Onychomycosis, commonly known as a fungal nail infection, is infection of the fingernails or toenails by forms of fungi or yeast. Fungal nail infections are the most common disease of the nails and account for nearly one-half of all nail disorders. In the most common form of fungal nail infections, fungus grows under the growing portion of the nail and then along the nail bed and the grooves on the sides of the nails. A toenail that is infected by a fungus usually turns white or yellow. As the fungus spreads, the nail turns a darker color and gets thicker, and its edges start to turn ragged and crumble. A bad infection can cause toe pain, and the nail may pull away from the toe. Thickened nails can easily separate from the nail bed along to have a buildup of debris, bacteria and dead skin.
Toenails that are exposed to moisture and warmth a lot are more likely to get infected by a fungus. This can happen from wearing sweaty shoes often and from walking barefoot on shower floors.
Fungal nail infection may occur at any age but is more common in adults, particularly in older individuals. Diabetics may be more likely than other people to develop a fungal nail infection.
Fungal nails are very hard to treat, and the infection can return after it has cleared up. But medicines and treatment can sometimes get resolve of toenail fungus for good. If the infection is very bad, or if it causes a lot of pain, you may need to have the nail removed.
In general, toenails are most commonly affected with fungal nail infection. If the fingernails are affected, the toenails are usually affected as well. Nails often become thicker and lift from the nail bed (onycholysis) starting at the growing portion of the nail. You might then see debris under the nails and discoloration of the affected area.
In some forms of fungal nail infection, you might see black or white, powdery discoloration on the surface of the nail plate.
In some forms of fungal nail infection, you might see these abnormal changes farther up the finger (proximally), where the nail originates.
In fungal nail infection, one, a few, or all nails may be affected.
Topical therapy with ciclopirox nail lacquer, which requires daily application for 9–12 months.
Oral antifungal treatments offer the best chance for curing fungal nail infection. The medications may cause liver problems or may affect blood cell counts. Blood tests are usually performed before starting therapy and during therapy to look for possible side effects.
In stubborn (refractory) fungal nail infection, surgical removal of part of the nail or the entire nail.
Nail fungus (onychomycosis) can easily be confused with onycholysis, and dystrophic nails not caused by fungal elements.