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Onychomycosis



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Fungal nail infection

Causes of a fungal nail infection

The most common causes of fungal nail infections are a fungal skin infection or damage to the nail or skin.

Athlete’s foot

A fungal infection in the toenail is often caused by a fungal skin infection such as athlete’s foot. About a third of people with athlete’s foot also develop a nail infection. Athlete’s foot usually affects the skin between your toes, causing it to become red, flaky and itchy.

Fungi grow and thrive easily in warm, damp environments, so an infection is more likely to occur after wearing trainers for long periods or if you often have hot, sweaty feet.

Other causes

Fingernail infections are most often caused by a yeast called candida, which causes infections such as vaginal thrush.

You’re more likely to develop a fingernail infection if your job involves a lot of handwashing or your hands are in water for long periods of time. This is because the skin at the base of your nail can become damaged and is more likely to become infected.

Your risk of developing a fungal nail infection is also increased if you have certain health conditions or health issues, such as:

Other factors that can increase the risk of nail infections include:

  • using artificial (cosmetic) nails
  • nail damage
  • constant nail biting
  • living in a warm and humid climate
  • smoking

Nail infections are more likely to occur with increasing age. Sometimes there’s no obvious cause for an infection.

Published Date
2014-02-18 15:08:52Z
Last Review Date
2014-01-10 00:00:00Z
Next Review Date
2016-01-10 00:00:00Z
Classification
Athlete's foot,Fungal infections,Fungal nail infections,Skin or nail infections

Fungal nail infection – NHS Choices

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Fungal nail infection 

Introduction 

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Your browser appears to have Javascript disabled, to view the nail abnormalities information in an accessible format please go to /Tools/Documents/nail_abnormalities_a_visual_guide.html

Who gets fungal nail infections?

Fungal nail infections mainly affect older adults. They are rare in children.

People with certain health conditions have an increased risk of developing a fungal nail infection. These include:

  • fungal skin infections, such as athlete’s foot
  • psoriasis, a skin condition that causes red, flaky and crusty patches of skin covered with silvery scales
  • diabetes
  • peripheral vascular disease

Nail infections are also more common in people with lowered immune systems.

Read more about who’s at risk of developing a fungal nail infection.

A fungal nail infection affects the hard material (keratin) that makes up the nails.

Fungal nail infections can affect part or all of the nail, including the nail plate, nail bed and root of the nail.

The infection develops slowly and causes the nail to become discoloured, thickened and distorted. The toenails are more frequently affected than the fingernails.

Onychomycosis is the medical name for a fungal nail infection.

Read more about other nail abnormalities.

Signs and symptoms of a fungal nail infection

The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.

You’ll not usually feel any pain at first, but the nail can look ugly. In most cases, a fungal nail infection won’t cause any further complications. However, it may cause pain and discomfort if the infection isn’t treated, although this is rare.

Read more about the signs and symptoms of a fungal nail infection.

What causes a fungal nail infection?

Most fungal nail infections are caused by dermatophyte fungi, which also cause athlete’s foot.

Athlete’s foot is a fungal skin infection that affects the skin between the toes. It can easily spread to the toenails.

Ocassionally, a nail infection can be caused by other types of fungi, such as Candida (a yeast that causes infections such as vaginal thrush).

Several factors increase the risk of a fungal nail infection developing. For example:

  • wearing shoes that cause your feet to get hot and sweaty
  • being in a humid environment
  • regular damage to the nail or skin
  • poor health or certain health conditions, such as diabetes or psoriasis

Read more about the causes of a fungal nail infection.

Treating a fungal nail infection

Treatment isn’t always needed for mild fungal nail infections. Your GP may send a clipping of your nail for laboratory testing to discover the exact cause of the infection and rule out other conditions. They’ll then discuss appropriate treatments with you.

Fungal nail infections can be treated and usually cured, but some treatments can take several months to work. Antifungal medicines include antifungal tablets and nail paint.

Antifungal tablets are usually effective, but they may cause side effects. You should discuss this with your GP before deciding which treatment to use.

Surgery to remove the nail may be recommended in very severe or painful cases. Laser treatment, where a high energy laser is used to destroy the fungus, is also an option. However, this is expensive and is only available privately.

During and after treatment it’s important to look after your nails properly and practise good foot hygiene to stop the infection returning.

Read more about treating a fungal nail infection.

Page last reviewed: 10/01/2014

Next review due: 10/01/2016

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Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

margarethe said on 13 October 2014

I tried all the over the counter treatments for my nails with no effect. Then from looking at these pages I tried a tea tree cream which I rubbed in daily onto cleaned feet. I also disinfect all my socks before treatment. After only a few weeks my symptoms had improved and have now almost gone. they also sell a tea tree liquid which may work. Hope this helps

Report this content as offensive or unsuitable

dawnee108 said on 28 June 2014

Years ago I had fungal nail infection and my doctor prescribed eye drops! I had to put two drops down behind the nail and it worked amazingly!! I have been back to the doctors as it recurred but they gave me the nail varnish stuff which doesn’t work for me. Does anyone know what drops these could have been. I have been trying to remember

Report this content as offensive or unsuitable

st just said on 12 May 2014

hi peple as enyone got eny updates on using vicks rub on feet I have been using it for over amonth now and seeing a big improvement

Report this content as offensive or unsuitable

Emily465 said on 01 December 2013

Hey thanks a lot for this article. Several years I suffered from nail fungus until my doc gave me the simplest tip he had: Just put cedarsoles made from cedarwood in all the shoes. Because the cedar is the most antifungal tree in nature it also works in relation to nail fungus.

Report this content as offensive or unsuitable

SpiffyRicky523 said on 15 February 2013

A good way to make sure your toenail fungus doesn’t return is by treating it properly the first time around. You can search the web and find several topical treatments; all of which who claim they are the best treatment available, but the most logical one, (not to mention the coolest), is the laser treatment. The statistics I read about it are amazing, and seem definitely worth looking into.

Report this content as offensive or unsuitable

kenneth james said on 08 June 2012

excellent advice!

Report this content as offensive or unsuitable

SamWoerth said on 01 October 2010

Essential that if you suspect a problem with your nails, feet or fingers – Get your GP involved fast.
Two reasons, firstly the longer the infection is in place, the treatment time escalate. Secondly it can take up to six weeks for laboratory culture tests to be completed. In this writer’s case, the first lot were negative. another sets of nail clippings were then dispatched, meantime the situation with my thumbs had worsened dramatically over a ten week period.
Now, at last being treated with a nail lacquer –
Trosyl – the active ingredient Tioconazole – is used for Vaginal growth infections. Presumably not painted on as a nail varnish! I am a keen gardener of 55 years and that is where I think it has come from. Mycorrhizal -the friendly fungi (plants), though as yet we cannot prove it. However the laboratory could not know the specific growth yeast involved with my thumbs.. Normally they do!
Perhaps I get one named after me -‘SamusWoertham’
SamWoe

Report this content as offensive or unsuitable

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How to keep your feet healthy, choose the right sports shoes and what to do if you have smelly feet

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Fungal nail infection – NHS Choices

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Fungal nail infection 

Introduction 

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Your browser appears to have Javascript disabled, to view the nail abnormalities information in an accessible format please go to /Tools/Documents/nail_abnormalities_a_visual_guide.html

Who gets fungal nail infections?

Fungal nail infections mainly affect older adults. They are rare in children.

People with certain health conditions have an increased risk of developing a fungal nail infection. These include:

  • fungal skin infections, such as athlete’s foot
  • psoriasis, a skin condition that causes red, flaky and crusty patches of skin covered with silvery scales
  • diabetes
  • peripheral vascular disease

Nail infections are also more common in people with lowered immune systems.

Read more about who’s at risk of developing a fungal nail infection.

A fungal nail infection affects the hard material (keratin) that makes up the nails.

Fungal nail infections can affect part or all of the nail, including the nail plate, nail bed and root of the nail.

The infection develops slowly and causes the nail to become discoloured, thickened and distorted. The toenails are more frequently affected than the fingernails.

Onychomycosis is the medical name for a fungal nail infection.

Read more about other nail abnormalities.

Signs and symptoms of a fungal nail infection

The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.

You’ll not usually feel any pain at first, but the nail can look ugly. In most cases, a fungal nail infection won’t cause any further complications. However, it may cause pain and discomfort if the infection isn’t treated, although this is rare.

Read more about the signs and symptoms of a fungal nail infection.

What causes a fungal nail infection?

Most fungal nail infections are caused by dermatophyte fungi, which also cause athlete’s foot.

Athlete’s foot is a fungal skin infection that affects the skin between the toes. It can easily spread to the toenails.

Ocassionally, a nail infection can be caused by other types of fungi, such as Candida (a yeast that causes infections such as vaginal thrush).

Several factors increase the risk of a fungal nail infection developing. For example:

  • wearing shoes that cause your feet to get hot and sweaty
  • being in a humid environment
  • regular damage to the nail or skin
  • poor health or certain health conditions, such as diabetes or psoriasis

Read more about the causes of a fungal nail infection.

Treating a fungal nail infection

Treatment isn’t always needed for mild fungal nail infections. Your GP may send a clipping of your nail for laboratory testing to discover the exact cause of the infection and rule out other conditions. They’ll then discuss appropriate treatments with you.

Fungal nail infections can be treated and usually cured, but some treatments can take several months to work. Antifungal medicines include antifungal tablets and nail paint.

Antifungal tablets are usually effective, but they may cause side effects. You should discuss this with your GP before deciding which treatment to use.

Surgery to remove the nail may be recommended in very severe or painful cases. Laser treatment, where a high energy laser is used to destroy the fungus, is also an option. However, this is expensive and is only available privately.

During and after treatment it’s important to look after your nails properly and practise good foot hygiene to stop the infection returning.

Read more about treating a fungal nail infection.

Page last reviewed: 10/01/2014

Next review due: 10/01/2016

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Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

margarethe said on 13 October 2014

I tried all the over the counter treatments for my nails with no effect. Then from looking at these pages I tried a tea tree cream which I rubbed in daily onto cleaned feet. I also disinfect all my socks before treatment. After only a few weeks my symptoms had improved and have now almost gone. they also sell a tea tree liquid which may work. Hope this helps

Report this content as offensive or unsuitable

dawnee108 said on 28 June 2014

Years ago I had fungal nail infection and my doctor prescribed eye drops! I had to put two drops down behind the nail and it worked amazingly!! I have been back to the doctors as it recurred but they gave me the nail varnish stuff which doesn’t work for me. Does anyone know what drops these could have been. I have been trying to remember

Report this content as offensive or unsuitable

st just said on 12 May 2014

hi peple as enyone got eny updates on using vicks rub on feet I have been using it for over amonth now and seeing a big improvement

Report this content as offensive or unsuitable

Emily465 said on 01 December 2013

Hey thanks a lot for this article. Several years I suffered from nail fungus until my doc gave me the simplest tip he had: Just put cedarsoles made from cedarwood in all the shoes. Because the cedar is the most antifungal tree in nature it also works in relation to nail fungus.

Report this content as offensive or unsuitable

SpiffyRicky523 said on 15 February 2013

A good way to make sure your toenail fungus doesn’t return is by treating it properly the first time around. You can search the web and find several topical treatments; all of which who claim they are the best treatment available, but the most logical one, (not to mention the coolest), is the laser treatment. The statistics I read about it are amazing, and seem definitely worth looking into.

Report this content as offensive or unsuitable

kenneth james said on 08 June 2012

excellent advice!

Report this content as offensive or unsuitable

SamWoerth said on 01 October 2010

Essential that if you suspect a problem with your nails, feet or fingers – Get your GP involved fast.
Two reasons, firstly the longer the infection is in place, the treatment time escalate. Secondly it can take up to six weeks for laboratory culture tests to be completed. In this writer’s case, the first lot were negative. another sets of nail clippings were then dispatched, meantime the situation with my thumbs had worsened dramatically over a ten week period.
Now, at last being treated with a nail lacquer –
Trosyl – the active ingredient Tioconazole – is used for Vaginal growth infections. Presumably not painted on as a nail varnish! I am a keen gardener of 55 years and that is where I think it has come from. Mycorrhizal -the friendly fungi (plants), though as yet we cannot prove it. However the laboratory could not know the specific growth yeast involved with my thumbs.. Normally they do!
Perhaps I get one named after me -‘SamusWoertham’
SamWoe

Report this content as offensive or unsuitable

Foot health

How to keep your feet healthy, choose the right sports shoes and what to do if you have smelly feet

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Community content from HealthUnlocked

How to stop smelly feet

Smelly feet aren’t much fun for anyone, but there are simple steps to make sure yours stay fresh

Getting help from the podiatrist

Taking care of your feet is essential. Here’s how podiatrists and chiropodists can help

//

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NHS Choices Syndication

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Fungal nail infection

Introduction

A fungal nail infection affects the hard material (keratin) that makes up the nails.

Fungal nail infections can affect part or all of the nail, including the nail plate, nail bed and root of the nail.

The infection develops slowly and causes the nail to become discoloured, thickened and distorted. The toenails are more frequently affected than the fingernails.

Onychomycosis is the medical name for a fungal nail infection.

Read more about other nail abnormalities.

Signs and symptoms of a fungal nail infection

The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.

You’ll not usually feel any pain at first, but the nail can look ugly. In most cases, a fungal nail infection won’t cause any further complications. However, it may cause pain and discomfort if the infection isn’t treated, although this is rare.

Read more about the signs and symptoms of a fungal nail infection.

What causes a fungal nail infection?

Most fungal nail infections are caused by dermatophyte fungi, which also cause athlete’s foot.

Athlete’s foot is a fungal skin infection that affects the skin between the toes. It can easily spread to the toenails.

Ocassionally, a nail infection can be caused by other types of fungi, such as Candida (a yeast that causes infections such as vaginal thrush).

Several factors increase the risk of a fungal nail infection developing. For example:

  • wearing shoes that cause your feet to get hot and sweaty
  • being in a humid environment
  • regular damage to the nail or skin
  • poor health or certain health conditions, such as diabetes or psoriasis

Read more about the causes of a fungal nail infection.

Treating a fungal nail infection

Treatment isn’t always needed for mild fungal nail infections. Your GP may send a clipping of your nail for laboratory testing to discover the exact cause of the infection and rule out other conditions. They’ll then discuss appropriate treatments with you.

Fungal nail infections can be treated and usually cured, but some treatments can take several months to work. Antifungal medicines include antifungal tablets and nail paint.

Antifungal tablets are usually effective, but they may cause side effects. You should discuss this with your GP before deciding which treatment to use.

Surgery to remove the nail may be recommended in very severe or painful cases. Laser treatment, where a high energy laser is used to destroy the fungus, is also an option. However, this is expensive and is only available privately.

During and after treatment it’s important to look after your nails properly and practise good foot hygiene to stop the infection returning.

Read more about treating a fungal nail infection.

Published Date
2014-10-08 16:28:55Z
Last Review Date
2014-01-10 00:00:00Z
Next Review Date
2016-01-10 00:00:00Z
Classification
Fungal infections,Fungal nail infections,Skin or nail infections


NHS Choices Syndication

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Fungal nail infection

Signs and symptoms of a fungal nail infection

The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.

A fungal nail infection is usually painless at first, and in most cases it won’t cause any further complications. But if the infection isn’t treated, it may cause pain and discomfort, although this is rare.

If you have pain in the affected toenail, it can eventually make walking and wearing shoes difficult. You may have problems writing if your fingernails are affected.

As the infection progresses you may experience other symptoms, such as the nail becoming brittle, with pieces of nail breaking off and coming away from the toe or finger completely.

If left untreated, the skin around the nail can sometimes become inflamed and painful. White or yellow patches may also be visible on the nailbed, or you may have scaly skin next to the nail.

Read more about how a fungal nail infection is treated.

Published Date
2014-02-18 15:10:07Z
Last Review Date
2014-01-10 00:00:00Z
Next Review Date
2016-01-10 00:00:00Z
Classification
Fungal infections,Fungal nail infections


NHS Choices Syndication

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Fungal nail infection

Treating a fungal nail infection

Treatment may not be necessary in mild cases of fungal nail infection.

But if you don’t treat the infection, there’s a chance it will spread to other nails.

Using simple self-care methods may be effective in some cases. For example, not wearing footwear that makes your feet hot, keeping your nails short and maintaining a high level of foot hygiene can help prevent fungal nail infections.

Medication

Medication may be recommended if your fungal nail infection is more severe. Antifungal medicines, such as tablets and nail paints, are the two main treatments.

Your GP and pharmacist will be able to advise you about whether you need treatment and, if so, recommend the type you need.

Your nail’s appearance may not return to normal after the infection has cleared. However, a sample of your nail should be tested if it still looks infected.

Antifungal tablets

Taking antifungal medication in the form of tablets means that the treatment reaches your nail through your bloodstream.

Terbinafine and itraconazole are the two medicines most commonly prescribed for fungal nail infections and they can be very effective.

However, you may have to take the tablets for several months to ensure that the infection has completely cleared up. If you stop taking the medication too early, the infection may return.

An advantage of using antifungal tablets is that they’ll also clear up any associated fungal skin infections, such as athlete’s foot, at the same time.

However, side effects of antifungal tablets can include: 

Antifungal nail paint

If you prefer not to take antifungal tablets, your GP may suggest you try antifungal nail paint instead.

Nail paint isn’t considered to be as effective as tablets because it’s painted onto the infected nail and has to work its way through to the infection. It can often be difficult to reach all of the infection.

A fingernail may need around six months of treatment, and a toenail may take up to 12 months.

Chemical nail removal

The abnormal infected nail plates can be removed using a paste containing 40% urea (a chemical that occurs naturally in the body which can also be manufactured). The paste is available over the counter from pharmacies.

You carefully apply the paste to the affected nails, which are covered and left overnight. You then wash the paste off in the morning and repeat the process each night after filing down the nail as instructed. It usually takes about two weeks to dissolve the nail plates.

Chemical nail removal is a painless treatment that gradually removes the abnormal nail plate and the fungus. It allows you to avoid taking tablets for several months and avoid surgery, which can be painful.

Once the nail plates have been dissolved, antifungal nail paint should be applied to the nails twice a week to prevent the nails being reinfected as the new nail forms.

Surgery and laser treatment

Surgery to remove the infected nail may be recommended if your infection is very severe or painful and other treatments have proved ineffective.

If your nail is surgically removed, a new nail should eventually grow back in its place. However, it could take a year or more for the nail to grow back completely.

Laser treatment is another possible option if you have a fungal nail infection that’s particularly stubborn. The laser emits high doses of light energy, which are used to destroy the fungus.

Research shows that laser treatment is a safe and effective procedure, with some studies reporting a success rate of up to 90% at three months.

However, there’s currently little evidence to show that laser treatment provides a long-term cure, as most studies only follow patients up for a period of three months.

To achieve these high success rates, you need to be treated every three months for up to a year. As laser treatment is only available privately, this could prove expensive.

Foot care during treatment

During your treatment, you should see a new healthy nail start to grow from the base of your nailbed. This is a sign that the treatment is working. The old infected nail should begin to grow out and can be clipped away over the course of a few months.

Speak to your GP if a new nail doesn’t start to grow after two to three weeks of treatment. Keep using the treatment until your GP says you can stop. Stopping too early could result in the infection returning.

Foot care tips

There are some things you can do to help keep the infection at bay during and after treatment. These are listed below.

  • keep your feet cool and dry, and wear shoes and socks that allow your feet to breathe
  • wear clean cotton socks and avoid wearing trainers
  • treat athlete’s foot with antifungal medicine as soon as possible to avoid the infection spreading to your nails
  • clip your nails to keep them short
  • use a separate pair of clippers or scissors to cut the infected nail to avoid spreading the infection to other nails
  • wear well-fitting shoes without high heels or narrow toes
  • maintain good foot hygiene
  • wear clean shower shoes when using a communal shower
  • consider seeking treatment from a podiatrist if thickened toenails cause discomfort when walking
  • consider replacing old footwear as it could be contaminated with fungal spores

Read more about how to keep your feet healthy.

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    <script type="text/javascript">brightcove.createExperiences();</script><noscript><a href="http://www.nhs.uk/flashcont/altflash/podiatry..htm">Read transcript for video – Look after your feet</a></noscript>
Published Date
2014-02-18 15:00:57Z
Last Review Date
2014-01-10 00:00:00Z
Next Review Date
2016-01-10 00:00:00Z
Classification
Fungal infections,Fungal nail infections,Skin or nail infections

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