Fungal nail infection
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Definition
Fungal nail infection is an infection of the nails by a fungus.
Alternative Names
Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium
Causes, incidence, and risk factors
The body normally hosts a variety of bacteria and fungi. Some of these are useful to the body. Others may multiply quickly and form infections. Fungi can live on the dead tissues of the hair, nails, and outer skin layers.
Fungal infections include mold-like fungi that cause:
Ringworm on the skin of the body or head
Fungal nail infections are most often seen in adults. They often follow fungal infection of the feet. Toenails are affected more often than fingernails.
People who often go to public swimming pools, gyms, or shower rooms, and people who sweat a great deal, often have mold-like infections. The fungi that cause them thrive in warm, moist areas.
The following increase the risk of a fungal infection:
References
Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Saunders Elsevier: pp 491-523.
Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2009:chap 267.
Review Date: 10/4/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium
Symptoms
- Nail changes on one or more nails (usually toenails):
- Brittleness
- Change in nail shape
- Crumbling of the outside edges of the nail
- Debris trapped under the nail
- Loosening or lifting up of the nail
- Loss of luster and shine
- Thickening of the nail
- White or yellow streaks on the side of the nail
Signs and tests
Your doctor will suspect a fungal infection based on the appearance of the nails.
The diagnosis can be confirmed by scraping the nail and:
Looking at it under a microscope to identify the type of fungus
Sending it for a culture (however, it may take up to 3 weeks to get results)
References
Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Saunders Elsevier: pp 491-523.
Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2009:chap 267.
Review Date: 10/4/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium
Treatment
Over-the-counter creams and ointments generally do not help treat this condition.
Prescription antifungal medicines taken by mouth may help clear the fungus.
You will need to take the medicine for about 2 to 3 months for toenails; a shorter time for fingernails
Fluconazole griseofulvin, terbinafine, and itraconazole are used to treat this condition.
Your health care provider will do lab tests to check for liver damage while you are taking these medicines.
In some cases, the health care provider may remove the nail. Nails grow slowly. Even if treatment is successful, a new, clearer nail may take up to a year to grow in.
Expectations (prognosis)
The fungal nail infection is cured by the growth of new, non-infected nails.
Fungal nail infections may be difficult to treat. Medicines clear up fungus in about 50% of patients.
Even with successful treatment, it is common for the fungus to return.
Complications
- Fungal infections that return on the nails or in other parts of the body
- Permanent damage to the nails
- Skin infections, including paronychia
Calling your health care provider
Call your health care provider if:
You experience persistent fungal nail infections
Your fingers become painful, red, or drain pus
References
Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Saunders Elsevier: pp 491-523.
Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2009:chap 267.
Review Date: 10/4/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Nails - fungal infection; Onychomycosis; Infection - fungal - nails; Tinea unguium
Prevention
Good general health and hygiene help prevent fungal infections.
Do not share tools used for manicures and pedicures.
Keep the skin clean and dry.
Take proper care of your nails.
Wash and dry your hands thoroughly after contact with any fungal infection.
References
Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Saunders Elsevier: pp 491-523.
Hay RJ. Dermatophytosis and other superficial mycoses. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2009:chap 267.
Review Date: 10/4/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 10/4/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.