Nail Fungus

Nail fungus is a common infection of the nail. It begins as a white or yellow-brown spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, the nail may discolor, thicken and crumble at the edge. Nail fungus can affect several nails.

If your condition is mild and not bothering you, you may not need treatment. If your nail fungus is painful and has caused thickened nails, self-care steps and medications may help. But even if treatment is successful, nail fungus often comes back.

Nail fungus is also called onychomycosis (on-ih-koh-my-KOH-sis). When fungus infects the areas between your toes and the skin of your feet, it's called athlete's foot (tinea pedis).

Symptoms of nail fungus include a nail or nails that are:

• *Thickened
• *Discolored
• *Brittle, crumbly or ragged
• *Misshapen
• *Separated from the nail bed
• *Smelly

Nail fungus can affect fingernails, but it's more common in toenails.

 How does someone get a fungal nail infection?

Fungal nail infections are caused by many different types of fungi that live in the environment. Small cracks in your nail or the surrounding skin can allow these germs to enter your nail and cause an infection.

 Who gets fungal nail infections?

Anyone can get a fungal nail infection. Some people may be more likely than others to get a fungal nail infection, including older adults and people who have the following conditions: 2,3

A nail injury or foot deformity

Trauma

Diabetes

Weakened immune system (for example, because of cancer)

Venous insufficiency (poor circulation in the legs) or peripheral arterial disease (narrowed arteries reduce blood flow to the arms or legs)

Fungal skin infections on other parts of the body

Occasionally, a bacterial infection can occur on top of a fungal nail infection and cause serious illness. This is more common in people with diabetes or other conditions that weaken the body’s defenses against infection.

 Prevention

Keep your hands and feet clean and dry.

Keep fingernails and toenails short and clean.

Don’t walk barefoot in areas like locker rooms or public showers.

Don’t share nail clippers with other people.

When visiting a nail salon, choose a salon that is clean and licensed by your state’s cosmetology board. Make sure the salon sterilizes its instruments (nail clippers, scissors, etc.) after each use, or bring your own.

Treatment Fungal nail infections can be difficult to cure, and treatment is most successful when started early. Fungal nail infections typically don’t go away on their own, and the best treatment is usually prescription antifungal pills taken by mouth. In severe cases, a healthcare professional might remove the nail completely. It can take several months to a year for the infection to go away.

Fungal nail infections can be closely associated with fungal skin infections. If a fungal infection is not treated, it can spread from one place to the other. Patients should discuss all skin concerns with their healthcare provider to ensure that all fungal infections are properly treated.

 Clinical research trials show laser treatment success being as high as 90% with multiple treatments, whereas current prescription therapies are about 50% effective.

Laser devices emit pulses of energy that produce heat. When used to treat onychomycosis, the laser is directed so the heat will penetrate through the toenail to the nail bed where the fungus is present. In response to the heat, the infected tissue is gasified and decomposed, destroying the fungus and the surrounding skin and nail. The heat from the lasers also has a sterilizing effect, which helps prevent new fungal growth.