Nail fungus is a common skin condition that can affect both fingernails and toenails, though it is more common in toenails. This condition may also be called onychomycosis or tinea unguium. While nail fungus is often perceived as a purely cosmetic issue, an untreated fungal infection can lead to more serious complications. Luckily, most treatments are relatively straightforward, and the board-certified dermatologists at The Dermatology Clinic can diagnose and treat nail fungal infections effectively.

Symptoms and Possible Complications

Nail fungus often begins as a small white spot on the nail. As the infection progresses, fungal nails tend to take on a white, yellow, or brown color. Infected nails may also increase in thickness and become brittle, flaky, pitted, or even lifted from the nail bed. Less commonly, nail fungus may create a foul odor or an itching or burning sensation.

Untreated nail fungus can cause serious complications, including permanent damage to the nail and nail bed. Without prompt treatment, the fungus can easily spread from one nail to others. Patients with weakened immune systems, poor circulation, or diabetes are more susceptible to complications, including the development of sores and an increased risk of secondary bacterial infections of the skin.

Causes and Types of Nail Fungus

Nail fungus is caused by multiple varieties of fungi. The most common culprit is a group of fungi called dermatophytes, which cause athlete’s foot and ringworm. Many cases of toenail fungus occur when already-present athlete’s foot spreads from the foot’s skin to the toenails. Nail fungus can also be caused by Candida and certain types of mold, but these types of nail infections are relatively rare. Fungal infections tend to occur in nails that have recently experienced an injury or are slightly lifted from the nail bed. In addition, nail fungus is more likely to occur in certain groups of people with preexisting conditions or lifestyle factors that may increase their exposure. Patients with poor circulation, diabetes, weakened immune systems, and psoriasis have an increased risk of developing nail fungus, as these conditions make it easier for fungi to take hold. Elderly people also have a higher risk of contracting nail fungus due to a higher chance of exposure over time coupled with reduced circulation and slowly growing nails, both of which tend to occur with age.

There are several behavioral risk factors, as well. Because nail fungus is often caused by the same fungi that caused athlete’s foot, walking around pools or in locker rooms barefoot can increase the risk of exposure. However, not all forms of nail fungi are contagious and can simply develop under the right circumstances. Nail fungus is more likely to develop in people who frequently have their hands submerged in water, wear rubber gloves, or wear the same airtight shoes day after day. Living in a hot, humid climate such as Louisiana may also increase one’s risk.

Diagnosis and Treatment

A dermatologist will diagnose nail fungus by looking at the infected nails and taking a sample, either as a nail clipping or by scraping accumulated debris under the nail. This sample will be tested to ensure that the inflammation is caused by fungus (and not a different infectious agent or skin condition) and to determine the exact type of fungus that is present.

Treatment will depend on multiple factors, including the severity of the fungal infection and if the patient has any other health conditions. Most cases of nail fungus can be treated with antifungal oral or topical treatments or a combination of both. Oral antifungals can often be more effective at fighting nail fungus, but they have a greater risk of side effects. Topical treatments can include medicated nail polish or medicated creams. Some topical treatments need to be applied daily, while others require weekly applications. Both oral and topical antifungal treatments need to be taken for several months or even more than a year because the infected nail needs to completely grow out and be replaced by a healthy nail before it is considered completely treated. In extremely rare and severe cases, your doctor may recommend surgery to remove the nail to directly fight the fungus and/or relieve pressure and pain.

When to Go to the Doctor

If you suspect that you have nail fungus, don’t hesitate to seek medical treatment. Over-the-counter antifungals may help keep the fungus from spreading to other nails, but they aren’t as effective at treating the nail bed as prescription medications. The dermatologists at The Dermatology Clinic can diagnose nail fungus and determine which course of treatment would be the most effective for your specific case. In addition, they can recommend ways to prevent nail fungus from reoccurring after it has been treated. Schedule an appointment today.

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