Have you noticed a toenail becoming discoloured, thick, brittle or crumbly? You may have a fungal nail infection. It’s common, especially in older people, for fungal nail infections to affect toenails. Mild fungal nail infections are not urgent, however if they progress, they can become unpleasant, difficult to treat, and cause complications. In this article look at what you need to know about fungal nail infections, how to prevent them, and how to treat them.
A fungal nail infection is a common type of fungal infection which happens when a fungus (or fungi) gets into the nail or the nail bed. There are a wide range of fungal infections, these diseases or conditions are caused by fungi. Fungi are a diverse group of microorganisms found practically everywhere.
A fungal nail infection, also known as onychomycosis, most often affects your toenails, but it can affect fingernails too. Most fungal nail infections are caused by dermatophytes, a group of fungi that feed on keratin, causing infections of the skin, hair and nails. Fungal nail infections can also be caused by moulds or yeasts.
Anyone can get a fungal nail infection, but there are factors that can increase your risk of developing it. You may be at higher risk if you:
Certain medicines can also increase your risk of fungal infections. Topical corticosteroids can worsen fungal skin infections. Long-term use of corticosteroids can also increase your risk of developing fungal infections. Antibiotics used to treat bacterial infections can also cause fungal infections.
If you are concerned about your medicines and fungal infections, you should speak to a pharmacist – Do not stop taking a prescribed medicine without medical advice. Speak to your doctor or pharmacist first.
A fungal nail infection will often begin small, with a light or dark spot on the nail, it may also begin as a small change to the edge or corner of the nail. As the fungal infection spreads through the nail it will cause the nail to change in colour and shape.
Common symptoms of a nail fungal infection:
If untreated the symptoms of a fungal nail infection will continue to develop (e.g., increasingly thick and misshapen) and may spread to other nails.
If you notice the symptoms of a potential fungal nail infection, or there are symptoms that re bothering you, speaking to a pharmacist can be a good first step. They can ask about our symptoms and recommend suitable treatment, or if necessary, recommend you see a healthcare provider.
In most cases it’s best to confirm whether the symptoms are caused by a fungus before starting treatment. This can involve a healthcare provider taking nail clippings/scapings and sending them to a laboratory.
The best treatment for a fungal nail infection depends on various factors, including but not limited to how many nails are affected, how severe the infection is, and what other medicines you take.
For mild infections that are only a cosmetic issue, not painful, or troublesome, treatment may not be needed. However, if symptoms have developed to the point where they are affecting your lifestyle, causing pain, are difficult to trim, or are spreading to other nails, treatment may be worthwhile.
These antifungal nail paints or lacquers are brushed directly onto the affected nail. They are suitable for mild infections of one or two nails where the nail has not thickened or when antifungal tablets are not suitable.
Nail paints may need to be used for at least 6 to 12 months and take several months before improvement is seen. Patience is important and instructions must be followed carefully, including trimming and filing the nail as instructed.
Oral antifungal medicines come in tablet and capsule form. They are more effective than paints, especially in cases where the infection is more developed (e.g., thickened nail). Oral antifungal medicines will be successful in about three quarters of patients, and must be taken for either 6 weeks (fingernail fungal infections) or 3 months (toenail fungal infections).
In some cases oral antifungal medicines are not suitable. Your healthcare provider will decide if they are right for you.
Laser treatment of fungal nail infections is another treatment option available to people. Generally, this treatment works by directly targeting the fungal infection to destroy it. Studies are mixed on how effect laser treatment is compared to paints and oral medicines, however it is regarded as safe and a possible alternative option for some people.
Here are some simple steps you can take to prevent fungal nail infections. This is important both if you want to avoid a new infection and stop a treated one from coming back.
To help prevent fungal nail infections:
Most mild fungal nail infections will only have a cosmetic impact to the nail, but they can get worse. You should see a doctor, or pharmacist for advice if:
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