What is a nail fungal infection?
Nail fungal infection or nail fungus is a common condition that begins as a white or yellow patch under the tip of the finger or toenail. As the fungal infection deepens, the nail fungus can cause the nail to change colour, thicken, and break off at the edge. It affects many nails.
Fungi are usually present in the body and together with various bacteria. But when a fungus starts to grow, you can get an infection.
If your condition is mild and does not bother you, you do not need treatment. If nail fungus hurts and thickened nails form, self-care steps and medications can help. Although treatment is successful, nail fungus often returns.
Onychomycosis, also known as a ringworm aneurysm, is a fungal infection that affects the fingernails or toenails. Yeast infections usually develop over time, so any immediate difference in the way the nail looks or feels may be too subtle to notice at first.
Common types of nail fungal infection?
Distant subclinical infection
Distal subangular infections are the most common type of fungal nail infection and can develop on both fingernails and toenails. When infected, the outer edge of the nail has the appearance of jaggery with white and/or yellow stripes across the nail. The infection attacks the nail bed and the base of the nail.
White surface infection
White surface infections usually affect the nails. A specific type of fungus attacks the upper layers of the nail and creates well-defined white spots on the nail.
Eventually, these white patches will cover the entire nail, making it harder, smoother, and more prone to breaking. Scars on the nail can become hollow and flaky.
Proximal subclinical infection
Proximal subangular infections are rare but affect the fingernails and toenails. Yellow spots appear at the base of the nail as the infection spreads upward.
This infection generally occurs in people with compromised immune systems. It also comes from a minor injury to the nail.
Candida yeast can cause this type of infection. Attacks nails damaged by a previous infection or injury. In general, Candida affects the nails. It often occurs in people whose hands are often soaked in water.
These infections usually start with the cuticle around the nail, which becomes swollen, red, and soft to the touch. The nail can also be partially lifted from the nail bed or dropped completely.
How do I know if I have a nail fungal infection?
Since other infections affect the nail and mimic the symptoms of fungal nail infection, the only way to make a diagnosis is to see a doctor. They take a scrape of the nail and look under a microscope for signs of fungus.
In some cases, your doctor may send a sample to the laboratory for analysis and identification.
Nail fungal infection symptoms
Commonly infected nails:
- It’s heavy
- In small pieces
- It can be dark or yellow
It can also be:
- Scales under the nail: Hyperkeratosis
- Yellow or white stripes: Lateral onychomycosis
- Yellow spots on the underside of the nail: Proximal onychomycosis
- Infected nails can separate from the nail bed: Onycholysis
Nail fungal infection can cause pain in the toes or fingers and can also cause bad breath.
Another symptom associated with fungal nail infections is dermatophytes, which are skin lesions that do not ferment. These look like a rash or itch on the body that is not infected with the fungus, like an allergic reaction.
Fungal nail infections are caused by various fungal organisms (fungi). The most common cause is a type of fungus called a dermatophyte. Yeast and mold can also cause nail infections.
Nail fungus infection can develop in people of any age, but it is more common in adults. As the nail ages, it becomes brittle and dry. The resulting cracks in the nails allow the fungus to enter. Other factors, such as decreased blood flow to the feet and a weakened immune system, also play a role.
Toenail fungus infection starts in the athlete’s foot (toenail fungus) and spreads from one nail to another. But it is not uncommon for an infection to come from someone else.
Factors that increase the risk of developing nail fungus:
- Due to aging, decreased blood flow, prolonged exposure to fungus, and slow-growing nails
- Sweat a lot
- Have a history of athlete’s foot.
- Walking barefoot in damp religious areas such as pools, gyms, and showers
- A skin condition, such as minor skin or nail lesions or psoriasis
- Have diabetes, circulatory problems, or a weakened immune system.
To diagnose fungal nail infections, a doctor will usually examine the scraped debris under the nail. Nail scraping is used in tests such as potassium hydroxide (KOH) smear or fungal culture. The KOH test can be done quickly, growing mushrooms takes weeks.
Doctors must be careful when diagnosing fungal nail infections because many other conditions can cause similar symptoms. These include psoriasis, lichen planus, contact dermatitis, trauma, nail bed tumour, eczema, and jaundice syndrome.
How is a fungal nail infection treated?
Treating nail fungus infections can be a long and expensive process. There are oral antifungal medications, topical ointments, and alternative therapies. Over the counter creams and ointments are available, but they have not proved very effective.
Oral medications for nail fungus infection include:
- Terbinafine (Lamisil)
- Itraconazole (Sporanox)
- Fluconazole (Diflucan)
- Griseofulvin (Gray-PEG)
Your doctor may prescribe other antifungal treatments such as antifungal nail polish or topical solutions. These treatments reach the nail in the same way that you apply nail polish.
Depending on the type of fungus causing the infection, as well as the extent of the infection, you may need to use these medications for several months. Topical solutions are generally not effective in curing fungal nail infections.
Treatment is not guaranteed to completely rid your body of the yeast infection. Complications from a yeast infection are also possible.
Topical nail fungus treatments appear to be obvious nail fungus infections, but they often don’t completely cure the infection.
Other home remedies that have clinical effects on nail fungus:
- Vix vaporub: Commonly used to treat coughs. However, a study published in 2011 suggests that it may be beneficial in treating nail fungus.
- SnakeRoot Extract: This study showed that ciclopirox, a prescription antifungal treatment, is naturally effective in treating plant fungi.
- Oil of oregano: Contains thymol, which has antifungal properties. Oil of oregano is sometimes mixed with tea tree oil in treatments, but the side effects are powerful and the combination can increase the risk of an allergic reaction or irritation.
- Ozonated Oils: Olive oil and sunflower oil are examples of oils that are filled with the same gases as the ozone layer. Several studies confirm the benefits of this type of oil in the treatment of nail fungus. In one study, ozonated sunflower oil showed greater clinical effects than the prescription antifungal drug ketoconazole.
Other alternative medicines used to treat fungal nail infections include Australian tea tree oil, vinegar, Listerine, and grapefruit seed extract. However, there is no scientific evidence for the use of these products.
Nail fungal infection complications
A severe case of nail fungus can be painful and cause permanent nail damage. If you have a weakened immune system due to medications, diabetes, or other conditions, it can lead to other serious infections that can spread beyond your feet.
If you have diabetes, it can reduce blood circulation and nerve supply in your feet. You also have an increased risk of bacterial skin infection (cellulitis). So any minor injury to your feet, including a fungal nail infection, can lead to a more serious problem. See your doctor if you have diabetes and think you are developing nail fungus.
Hand and foot hygiene is essential to prevent fungal nail infections. Some clues:
- Keep nails short, dry and clean
- They usually wear breathable synthetic socks.
- Using antifungal sprays or powders
- Wear rubber gloves to avoid excess water.
- Avoid picking or biting your nails
- Wearing shoes or sandals in public places and swimming pools
- Properly sterilize tools in your nail or pedicure salon.
- Less frequent use of artificial nails and nail polish.
- Washing your hands after touching infected nails
- Avoid sharing shoes and socks.