Patient education: Fungal nail infections (The Basics)
Written by the doctors and editors at UpToDate
What is a fungal nail infection?
— A fungal nail infection is an infection of the nail that makes it get thick or turn white, yellow, or brown. It is caused by a type of germ called a “fungus.”
Fungal infections happen in the toenails more often than the fingernails. They usually start on the big toe, and can affect 1 or more nails. People who have a toenail infection might also have a condition known as “athlete’s foot” (a fungal infection of the foot). That’s because certain types of fungi (plural of fungus) can cause both of these problems.
Fungi like to grow in warm and wet places. People who swim or whose feet sweat a lot might have a higher chance of getting a fungal nail infection.
What are the symptoms of a fungal nail infection?
— A fungal infection can cause a nail to:
●Turn white, yellow, or brown (picture 1)
●Get thick, change shape, or lift up
●Break off easily
Fungal nail infections don’t usually lead to serious long-term problems. But in some people they can. In people who have diabetes or whose bodies have trouble fighting infections, the nail infection can make them more likely to get other infections.
Is there a test for a fungal nail infection?
— Yes. Usually, your doctor can tell if you have a fungal nail infection by talking with you and doing an exam. But to make sure, he or she might take a small sample of the nail and look at it under a microscope. Your doctor might also send the sample to a lab where another doctor can see which germs are causing the infection.
Can I treat my fungal nail infection on my own?
— You can buy over-the-counter creams or products, but they usually don’t work.
How are fungal nail infections treated?
— Treatment depends, in part, on how severe the infection is, and how much it bothers you. If your infection is mild or doesn’t bother you very much, you might choose not to treat it. An untreated nail infection probably won’t go away, but it probably won’t cause any long-term problems either.
When people need or choose to have treatment, it usually involves “antifungal” medicines that you get with a prescription from your doctor. These medicines are taken by mouth or put on the nail.
Treatment with pills usually lasts a few months. Some people who take these medicines need to have blood tests. That’s because these medicines can affect the liver.
If you don’t want to or can’t take antifungal pills, your doctor will talk with you about other treatment options. These might include using an antifungal medicine on the nail or having surgery to remove your nail.
Before starting any of these treatments, you should know that:
●It can take many months for your nail to look normal again.
●There is a chance that the treatment won’t work. The infection might not get better, or it might come back. If either of these things happen, your doctor can try another treatment or send you to a specialist.
Can fungal nail infections be prevented?
— Sometimes. To reduce your chance of getting one, you can:
●Keep your feet clean and dry.
●Avoid sharing nail tools, such as clippers and scissors.
●Wear flip-flops or other footwear in a gym shower or locker room.
What if I want to get pregnant?
— If you want to get pregnant, let your doctor know. He or she might recommend that you not take certain antifungal medicines during pregnancy.