What is a fungal toenail?

A fungal toenail describes an infection of the nail plate and the nail bed beneath it. The medical term for a fungal toenail is onychomycosis, or tinea unguium.

Just like bacteria and viruses, fungi are microscopic organisms that pervade our environment. Fungi tend to reside in moist, dark areas and can thrive beneath a nail plate.

There are three kinds of fungi: dermatophytes, yeasts, and nondermatophyte molds. Dermatophytes are by far the most common cause of onychomycosis, although all three can infect the nail.

Small cracks in your nail or the surrounding skin can allow these germs to enter your nail and cause an infection. Over time, even a mild infection will develop and invade further towards the matrix, where the nail originates under the skin. The nail changes color, thickens, lifts off of the nail bed, and even causes serious discomfort! Early detection and treatment is best. The longer the infection has been present in the nail, the longer it will take to get rid of.

Signs of a fungal infection of the nails include:
• Scaling or buildup of skin below the nail
• White, yellow, or darkened streaks on the surface of the nail
• Crumbling or easily broken corners or tips of the toenail
• Flaking areas or pits in the nail’s surface that may be white in color
• Yellow spots on the bottoms of the nails
• Malformed or distorted toenail growth
• Toenails that lift away from the cuticle
• Thickened nails
• Loss of toenails
• Foul odors, pus, and other signs of infection

Risk factors for developing nail fungus include:
• Being older, owing to reduced blood flow, more years of exposure to fungi and slower growing nails
• Sweating heavily
• Having a history of athlete's foot
• Walking barefoot in damp communal areas, such as swimming pools, gyms and shower rooms
• Having a minor skin or nail injury or a skin condition, such as psoriasis
• Having diabetes, circulation problems or a weakened immune system

How to prevent a fungal infection:
• Wash your hands and feet regularly. Wash your hands after touching an infected nail.
• Keep your nails well trimmed. A long toenail creates a tiny pocket where moisture and debris can collect, creating an excellent breeding ground for fungi.
• Wear sweat-absorbing socks or change your socks throughout the day.
• Choose shoes made of materials that breathe.
• Discard old shoes or treat them with disinfectants or antifungal powders.
• Wear footwear in pool areas and locker rooms.
• Choose a nail salon that uses sterilized manicure tools for each customer.

Treatment
There are limited options to treat a fungal toenail, including oral antifungal medication, topical medication, laser treatment and nail removal. Each varies in effectiveness and patient safety. You should discuss with your doctor which method of treatment is best for you.

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