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Fungal nail infections are relatively common and cause discoloured nails with a thickened appearance. They can often become painful.
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A fungal nail infection (known by its medical name of Onychomycosis) most commonly affects toenails, 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. Your nails might feel jagged and 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.
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.
It’s estimated that at any one time, 10% of the global population has a fungal nail infection . 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).
These infections are more common in people who are over 55, and can often occur in patients who have diabetes or other auto-immune conditions too. If you have a weakened immune system from long term illness and treatment, your risk of getting a fungal nail infection may also increase.
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.
Fungal Nail Infections (Onychomycosis): A Never-Ending Story? PLoS Pathogens, 10(6), p.e1004105. [Accessed 28-09-21]
REVIEW ARTICLE: Toenail onychomycosis: an important global disease burden. Journal of Clinical Pharmacy and Therapeutics, 35(5), pp.497–519. [Accessed 28-09-21]
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When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
In most cases, fungal nail infections are caused by a particular type of fungi known as dermatophytes . 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.
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.
The dermatophytes. Clinical Microbiology Reviews, 8(2), pp.240–259. [Accessed 28-09-21]
Treating a Fungal Nail Infection can be done in a number of ways, depending on how quickly it’s caught. Our clinician will talk to you about any other health conditions you have, other medications you are taking and your general overall health before deciding the best course of treatment for you.
There are a range of different treatment options. Firstly, there are tablets like Lamisil and Terbinafine. They are both the same medication, but Lamisil is the branded version of Terbinafine. These work by getting into your bloodstream to kill the infection at its source.
There are also topical treatments that come in different liquid forms that can be used for milder fungal nail infections. Loceryl is similar to a nail lacquer in that you paint it onto your nail and leave it to sink in and quell the infection. Trosyl is exactly the same kind of product, but must also be applied to the skin around the nail area too.
Generally, oral treatments such as Lamisil are considered to be the most successful at treating fungal nail infections, especially if they are well established. Trosyl and Loceryl will help if the infection is relatively mild.
However, fungal nail infections can be tricky to get rid of once they have taken hold, and can sometimes have high recurrence rates. Oral treatments have great success rates in helping with fungal nail infections but often come with a raised risk of side effects. You may perhaps feel nauseous or have indigestion when taking them at first, whilst your body adjusts to the tablets.
Speaking to one of our friendly clinicians can really help you make the best decision if you want to treat a fungal nail infection. They’ll help you find out which treatment will suit you best and discuss any questions you might have.
Yes. A fungal nail infection will rarely disappear without some form of treatment. If it’s a mild infection then a topical treatment combined with careful foot hygiene may be enough to stop the infection from spreading further.
If the infection is deeper or already causing a lot of pain and discomfort then it’s important to talk to a clinician as soon as possible to discuss different treatment options.
There are things you can do at home as well, to help yourself get better. Important self-care steps such as:
If you’re a regular visitor to the swimming pool, then try not to walk barefoot around the pool or in the showers.
If you notice you have a case of athlete’s foot, treat this as promptly as possible, then there is less chance of it spreading and causing a fungal nail infection.
Fungal Nail Infection. [Accessed 28-09-21]
Challenges and Opportunities in the Management of Onychomycosis. Journal of Fungi, 4(3), p.87.
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