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Onychomycosis

(Tinea Unguium; Fungal Nail Infection)

Definition

Onychomycosis is an infection of the toenail or fingernails.

Fungal Infection of the Toenails
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Causes

The infection is caused by a fungus. It can spread to humans from direct contact. This type of fungus lives in warm, moist places such as showers.

Risk Factors

Things that increase the risk of onychomycosis include:

Symptoms

Onychomycosis may cause:

  • Thickened nail that is difficult to cut
  • Brittle or ragged nail
  • Discolored or unsightly nail
  • Pain in the nail with normal use

It may happen in one or more of the nails.

Diagnosis

The doctor will ask about and past health. A physical exam will be done. A piece of the nail may be removed for testing. Results make take several weeks.

Treatment

Onychomycosis can be hard to treat. It may return after treatment. Treatment options include:

  • Antifungal medicine—may be pills or creams and lotions applied to the area
  • Surgery—nail may need to be removed for severe infections

Nails grow slowly. It can take up to a year to clear the nail.

Prevention

Steps that may lower the chance of onychomycosis:

  • Keep feet clean. Dry them completely after washing.
  • Keep hands dry. Wear rubber gloves when cleaning.
  • Keep nails short and clean. Trim them straight across.
  • Do not trim or pick at the skin near nails.
  • Do not wear shoes that are too tight.
  • Wear cotton socks that can pull moisture away from skin. Change socks if they are damp.
  • Use footwear when walking around swimming pools, locker rooms, and other public places.
  • Avoid artificial nails. They can trap moisture.
RESOURCES:

American Academy of Dermatology
https://www.aad.org

Foot Health Facts—American College of Foot and Ankle Surgeons
https://www.foothealthfacts.org

CANADIAN RESOURCES:

Canadian Podiatric Medical Association
http://www.podiatrycanada.org

The College of Family Physicians of Canada
http://www.cfpc.ca

REFERENCES:

Nandedkar-Thomas MA, Scher RK. An update on disorders of the nails. J Am Acad Dermatol. 2005;52(5):877-887.

Onychomycosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115521/Onychomycosis. Updated December 3, 2018. Accessed January 11, 2019.

Onychomycosis. Merck Profesional Manual. Available at: https://www.merckmanuals.com/professional/dermatologic-disorders/nail-disorders/onychomycosis. Updated November 2017. January 11, 2019.

Westerberg DP, Voyack MJ. Oonychomycosis: Current trends in diagnosis and treatment. Am Fam Physician. 2013;88(11):762-770.

Last reviewed November 2019 by EBSCO Medical Review Board Monica Zangwill, MD, MPH  Last Updated: 11/5/2019