Fungal Nail Infections
What is a fungal nail infection?
Our bodies are host to a number of micro-organisms including fungi. While fungi are naturally present in and on our body, an overgrowth can cause a fungal infection. These infections can occur anywhere on the body, including our fingernails and toenails — which are known as fungal nail infections.
Fungal nail infections are also known as onychomycosis or tinea unguium and affect between 2% and 8% of the general population1. Incidence increases with age with up to 50% of people over the age of 70 experiencing these infections.
What causes nail infections?
Fungal nail infections are caused by an overgrowth of fungi which can occur in, under, or on the nail. The most common type of fungi that causes nail infections are called dermatophytes. However, yeast and moulds can also cause infections.
If you have broken or injured nails, fungus can enter these cracks and set off an infection. Fungal nail infections may also be spread from another skin infection, such as athlete’s foot (tinea).
Fungus thrives in a warm, moist environment which means you can pick up a fungal nail infection by walking barefoot in areas such as public changing rooms, pools and showers, or by sharing shoes. Shoes are an ideal environment for fungus to thrive in because they provide a warm and moist environment that is needed for fungal growth, which is why toenail infections are more common than those that affect the fingernails.
Signs and symptoms of fungal nail infections
Signs you may have a fungal nail infection include4:
white or yellow streaks or spots under the tip of your nail
thickened or rough nails
nail edges that are crumbling, ragged or brittle
discoloured nails (white, yellow or brown)
a nail that has separated from the nail bed
pain and tenderness around the nail
a nail that smells bad
Anyone can get a fungal nail infection but some factors increase your risk, including5 6:
age — risk increases with age as poorer circulation leads to more brittle nails
gender — infections occur more often in men than women
having diabetes
having poor circulation
problems with your immune system
having a history of athlete’s foot
walking barefoot in communal areas such as showers, change rooms and pools
having a minor skin or nail injury
having moist fingers or toes for an extended time (e.g. athletes, kitchen hands or cleaners)
wearing artificial nails
wearing closed-in shoes with poor ventilation such as boots, closed-toe shoes and sports shoes
visiting nail salons that have poor hygiene or sanitation practices
How are fungal nail infections diagnosed?
To treat a nail infection, it’s important to diagnose it correctly. Diagnosis is usually done by taking a scraping or clipping of the infected nail and sending it off to a laboratory for testing. This will indicate what type of fungus is causing the infection, which will help your doctor determine the best course of treatment.
Fungal nail infection treatment
Fungal nail infections can be hard to treat and it may take more than a year for your nail to appear normal. This is because it takes time for your infected nail to grow out. Infections can also recur even after successful treatment. Fingernails are usually treated more quickly and effectively than toenails as fingernails grow faster than toenails. Depending upon the cause and severity of the infection, treatment may include:
topical antifungal treatment (lacquers or creams)
topical acidic treatments
oral antifungal medications
removal of the nail to allow a new nail to grow in its place
You should also practice good foot hygiene while treating your infection, including airing shoes regularly, disinfecting the base of your shower, and keeping all floor surfaces clean. Avoid wearing nail polish, false nails or other cosmetic products on treated nails, and avoid sharing shoes
What are complications of a fungal nail infection?
Left untreated, fungal nail infections can become inflamed, painful and may begin to give off a foul smell. There is also the possibility of permanent damage to your nails or other serious infections that can spread beyond your feet. People with reduced blood circulation, including those with diabetes are at greater risk of complications.
When to see a doctor
If you suspect you have a fungal nail infection, you should see your doctor, rather than self-diagnosing and treating it yourself. Diagnosing the exact cause of your infection will determine the right treatment, which will mean the infection will clear up quicker, and there will be less risk of complications.
How to prevent fungal infections
Fortunately, there are several things you can do to prevent fungal nail infections, most of which relies on practising good foot hygiene. You should:
wash your feet frequently
ensure you don’t wear wet or sweaty socks and change socks every day
avoid walking barefoot in public changing rooms, showers and pools
avoid sharing footwear with other people
dry your feet thoroughly after showering or swimming
keep toenails trimmed with no sharp edges
wear open-toed shoes or shoes that breathe
never share nail clippers or nail files
wear waterproof gloves when doing tasks like cleaning or washing up
How MediADVICE can help
Your local MediADVICE pharmacist is available to help you manage your health and we can recommend a range of products to assist with the symptoms and treatment of fungal nail infections. Speak to your MediADVICE pharmacist about your symptoms so we can recommend products and medications that may be suitable for you.
Visit your nearest MediADVICE today.