Fungal nail

What is a fungal nail infection?

A fungal nail infection (known by its medical name of Onychomycosis) most commonly affects toenails,^[1] but it can also occur in fingernails too. It’s caused by a fungus that attacks the nail bed. The first sign is often a small white or yellow spot underneath the nail. From there it spreads into the nail itself and becomes more noticeable.

If you have a fungal nail infection, one of the other main symptoms you’ll notice is that your nails will thicken and become discoloured. They can turn black, green, yellow or white in tone. There may also be soreness or pain present around or on the site of infection.

Your nail may become ragged looking or feel crumbly and this can lead to easy tears and breakages. Infected nails can also appear jagged and become brittle.

A fungal nail infection needs prompt treatment. If it’s left untreated, the nail can become permanently damaged. In some cases it can also come away from the bed itself, so you lose the nail.

Who gets fungal nail infections?

Whilst fungal nail infections can affect anyone, no matter what their age or stage of life, they’re more common in people over the age of 55.

Certain health conditions can also make you more predisposed to getting them too. If you have diabetes, psoriasis or poor circulation, you can be more susceptible.

Similarly, if you have auto-immune conditions or have a weakened immune system due to prolonged ill health, you may also find you’re more likely to get fungal nail infections.

External factors such as regular hand washing or prolonged contact with water (for instance if you work in a role such as hairdressing) can make fungal nail infections more likely, as can living in warm or hot climates, where you’re more likely to sweat.

Being a smoker may also raise your risk of getting fungal nail infections too.

How common are fungal nail infections?

It’s estimated that at any one time, 10% of the global population has a fungal nail infection.^[2] The rates of infection have increased over the last decade, in predominantly Western countries. This is likely due to an increasingly ageing population and even factors such as regular lifestyle changes (foreign holidays in warm climates).

For most people they aren’t serious, but they can take a while to treat and can often recur once you have had one or two infections.

What causes fungal nail infections?

In most cases, fungal nail infections are caused by a particular type of fungi known as dermatophytes.^[1] They have a particular liking for keratinised tissue (this is basically your hair, nails and skin and they also like to use these bits of our body to feed off and then infect.

Sometimes fungal nail infections can be caused by infections like candida (the overgrowth of yeast in your body). Candida is a condition that can affect many areas of your body in different ways. For instance, it can cause thrush infections and it can also cause skin complaints like Angular cheilitis too.

Fungal nail infections are also frequently linked to other skin conditions such as athlete’s foot. This is when the skin on the feet which surrounds the nails and toes becomes itchy and scaly. You’ll often find it flakes off when you take off footwear or socks, or are drying your feet after bathing. If this is left untreated the microspores that it creates attack the nail bed and go into the nail itself causing the unpleasant symptoms of the infection.

What are the symptoms of a fungal nail infection?

The first sign you may notice is that you develop a yellow or white spot underneath your nail. Once the infection takes hold, your nail will start to thicken and discolour to a green, yellow or white tone.

Once this has happened, your nails can become ragged in appearance or crumble and break easily at the edge.

Fungal nail infections can infect just one nail at once, or several nails on one or both feet. They almost always need medical treatment.