Onychomycosis: Fungal Toenails

Fungal toenails, also known as onychomycosis, is the most common infection of the nail. When infected, nails become thickened, have a yellowed or whitened discoloration and may be difficult to cut. Nails may become so thickened that they are unable to be cut with traditional nail clippers. Fungal nails may be so dystrophic that they can become ingrown and become infected.

Onychomycosis is an issue more commonly seen in older individuals. Men are more likely to present with fungal nails than women, and diabetics also tend to be more susceptible to this problem. About 30-60% of fungal nails may originate from Tinea Pedis from the surrounding skin. Repeated nail trauma is a also a risk factor because trauma can lead to keratin accumulating underneath the nail, creating a moist, warm environment for the fungus to grow. Humidity and exposure also play a role in fungal infections.

There are many treatments for the care of fungal nails.  If only one or two nails are involved, nail avulsions may be appropriate to try and eradicate the infection and allow for a new healthy nail to grow back. There are multiple topical anti-fungal medications that come in cream, solution, or lacquer forms. Topical treatment is indicated for mild cases, usually when less than half the nails are affected. Depending on the severity of the condition and patient’s overall health, oral medication is also available as a form of treatment. With oral antifungals, liver tests usually must be ordered before and during the medication regiment. Your podiatrist may want to take a sample of affected nails to determine what kind of infection the nail is undergoing. Call your podiatrist today if you have questions or concerns about fungal nails and the treatment options available.

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