Fungal nail infections, also known as “onychomycosis,” are incredibly common, affecting up to 14% of the general population. Interestingly, these infections tend to appear more frequently in toenails than in fingernails[^1^].
Symptoms
Most fungal nail infections are not serious, but they can cause discomfort and concern due to the appearance of the nails. Infected nails may become discolored, thick, fragile, or cracked. In some cases, the nail may even separate from the nail bed. It’s worth noting that individuals with fungal toenail infections often have a concurrent fungal skin infection on their feet, typically found between the toes, which is commonly known as athlete’s foot, ringworm on the foot, or tinea pedis.
How does someone get a fungal nail infection?
Fungal nail infections are caused by various types of fungi present in our environment. These microscopic organisms can enter the nail and cause an infection through small cracks in the nail or the surrounding skin.
Who gets fungal nail infections?
Fungal nail infections can affect anyone. However, certain individuals may be more susceptible to developing these infections. Older adults and people with specific conditions such as nail injuries or foot deformities, trauma, diabetes, weakened immune systems (e.g., due to cancer), venous insufficiency, peripheral arterial disease, or fungal skin infections on other parts of the body may have a higher risk of fungal nail infections[^2^][^3^]. It’s important to note that individuals with diabetes or weakened immune systems are particularly vulnerable to bacterial infections that may occur on top of fungal nail infections, potentially leading to severe illness.
Prevention
To reduce the risk of fungal nail infections, practicing good hygiene is crucial. Keep your hands and feet clean and dry, and ensure that your nails are kept short and clean. Avoid walking barefoot in areas like locker rooms or public showers, and refrain from sharing nail clippers with others. When visiting a nail salon, choose a clean and licensed establishment that sterilizes their instruments after each use. Alternatively, you can bring your own instruments for added peace of mind.
Diagnosis
Although fungal infections are a common cause of nail problems, it’s important to consider other potential conditions that may have similar symptoms. To confirm a fungal nail infection, healthcare providers generally perform laboratory testing, such as examining a nail clipping under a microscope or sending it to a laboratory for further analysis.
Treatment
Treating fungal nail infections can be challenging, and early intervention is key to successful treatment. These infections typically do not resolve on their own, and the most effective treatment usually involves prescription antifungal pills taken orally. In severe cases, a healthcare professional may even opt to remove the nail completely. It’s important to understand that it may take several months to a year for the infection to fully clear.
It’s worth noting that fungal nail infections can be closely associated with fungal skin infections. Failure to treat a fungal infection can result in its spread from one area to another. Therefore, it’s crucial for patients to discuss any skin concerns with their healthcare provider to ensure that all fungal infections are properly addressed.
Even after treatment, fungal nail infections can sometimes recur, especially in individuals with conditions like diabetes that make them more susceptible. If you suspect that an infection has returned, it is important to contact your healthcare provider promptly.
Information for healthcare professionals
For healthcare professionals, it is vital to confirm the diagnosis of a fungal nail infection through laboratory testing before initiating antifungal treatment. Collecting a nail clipping for microscopic examination or laboratory testing can help validate the diagnosis and inform appropriate treatment decisions.
