Sophia Delgado
Fingernail fungus, or mycotic nail, is a common fungal infection that can affect anyone. It occurs when a fungus attacks a fingernail or the skin underneath the nail, known as the nail bed. Symptoms include discoloured nails that appear white, yellow, green, brown, or black, thickened nails that are hard to trim, and nails that have become brittle, fragile, or misshapen. In some cases, the nail may emit a foul odour or start to separate from the nail bed. If you suspect you have a fingernail fungus, it is recommended to see a doctor or healthcare provider for a proper diagnosis and treatment.
| Characteristics | Values |
|---|---|
| Colour | White, yellow, green, or black |
| Texture | Thick, brittle, crumbly |
| Shape | Distorted, curled up or down, loose from the nail bed |
| Pain | Pain or discomfort, swollen and inflamed skin around the nail |
| Odour | Foul odour |
| Cause | Fungi entering through cracks in the nail or skin around it; warm and damp conditions; walking barefoot in places where fungus spreads easily |
| Treatment | Oral antifungals, topical antifungals, surgery, laser treatment |
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Nail discolouration
Fungal nail infections are caused by fungi that enter the skin through small cuts or separations between the nail and the nail bed. These fungi thrive in dark, warm, and moist environments, which is why toenails are more frequently affected than fingernails. However, it is important to note that fungal nail infections can occur in both toenails and fingernails.
The medical term for a fungal nail infection is onychomycosis. There are four main types of onychomycosis, each with slightly different characteristics. Distal or lateral subungual onychomycosis is the most common type, affecting both fingernails and toenails. It starts in the nail bed, and you will notice a yellowish area spreading from the edges of the nail to the centre and places where it comes apart from the nail bed. White superficial onychomycosis is less common and only affects the nail surface, usually on the toenails.
Another type of fungal nail infection is caused by yeast and is known as candidal onychomycosis. This type of infection usually affects the fingernails and is often the result of an injury or another infection. The area around the nails may become swollen and inflamed, and the nails may even come off entirely.
If you suspect you have a fungal nail infection, it is important to see a doctor or a pharmacist for advice. They may recommend antifungal medications, which can be taken orally or applied directly to the nail. In some cases, laser treatment may be an option, but it is not yet widely available as a routine treatment.
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Nail thickening
Fungal nail infections cause the nail to become thickened, distorted, and discoloured, often turning the nail thick, yellow, and brittle. The infection can make the nail difficult to trim and may cause pain or discomfort, especially when placing pressure on the affected finger or toe. In some cases, the nail may become so thick that it causes discomfort when wearing shoes.
If you notice that your nails are thickening, it is important to seek medical advice. A doctor can examine your nails and diagnose the condition. They may refer you to a dermatologist, a specialist in skin, hair, and nail conditions, who may use a dermatoscope (a handheld instrument) to examine your nails more closely. To confirm the presence of a fungal infection, the doctor or dermatologist may take a small nail clipping or swab from underneath the nail for testing.
Treating nail thickening caused by a fungal infection typically involves the use of antifungal medications. These can come in the form of tablets or a special nail paint applied directly to the nail. The two most commonly prescribed antifungal medications are terbinafine and itraconazole, which are usually taken once or twice daily for several months to ensure the infection clears completely. It is important to continue taking the medication as directed, as stopping too early may allow the infection to return. In severe or stubborn cases, laser treatment may be an option, although this is typically not covered by insurance and can be expensive.
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Nail separation
Fingernail fungus, or onychomycosis, is characterised by discolouration, thickening, and distortion of the nail. However, nail fungus may not always present obvious symptoms. One way to identify a fungal infection is through nail separation, or onycholysis, which occurs when the nail is separated from the nail bed. Onycholysis is easy to spot—you will notice your nail lifting or peeling away from the nail bed underneath. The detached nail is usually white and opaque, with a sharply defined border between the pink portion of the nail bed and the white edge of the lifted nail.
Onycholysis can be caused by trauma to the nail, such as artificial tips applied to the nail, or an allergic reaction. It can also be caused by a fungal or yeast infection, which can be treated by applying a mixture of tea tree oil diluted with a carrier oil, such as jojoba or coconut oil, to the affected area. It is important to keep the nail dry while it heals. Other ways to treat onycholysis include using a hairdryer on low heat once or twice a day to prevent bacteria from growing, and avoiding things like bandages, gloves, or creams on the affected area, as they can create a moist environment that promotes bacterial growth.
If you have onycholysis, it is important to determine the underlying cause to resolve the issue. While the nail won't reattach to the nail bed, a new nail will grow to replace the old one, resolving the symptoms. Fingernails take 4 to 6 months to fully regrow, while toenails can take 8 to 12 months. In the meantime, it is recommended to keep your nails short and trimmed to avoid activities that might harm them.
If you suspect a fungal nail infection, you can opt for antifungal medication, which comes in the form of tablets or special nail paint. The two most commonly prescribed antifungal medications are terbinafine and itraconazole, which need to be taken for several months to ensure the infection clears up completely. Antifungal nail paint is generally considered less effective than tablets but doesn't usually cause any side effects.
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Nail brittleness
Fingernail fungus, or onychomycosis, is an infection that occurs when fungi enter the nail or the skin underneath it through a crack in the nail or the skin surrounding it. Toenails are more frequently affected than fingernails because fungi thrive in dark, warm, and moist environments, and the toes have less blood flow than the fingers, making it harder for the body to detect and prevent an infection.
Fungal nail infections usually start mildly and get more serious over time. At first, you may only see a white or yellow spot under your nail, which can spread and turn the entire nail white, yellow, green, or black. The nail may start to curl up or down or loosen from the nail bed. In some cases, the infection may cause a bad smell or make it difficult to walk.
If you suspect you have a fungal nail infection, it is important to see a doctor or a healthcare professional for a proper diagnosis and treatment. Mild cases of fungal nail infection may not require treatment, but more severe or troublesome infections may be treated with antifungal medication, such as oral antifungal tablets or topical antifungal nail paint. Laser treatment is also an option for particularly stubborn infections, although it is not yet a routine treatment due to the lack of sufficient evidence.
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Treatment options
Fingernail fungus is unlikely to clear up without treatment. However, treatment for mild cases may be unnecessary as they are also unlikely to cause further problems. For more severe infections, antifungal medication is usually recommended. This medication comes in two forms: tablets or a special paint that is applied directly to the nail. The two most commonly prescribed antifungal medicines are terbinafine and itraconazole, which are taken once or twice a day for several months. Antifungal tablets are not without their drawbacks, as they have many listed side effects, contraindications, and require long-term use.
If you prefer not to take antifungal tablets, your doctor or pharmacist may suggest trying antifungal nail paint instead. While nail paint is not generally considered as effective as tablets because it can be difficult for it to reach the deeper layers of the nail, it rarely causes side effects. To completely get rid of the infection, most people also need one or more additional treatments. Before treatment starts, a small sample of the infected nail may need to be taken and sent off for testing to confirm that you have a fungal infection.
A procedure to remove the affected nails may be recommended if the infection is severe or painful and other treatments haven't helped. Treatment kits are available from pharmacies that contain a 40% urea paste, plasters, and a scraping device. The paste softens the infected parts of the nail, allowing them to be scraped away so they can be gradually replaced with a healthy nail. Once no more infected parts of the nail can be removed, ask your pharmacist for antifungal nail paint to prevent re-infection as the nail regrows over the next few months.
Laser treatment is another option for particularly stubborn fungal nail infections. The laser emits high doses of light energy, which are used to destroy the fungus. While early research suggests that the treatment may be helpful, there is not enough evidence to recommend it as a routine treatment. It may also need to be repeated several times for up to a year, so it could get very expensive.
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Frequently asked questions
You may have a fungal nail infection if you notice any of the following symptoms: discolouration (white, yellow, green, or black spots), thickening, distortion, brittleness, crumbling, foul odour, or pain.
If you think you have a fungal nail infection, you should seek medical attention. Your doctor may prescribe antifungal medication, which comes in the form of tablets or a special paint that you apply directly to the nail.
To prevent a fungal nail infection, it is important to maintain good nail hygiene. Keep your nails trimmed, clean, and dry. Avoid walking barefoot in damp communal areas, such as gym showers, swimming pools, and locker rooms, as these are places where fungi can spread easily.
There are four main types of fungal nail infections: distal or lateral subungual onychomycosis, white superficial onychomycosis, proximal subungual onychomycosis, and candidal onychomycosis. Each type presents differently and has its own unique cause.
The treatment for a fungal nail infection depends on the severity of the infection. Mild infections may be treated with topical antifungal medications, while more severe infections may require oral antifungal medication or laser therapy. In some cases, surgery may be necessary to remove the infected nail.
