Fungal infection of the nail is called “onychomycosis.” It is increasingly common with increased age. It rarely affects children.

Onychomycosis can be due to:

• Dermatophytes such as Trichophyton rubrum cause Tinea Unguium
• Yeasts such as Candida albicans
• Molds especially Scopularis brevicaulis

Tinea Unguium

Tinea Unguim may affect one or more toenails and/or fingernails and most often involves the great toenail. It can be seen in several different ways including streaking of the nail, scaling and thickening under the nail, patches on the nail and complete destruction of the nail

Yeast infection

Candida infection of the nail plate generally results from paronchychia and starts at the cuticle. The cuticle gets becomes swollen and red. The nail may lift off its bed and is tender when you press it.

Mold Infections

Mold infections are indistinguishable from tinea unguim

Onychomycosis must be distinguished from

Bacterial infections, Psoriasis, Eczema, Lichen planus, Warts, Onychogryphosis

Diagnosis

To confirm the diagnosis and identify the infection a clipping of your nail can be taken in the doctor’s office. This will be sent for fungal culture.

Treatment

• Treatment of onychomycosis usually requires an oral antifungal medication such as Terbenifine or Itraconazole
• Mild infections may respond to topical agents such as Penlac nail lacquer
• Treatment is required for a prolonged period and is expensive.
• Fingernail infections are usually cured more quickly and effectively than toenail infections
• Oral antifugal medications interact with medications and can cause side effects. Discuss treatment carefully with your doctor

Recurrences

• Recurrence of fungal nail infection can occur after treatment with either oral antifungal medications or topical agents.
• Many people choose not to treat fungal nail infections due to frequency of recurrence, cost, and risk of side effects from the medication.

Prevention

• Keep toenails trimmed short to prevent trauma
• Use an antifungal cream(i.e. Miconazole, Lanisil cream) on the feet to prevent spread from the nails to the feet
• Use an antifungal powder to control perspiration (Zeasorb AF powder)
• Wash and dry feet properly
• Avoid being barefoot in public places, i.e. swimming pools, locker rooms