Onychomycosis
(Tinea Unguium; Fungal Nail Infection)
Definition
Onychomycosis is an infection of the toenail or fingernails.
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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:
- Shoes that trap in moisture and warmth such as workboots
- Fungal infection of the foot called athlete's foot
- Injury to the nail
- Type 1 or type 2 diabetes
- Problems with blood flow, such as peripheral artery disease (PAD)
- Issues with the immune system, such as HIV infection
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