Home Diseases & Conditions Nail Fungal Infection – Causes, Symptoms, Risk Factors, Prevention & Treatment

Nail Fungal Infection – Causes, Symptoms, Risk Factors, Prevention & Treatment

Nail fungal infection is a common infection that affects the nail. It is caused by fungi and evidenced by the discoloration and thickening of the nail. It can either affect the fingernails or the toenails but most commonly affects the toenail.

Nail fungal infection is also called Onychomycosis or tinea unguium.

Nail fungal infection


Nail fungal infection is caused by microscopic organisms called fungi. Fungi are present on the human body but an overgrowth can cause serious problems. They thrive well in a warm and moist environment.

The most common group of fungi that infect the nails are called dermatophytes. The molds and the yeast can also cause nail infections. The common fungi that cause nail infections include:

  • Trichophyton rubrum – the most common dermatophyte that causes nail fungal infections.
  • Trichophyton interdigitale.
  • Epidermophyton floccosum.
  • Trichophyton violaceum.
  • Microsporum gypseum.
  • Trichophyton tonsurans.
  • Trichophyton soudanense.

Risk Factors

  • Old age
  • Weakened immune system
  • Sweating heavily
  • Swimming in a public swimming pool
  • History of athlete’s foot
  • Walking barefoot in wet or damp areas
  • Use of artificial nails
  • Wearing tight cover shoes such as boots and tennis shoes for an extended period of time
  • Nail injury
  • Diabetes


Symptoms include one or more of the following nail features:

  • Thickened
  • Brittle
  • Distorted shape
  • Raised above the nail bed
  • Yellowish or dark discoloration
  • Painful or foul-smelling in severe cases

There may also be:

  • scaling under the nail – hyperkeratosis
  • yellow or white streaking – lateral onychomycosis
  • yellow spots at the bottom of the nail – proximal onychomycosis
  • infected nails may separate from the nail bed – onycholysis


Proper hygiene is essential in preventing fungal infections.

  • Trim and keep nails short
  • Keep fingers and feet clean and dry
  • Wear comfortable footwear when walking in warm, moist areas.
  • Avoid wearing tight shoes
  • Do not wear the same shoes for a long period of time
  • Put on a clean pair of socks every day and whenever your socks get sweaty.
  • Do not share shoes, nail clippers, and other personal items
  • Treat athlete’s foot as soon as possible
  • Keep skin moisturized
  • Discard or disinfect footwear after treating toenail infection to avoid recurrence


Nail infections can result in complications especially when an individual has a suppressed immune system. This can be due to the presence of a chronic disease like diabetes, medication, or old age.

When To See The Doctor

See the doctor if symptoms do not improve after self-care procedures. It is also important to see the doctor if you have a medical history of chronic diseases like diabetes, HIV, or any other diseases that suppress the immune system.


A doctor makes a diagnosis of a nail fungal infection by examining debris scrappings from the nail under a microscope.

Scraping away the debris beneath the nail can help get rid of the fungus. The following drugs may be prescribed by the doctor to be applied to the nail:

  • Amorolfine
  • Ciclopirox
  • Efinaconazole
  • Tavaborole

In more severe conditions, oral antifungal drugs may be prescribed, these include:

  • Fluconazole
  • Griseofulvin
  • Itraconazole
  • Terbinafine

The non-surgical and surgical removal of the nail is also a treatment modality for severe nail fungal infections.


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