Ava Monroe
Toenail fungus is more common than fingernail fungus, partly because toes have less blood flow than fingers, making it harder for the body to detect and prevent infection. Fungi thrive in dark, warm, and moist environments, so toenails provide the perfect conditions. Fungal nail infections are caused by microorganisms that invade the nail through small cracks in the nail or the skin surrounding it. The medical name for a fungal nail infection is onychomycosis, and it is often caused by the same fungi that cause athlete's foot, jock itch, and ringworm.
| Characteristics | Values |
|---|---|
| Formal name | Onychomycosis, Tinea Unguium |
| Appearance | Yellow, white streaks, jagged, thickened, distorted, brittle |
| Cause | Fungi, Candida Yeast, Dermatophytes, Molds |
| Risk Factors | Age, diabetes, athlete's foot, psoriasis, immunodeficiency, frequent moisture, warm and moist environments, sharing nail clippers or towels |
| Treatment | Antifungal drugs, laser treatment, nail removal, antifungal nail paint |
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What You'll Learn
- Onychomycosis, also known as tinea unguium, is a fungal infection that affects either the fingernails or toenails
- Distal subungual infections are the most common type of fungal nail infection
- Proximal subungual infections are uncommon but can affect both fingernails and toenails
- Candida yeasts cause this type of infection and can invade nails previously damaged by a prior infection or injury
- Treatment for nail fungus includes medication, creams, and laser treatment
Onychomycosis, also known as tinea unguium, is a fungal infection that affects either the fingernails or toenails
There are several types of onychomycosis, including distal subungual onychomycosis, which is the most common form. It can develop in both fingernails and toenails and is caused by a fungus called a dermatophyte. The infection starts in the nail bed, and you may notice yellowish discolouration spreading from the edges of the nail to the centre, along with places where the nail comes apart from the nail bed. Proximal subungual onychomycosis is another form, although it is less common and usually affects people with compromised immune systems. It first appears as white spots in the centre of the nail bed at the cuticle, moving outward as the nail grows.
The symptoms of onychomycosis may include white, yellow, black, or green nail discolouration, thickening of the nail, and separation of the nail from the nail bed. The nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. There may also be white or yellow patches on the nail bed, scaly skin next to the nail, and a foul smell. In rare cases, toenail fungus can lead to a serious infection called cellulitis.
Onychomycosis is typically diagnosed by evaluating the appearance of the affected nail. To confirm the presence of a fungal infection, a healthcare provider may take a small sample from underneath the nail for microscopic analysis or send it to a lab for culture and further identification of the fungus type. Treatment options include oral or topical antifungal medications, laser therapy, or, in severe cases, removal of the affected nail to allow a healthy new one to grow.
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Distal subungual infections are the most common type of fungal nail infection
Fungal nail infections are caused by fungi that enter through small cracks in the nail or the skin surrounding it. These fungi are typically present in the environment and on the body, alongside various bacteria. However, when they start to overgrow, they can lead to infections. Onychomycosis, also known as tinea unguium, is a fungal infection that affects either the fingernails or toenails.
Distal subungual infections are the most prevalent type of fungal nail infection, affecting both fingernails and toenails. This type of infection is caused by a fungus called a dermatophyte, which invades the nail bed and the underside of the nail. Initially, the outer edge of the nail takes on a jagged appearance, with white and/or yellow streaks extending across it. As the infection progresses, these streaks spread from the edges of the nail towards the centre, and the nail begins to separate from the nail bed. The affected nail may also exhibit places where it comes apart from the nail bed.
The symptoms of distal subungual infections can be quite noticeable. The nail may thicken and become challenging to trim. It might start to curl up or down, and there could be noticeable lifting or separation from the nail bed. In some cases, the nail may become brittle and crumble upon touch. Additionally, the nail may become misshapen, and there could be a noticeable discolouration.
It is important to address distal subungual infections, as they can cause significant pain and impact one's mobility and daily activities. Moreover, they can lead to social stigma. To confirm the presence of a fungal infection, a doctor will take a scraping of the nail and examine it under a microscope for signs of fungus. In some cases, a laboratory analysis of the sample may be required for confirmation.
It is worth noting that fungal nail infections can be challenging to treat, and over-the-counter products are generally not recommended due to their unreliable results. Instead, a doctor may prescribe oral antifungal medications or suggest other treatments such as antifungal nail lacquer or topical solutions.
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Proximal subungual infections are uncommon but can affect both fingernails and toenails
Onychomycosis, or tinea unguium, is a fungal infection that affects either the fingernails or toenails. It is caused by an overgrowth of fungi in, under, or on the nail. Fungi thrive in warm, moist environments, so this type of environment can cause them to naturally overpopulate. Proximal subungual onychomycosis is a rare form of onychomycosis, but it can affect both finger and toenails. It is caused by an infection that enters the nail unit through the proximal nail fold and migrates distally. This type of infection is usually caused by T. rubrum, a type of dermatophyte, and appears as a white spot under the lunula that progresses outward as the nail grows. It can also be referred to as proximal white subungual onychomycosis (PWSO) and is often seen in patients with AIDS or those who are immunocompromised.
The clinical presentation of proximal subungual onychomycosis includes subungual hyperkeratosis, proximal onycholysis, leukonychia, and destruction of the proximal nail plate. It is characterised by an invasion of the undersurface of the nail plate, beginning at the stratum corneum of the proximal nail fold and progressing to the matrix. This infection can commonly occur in people with compromised immune systems, including those with HIV infection. In fact, in one study of 61 individuals with onychomycosis who were also infected with HIV, 54 (87.1%) had PWSO.
The most common type of onychomycosis is distal subungual onychomycosis, which can affect both finger and toenails. It is caused by an infection that begins in the nail bed and underside of the nail plate, starting at the hyponychium and migrating proximally through the underlying nail matrix. This type of onychomycosis is usually caused by T. rubrum, although T. mentagrophytes, T. tonsurans, and E. floccosum are also known to cause it. Distal subungual onychomycosis is characterised by mild inflammation, resulting in focal parakeratosis and subungual hyperkeratosis, with two consequences: onycholysis (detachment of the nail plate from the nail bed) and thickening of the subungual region.
Fungal nail infections can be treated with oral medication or topical creams. In serious cases, the nail may need to be removed so that a healthy new one can grow in its place. Doctors can also use lasers to treat nail fungus. It is important to see a doctor if you think you have a nail fungus, as over-the-counter products are not usually recommended for treatment since they do not provide reliable results.
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Candida yeasts cause this type of infection and can invade nails previously damaged by a prior infection or injury
Candida is a type of yeast that is present in every human body. While it normally exists on and in the body, certain factors can cause it to multiply out of control and lead to an infection. Candida yeasts can cause nail infections, also known as onychomycosis, which affect either the fingernails or toenails. Candida nail infections generally result from paronychia and start near the nail fold (the cuticle). The cuticle becomes swollen, red, and tender, and the nail may partially lift off the nail bed or even fall off completely. Candida thrives in a warm, humid environment, and a reduced immune response or other conditions can allow an infection to develop.
Candida nail infections can invade nails that were previously damaged by a prior infection or injury. This type of infection more commonly affects the fingernails of individuals who frequently soak their hands in water. The infection usually starts by the cuticle, which is the skin around the nail. Since fungus thrives in dark, warm places, toenails are more likely to be affected than fingernails. Toenails also have less blood flow than fingernails, making it harder for the body to detect and prevent an infection.
Fungal nail infections can cause discoloration and weakening of the nails. Without treatment, the affected nails can become thicker and more discolored, and the infection may progress to cause pain when wearing shoes. Fungal nail infections are often regarded as a trivial cosmetic problem, but they can significantly impact one's quality of life, causing pain, affecting mobility and activities, and leading to social stigma. Treatment is often essential to prevent the infection from spreading to other parts of the body and other people.
The first step in treating a Candida nail infection is to identify and address any underlying medical causes. Treatment may involve topical or oral antifungal medications, and it is recommended to see a doctor for a prescription. Good general health and hygiene can help prevent fungal infections. Keeping the skin clean and dry, practicing proper nail care, and avoiding sharing tools used for manicures and pedicures can also help prevent infections.
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Treatment for nail fungus includes medication, creams, and laser treatment
Onychomycosis, more commonly known as nail fungus, is a common condition that can affect toe and fingernails. It occurs when fungi infect one or more of your nails, leading to discoloration, thickening, and even separation of the nail from the nail bed. Treatment for nail fungus aims to eliminate the fungus and improve the appearance and health of the affected nails. The good news is that there are several effective treatment options available, including medication, topical creams, and laser therapy. Here's an overview of each treatment type:
Medications: Antifungal medications are typically the first line of treatment for nail fungus. These medications work by inhibiting the growth and spread of fungi. Oral antifungals are usually prescribed for nail fungus, as topical medications may not penetrate the nail plate effectively. Common oral antifungals include terbinafine (Lamisil) and itraconazole (Sporanox). These medications help new, healthy nail growth free of fungus. It is important to take the medication as directed and complete the full course of treatment, which typically lasts for several weeks. Antifungal medications may cause side effects, such as nausea, diarrhea, and liver problems, so regular monitoring by your healthcare provider is essential.
Topical Creams: Topical antifungal creams, gels, or nail polishes can also be used to treat nail fungus. These treatments are applied directly to the affected nails and the surrounding skin. While topical treatments may not be as effective as oral medications for more severe infections, they can be useful for mild to moderate cases. Examples of topical antifungals include ciclopirox (Penlac) and efinaconazole (Jublia). These medications need to be applied daily for several months to see improvement. Topical creams are generally well-tolerated but may cause local skin irritation or allergic reactions in some individuals.
Laser Treatment: Laser therapy has emerged as a promising treatment option for nail fungus. This non-invasive procedure uses targeted laser energy to heat and destroy the fungi responsible for the infection. Several types of lasers can be used, including Nd:YAG, fractional erbium, and picosecond lasers. During the procedure, the laser light passes through the nail to reach the underlying fungus without damaging the surrounding tissue. Multiple treatment sessions are typically required, spaced several weeks apart, to ensure the fungus is eliminated. Laser treatment is generally safe and well-tolerated, with minimal side effects, and offers a promising alternative for those who may not respond to or tolerate oral or topical medications.
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Frequently asked questions
A fungal nail infection, medically known as onychomycosis or tinea unguium, is an infection caused by fungi that live in the environment. These fungi enter through small cracks in the nail or the skin surrounding it.
Symptoms include discolouration, thickening, and distortion of the nail. Nails may become yellow, brittle, or crumbly, and pieces may break off. In some cases, the nail may become painful or tender to the touch.
Fungi thrive in warm, moist environments, such as pool decks, locker rooms, and sweaty shoes and socks. Walking barefoot in these areas or having frequent skin-to-skin contact with someone who has a fungal infection can increase the risk of contracting a fungal nail infection.
Antifungal treatments are considered effective in treating fungal nail infections. Oral medications such as terbinafine and itraconazole are commonly prescribed. Topical treatments, such as antifungal nail paint, are also available but may be less effective in reaching deeper layers of the nail. In severe cases, nail removal or laser treatment may be recommended.
