When nail fungus sets in, they become thicker and yellow and may have white spots and streaks. One type of fungus causes onychomycosis, the most common nail fungus. It most commonly affects toenails, but it can also affect fingernails. Here, on the Digital Clinics platform, you can get advice and answers to all the questions you have, from dermatologists with a lot of experience in treating this medical condition.

What is nail fungus?

Toenail fungus is a widespread fungal infection that affects the toenails. Less commonly, nail fungus can infect the fingernails. The condition occurs when fungi penetrate between the nail and the nail bed (the tissue immediately under the nail). This usually happens through a crack or cut on the toe.

What is onychomycosis?

When dermatophytes cause nail fungus, the condition is called onychomycosis. A dermatophyte is a type of mold that needs a protein called keratin to grow. Keratin is the protein that nails are made of. Dermatophytes cause 90% of fungal toenail infections.

Who is affected by nail fungus?

Anyone can contract nail fungus. But it mainly affects the elderly, especially those over 60 years old.

You may be at higher risk of getting nail fungus if you have:

• Athlete's foot
• Diabetes
• Hyperhidrosis (a condition that causes excessive sweating)
• A nail injury
• Poor blood circulation due to vascular diseases
• Psoriasis
• A weakened immune system, such as with an autoimmune condition or HIV

How common is nail fungus?

Nail fungus is very common, especially as people age. Medical experts estimate that onychomycosis affects 1 in 10 people overall. This figure rises to 1 in 2 (50%) for people over 70.

Symptoms and Causes

What does onychomycosis look like?

Nail fungus can change the appearance of the toenail in several ways. Nails can:

• To change its color, becoming white, yellow or brown
• They looked as if they were covered with a gray or muddy film in some places
• To thicken and appear distorted
• To detach from the nail bed (leaving a space between the nail and the underlying skin).
• To crack or tear in one or more places

What causes onychomycosis?

A type of fungus called dermatophyte causes nail fungus. Dermatophytes are fungal microorganisms (too small to be seen with the naked eye). They feed on keratin, a protein found in fingernails and toenails. Keratin is what makes nails hard.

Dermatophytes are the cause of 90% of fungal toenail infections. However, other types of fungus can also infect toenails.

Is nail fungus contagious?

Yes, many types of nail fungus, including onychomycosis, are quite contagious. You can pass the fungus on to someone else through direct contact. You can also get nail fungus by touching an infected surface.

Nail fungi prefer warm, moist and dark places. You can contract nail fungus by:

• Walking barefoot around pools.
• Use of gyms or public showers.
• Walking barefoot in public spaces.

Can nail fungus spread to other areas of the body?

Onychomycosis can spread to:

• Other toenails
• The skin between the toes (a condition called athlete's foot)
• Groin area (condition called inguinal mycosis)
• Scalp (the skin on the top of the head)

Diagnosis and analysis

How is nail fungus diagnosed?

The dermatologist will first carefully examine the affected nail to assess the symptoms. It can identify nail fungus just by looking at your nail. However, the doctor may also order tests to confirm a fungal infection.

Treatment of onychomycosis

How is nail fungus treated?

Nail fungus is difficult to treat. It may take several months of treatment to get rid of the fungus. And even so, let it often return.

The most effective treatment for nail fungus will depend largely on your symptoms and personal situation. It is necessary for the dermatologist to customize a treatment plan for each individual patient.

In general, oral antifungal medications may provide the most successful treatment. Combining oral medications with topical antifungal medication can make treatment more effective.

Prevention

How can I prevent nail fungus?

There is no way to guarantee that you will not contract nail fungus. However, you can take several steps to help prevent it:

• Avoid going barefoot in public areas such as public showers, gyms and swimming pools. Most people contract the fungus in these situations. It is helpful to wear flip flops in these public areas.
• If you have a family member with toe or toenail fungus, use a different shower or wear flip-flops in the shower to avoid contact with it.
• Trauma from accidental or aggressive nail clipping can become entryways for the fungus.
• Clean nail clippers before use.
• If you have diabetes, follow all foot care recommendations from your doctor.
• Keep your feet dry. Be sure to dry them completely after a bath or shower.
• Soak your toenails in warm water before clipping them.
• Cut your toenails straight (don't round the edges).
• Wear shoes that fit properly. They should not be too tight or too loose around the toes.

If you are experiencing the symptoms described in this article, you are one click away from an online consultation with dermatologists with at least five years of experience, from our telemedicine platform.