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Fungal nail infection

Nails - fungal infection; Onychomycosis; Tinea unguium

Fungal nail infection is a fungus growing in and around your fingernail or toenail.

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Nail infection - candidal
Yeast and mold

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Causes

Fungi can live on the dead tissues of the hair, nails, and outer skin layers.

Common fungal infections include:

Fungal nail infections often start after a fungal infection on the feet. They occur more often in toenails than in fingernails. And they are most often seen in adults as they age.

You are at higher risk of getting a fungal nail infection if you have any of the following:

Symptoms

Symptoms include nail changes on one or more nails (usually toenails), such as:

Exams and Tests

Your health care provider will look at your nails to find out if you have a fungal infection.

The diagnosis can be confirmed by looking at scrapings from the nail under a microscope. This can help determine the type of fungus. Samples can also be sent to a lab for a culture. (Results may take 4 to 6 weeks.)

Treatment

Over-the-counter creams and ointments usually do not help treat this condition.

Prescription antifungal medicines that you take by mouth may help clear the fungus.

Laser treatments may sometimes get rid of the fungus in the nails. This is less effective than medicines.

In some cases, you may need to have the nail removed.

Outlook (Prognosis)

The fungal nail infection is cured by the growth of new, non-infected nails. Nails grow slowly. Even if treatment is successful, it may take up to a year for a new clear nail to grow.

Fungal nail infections may be hard to treat. Medicines clear up fungus in about one half of people who try them.

Even when treatment works the fungus may return.

When to Contact a Medical Professional

Call your provider if:

Prevention

Good general health and hygiene help prevent fungal infections.

Related Information

Athlete's foot
Jock itch
Ringworm
Ringworm of the scalp
Rash - child under 2 years
Candida infection of the skin
Paronychia

References

Habif TP. Nail diseases. In: Habif TP, ed. Clinical Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 25.

Holguin T, Mishra K. Fungal infections of the skin. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2019. Philadelphia, PA: Elsevier; 2019:981-984.

Tosti A. Tinea unguium. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 243.

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Review Date: 10/14/2018  

Reviewed By: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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