.
You are at higher risk of getting a fungal nail infection if you:
Have minor skin or nail injuries
Have a deformed nail or nail disease
Have moist skin for a long time
Have immune system problems
Wear footwear that does not allow air to reach your feet
Symptoms include nail changes on one or more nails (usually toenails), such as:
Change in nail shape
Crumbling of the outside edges of the nail
Debris trapped under the nail
Loosening or lifting up of the nail
Loss of luster and shine on the nail surface
Thickening of the nail
White or yellow streaks on the side of the nail
Exams and Tests
Your health care provider will look at your nails to find out if you have a fungal infection.
The diagnosis can be confirmed by looking at scrapings from the nail under a microscope. This can help determine the type of fungus. Samples can also be sent to a lab for a culture. (Results may take up to 3 weeks.)
Over-the-counter creams and ointments usually do not help treat this condition.
Prescription antifungal medicines that you take by mouth may help clear the fungus.
You will need to take the medicine for about 2 to 3 months for toenails; a shorter time for fingernails.
Your health care provider will do lab tests to check for liver damage while you are taking these medicines.
Laser treatments may get rid of the fungus in the nails.
In some cases, you may need to have the nail removed.
The fungal nail infection is cured by the growth of new, non-infected nails. Nails grow slowly. Even if treatment is successful, it may take up to a year for a new clear nail to grow.
Fungal nail infections may be hard to treat. Medicines clear up fungus in about half of people who try them.
Even when treatment works the fungus may return.
When to Contact a Medical Professional
Call your health care provider if:
You have fungal nail infections that do not go away
Your fingers become painful, red, or drain pus
Good general health and hygiene help prevent fungal infections.
Do not share tools used for manicures and pedicures.
Keep your skin clean and dry.
Take proper care of your nails.
Wash and dry your hands thoroughly after touching any kind of fungal infection.
Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 267.
Richard J. Moskowitz, MD, dermatologist in private practice, Mineola, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.