Onychomycosis: A Fungal Nail Infection
July 28, 2021 | Farah Jassawalla

Onychomycosis: A Fungal Nail Infection

Onychomycosis is an infection of the nail bed, plate or matrix caused by different species of fungi. A person suffering from onychomycosis experiences a variety of symptoms such as yellow or white nail discoloration, pain, discomfort, etc.

Onychomycosis, also known as tinea unguium, is an infection in which both the toenails and the fingernails get affected. However, studies show that the toenails get infected more than the fingernails because of their slower growth, reduced blood supply, and frequent confinement in dark and moist environments.

If the infection is mild, no treatment is required. In addition to self-care procedures, medical treatment must be carried out to treat severe infections.

What are the types of onychomycosis?

The five most common types of onychomycosis are:

       Proximal subungual onychomycosis

       Distal subungual onychomycosis

       Candidal onychomycosis

       White superficial onychomycosis

       Total dystrophic onychomycosis

What are the causes of onychomycosis?

The nail becomes dry and brittle as it ages. Fungi enter the nail through the resulting cracks and cause infection. The causative pathogens are candida (yeasts), dermatophytes and non-dermatophyte molds. Out of these three classes of fungi, the dermatophytes class is the most common cause of onychomycosis. Poor blood circulation to the feet or a weak immune system also play a vital role in the formation of this fungal infection.

What are the risk factors of onychomycosis?

The factors that increase the risk for developing nail infections are:

       Excessive sweating

       Injured nail

       Skin conditions like psoriasis

       Weak immune system


       Ringworm on the foot (athlete’s foot)

       Poor blood circulation

       Slow growth of nails

       Walking barefoot in gyms or shower areas

What are the symptoms of onychomycosis?

The symptoms of onychomycosis vary depending upon the severity of the infection. The most common symptoms include:

       Yellow or white nails

       Cracked nails

       Foul smell

       Nails break easily

       Nails become thick

       Nails become brittle

       Pain underneath and around the nail

       The skin around the nail becomes inflamed

       Dermatophytids (skin lesions that spread to other parts of the body other than nails)

Other psychosocial symptoms include:


       Feeling anxious around people

       Loss of self-confidence

How can you prevent onychomycosis?

The ten steps taken to prevent onychomycosis are:

1.    Wash your hands and feet frequently

2.    Dry them properly

3.    Do not share your nail clippers with other people

4.    Avoid using public showers.

5.    Do not walk barefoot

6.    Avoid using nail polish

7.    Apply moisturizer after washing your hands

8.    Change your socks regularly

9.    Choose shoes made of materials that allow your feet to breathe (ventilation)

10. Choose a salon with an aseptic environment

What is the diagnosis of onychomycosis?

The following tests/steps are performed for the diagnosis and the confirmation of the infection:

       patient history

       the severity of symptoms.

       Monitoring the appearance of the infected area

       laboratory tests such as potassium hydroxide smear, culture, histology examination and polymerase chain reaction.

What is the treatment of onychomycosis?

The treatment depends upon the severity of the infection and the type of fungus causing it.  Many Self-care strategies, antifungal drugs, surgery and over-the-counter medications can be used to treat onychomycosis. The antifungal medications may include:

     Ciclopirox: It is an antifungal nail polish that is applied to the nails and the surrounding skin.

     Itraconazole (Sporanox): It replaces the infected nail with a new nail.

     Terbinafine Hydrochloride: An antifungal cream that is rubbed into your nails to prevent fungus growth.

You can book your appointment at Shifa4U to acquire these medications online.

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.