Fungal nail (onychomycosis) is a fungal infection of the nail, caused by fungi that commonly thrive in warm and moist environments. People who wear trainers for a lengthy periods of time and have hot sweaty feet have an increased chance of getting the infection. Fungal nail infections are seven times more likely to occur on your toenails compared to fingernails, but you can get them on your fingernails too. 

You might have a fungal nail infection if you notice:

·      White or yellow streaks on the nail

·      Yellow toenails or discoloured toenails

·      Thickening or distortion of the nail

·      Brittle or crumbly nails – pieces may break off and come away completely.

·      Loss of lustre and shine

·      Loosening or lifting up of the nail

·      Debris trapped under the nail.

·      An odour coming from the infected nail.

Understanding Fungal Nail

A fungal nail infection can affect part of the nail, the entire nail, or several nails. The infection can occur on the surface of your nail or on the underside of the nail where your nail meets your nail bed (the skin under the nail).

The part of the nail the infection affects, and your exact fungal nail symptoms depend on the type of fungal nail infection you have. The two most common forms are:

Distal and lateral subungual onychomycosis (DLSO)

These infections are the most common type of fungal nail infection. They occur when the nail fungus invades the underside of the nail where the nail meets the nail bed. The tip of the nail is affected first, causing discoloured toenails or fingernails. White, yellow or brown vertical stripes may also appear on the nail as the infection spreads from the tip towards the base of the nail. As the infection progresses, the edge of the nail may become brittle and pieces can break off. You might also notice the nail lifting off the nail bed. This is caused by the fungus breaking down the nail and depositing debris called keratin under the nail which builds up and causes the nail to lift off. 

Superficial white onychomycosis (SWO)

These are the second most common type of fungal nail infection. Unlike distal and lateral subungual infections this infection affects the top layer of the nail rather than the nail bed. It initially forms white spots on the surface which gradually spread to the entire nail, causing it to become soft and crumbly. The top of the nail becomes covered with chalky powder due to the infection. 

What causes fungal nail?

Fungal nail is most commonly caused by a group of fungi called dermatophytes which infect the nail and the nail bed. It is highly contagious and transmitted in places like shower cubicles, swimming pools and changing rooms where people are barefoot. Toenail fungus can also be transferred in nail salons where the same nail accessories are used for many customers. Furthermore, nail trauma can also increase the chances of developing a fungal nail infection.

Who is at risk of getting a fungal nail infection?

Fungal nail infections can affect anyone as they are very contagious but are most prevalent in older individuals. You are more likely to develop fungal nail if you are over the age of 60. Gender also plays a role, with men three times more likely to have a fungal nail infection than women. 

Other risk factors include:

·      Diabetes 

·      Diseases that cause poor blood circulation 

·      A weakened immune system

There are many types of fungus that can get into the nail bed and destroy the toenails. Treatment is with anti-fungal creams which the pharmacist can offer. However, I can help here by cutting back the nail as far as possible which will help to remove some of the infected nail and allow creams to penetrate further down. 

Fungal nail will not clear up on its own and fungal nail treatment will depend on the severity of the infection. Fungal nail infections can take long time to clear because your nail grows slowly, and you will only notice improvement once a new nail has grown through. If your infection is mild your pharmacist may suggest: 

• Anti-fungal nail cream – it can take up to 12 months to cure the infection and does not always work. 

• Nail-softening cream – used for 2 weeks to soften the nail so the infection can be scraped off. 

If your fungal nail symptoms are severe, your GP may prescribe you a course of oral anti-fungal tablets. In the most serious cases, the infected toenail can be chemically or surgically removed. Laser therapy can also be recommended for fungal nail treatment. A Foot Health Practitioner can cut back the fungal nail and recommend anti-fungal creams.