Fingernail and toenail fungus is a surprisingly stubborn issue faced by many worldwide. Whether it starts with a small spot of discoloration or nails that gradually thicken and harden, this condition, known as onychomycosis, often creeps in unnoticed before becoming a frustrating and long-term challenge.
Although nail fungus itself is rarely life-threatening, neglecting treatment can result in serious complications such as cellulitis, tissue damage, osteomyelitis (a bone infection), or nail loss. Each type of nail fungus requires a tailored approach, so understanding the different infections that can cause onychomycosis and their unique symptoms is key to addressing the problem effectively.
Types of Nail Fungus
Nail fungus, or onychomycosis, can be caused by various organisms, including dermatophytes, yeast, or mold. Learning to differentiate between these different types of infection is critical for choosing the appropriate treatment.
Onychomycosis
This general term refers to any fungal infection of the nails. While it can affect either fingernails or toenails, it occurs most commonly in toenails and affects between 1 and 8% of people in the United States.1 It’s characterized by thickened, discolored nails that may be brittle or prone to cracking.
Dermatophytes
Dermatophytes are the most common cause of onychomycosis, responsible for 90% of toenail and 50% of fingernail fungal infections.1 These fungi thrive on keratin, the protein that makes up the structure of nails. Dermatophytes typically infect toenails and are more prevalent in warm, moist environments, such as communal showers or pools.
Yeasts (Candida Species)
Yeast infections, primarily caused by the Candida species, are less common than dermatophyte infections but are still prevalent, especially among individuals with weakened immune systems. Candida thrives in warm, moist environments, often affecting fingernails more than toenails. Conditions that compromise nail health, like frequent hand washing, can increase susceptibility to yeast infections.
Non-Dermatophyte Molds
Although relatively rare, non-dermatophyte molds are another type of fungus that can infect nails. They are often associated with specific environmental conditions, such as working in damp environments. These infections can be challenging to treat, often requiring specialized care.
Fungi typically enter the nail through small cracks or injuries, allowing the organism to establish itself and grow in the nail bed. For this reason, protecting nails from trauma and keeping them dry are essential preventive measures.
Symptoms of Nail Fungus
Recognizing the symptoms of nail fungus early on is key to effective treatment and minimizing nail damage. Common signs include:
- Discoloration: Infected nails may turn yellow, white, brown, or even black.
- Thickening and brittleness: The nail may become thick, hard to trim, and break or crumble easily.
- Distorted shape and texture: Fungal infections can cause nails to change shape, appear ragged, or develop ridges.
- Nail separation: In severe cases, the infected nail may detach from the nail bed, a condition known as onycholysis, which can be painful and cause further complications.
Nail Fungus vs. Psoriasis
While nail fungus is common, it can sometimes be mistaken for other nail conditions, most notably psoriasis. Nail psoriasis affects 10 to 82% of people with the autoimmune condition psoriasis.2 Although nail fungus and psoriasis symptoms resemble each other, the conditions require very different treatments. Understanding the key differences is essential for accurate diagnosis and appropriate treatment.
Distinguishing Features and Symptoms
Unlike fungal infections, which often present with yellowish discoloration and nail thickening, psoriasis may cause pitting (small depressions in the nail surface), crumbling nails, oil drop signs, blood under the nail, and detachment.3
In addition to psoriasis, conditions like eczema, lichen planus, and trauma can also mimic the appearance of nail fungus. If you suspect you have nail fungus, psoriasis, or other nail condition, consult a healthcare professional. They may conduct tests, like a nail culture or biopsy, to accurately diagnose the cause and recommend appropriate treatment.
Treatment and Care Differences
Treating nail fungus effectively requires individualized care based on the type of fungus causing the infection. The following are general guidelines for common fungal types:
Dermatophytes Treatments
Over-the-counter (OTC) topical treatments, such as antifungal creams containing Tolnaftate, can be effective for dermatophyte infections, particularly in mild cases.4 PROclearz Fungal Shield is an OTC brush-on antifungal liquid that contains 1% Tolnaftate and is clinically proven to cure and prevent dermatophyte infections of the skin around, adjacent to, and under toenails and fingernails.
Yeast Infection (Candida) Treatments
Candida-related infections may respond to specific OTC antifungal treatments tailored to target yeast. These are typically more effective for fingernail infections than toenail ones.
Non-Dermatophyte Molds
Non-dermatophyte infections are harder to treat and may not respond well to standard OTC treatments. In such cases, a healthcare professional may recommend prescription cream or nail polish, oral antifungals, or even minor surgical procedures if necessary.
Good and Preventive Nail Care
Good and preventive nail care is the foundation of long-term nail health and reduces the risk of fungal infections. Incorporate these simple habits into your daily routine to prevent fungal infections and grow strong, healthy nails.
- Trim nails properly: Trim nails straight across, rounding the edges slightly to prevent ingrown nails, which can lead to infection.
- Moisturize: Keeping nails and surrounding skin hydrated reduces the risk of cracks, which create entry points for fungi. Look for nail-specific moisturizers or cuticle oils.
- Avoid trauma: Protect nails from potential injury by wearing gloves during manual labor and activities like gardening or washing dishes, which exposes nails to moisture.
- Protect your feet in public places: Wear flip-flops or waterproof sandals in moist, public areas like pools, gyms, locker rooms, saunas, or public showers where people frequently walk barefoot.
- Change socks daily: Clean, dry socks help reduce fungal growth around your feet and toenails.
- Do regular check-ups and self-exams: Periodically inspect nails for any unusual changes to identify and treat issues early.
Conclusion
Nail fungus is a common condition caused by various fungi, each capable of producing different symptoms and levels of severity. Understanding the primary types of fungal infections helps you recognize symptoms and choose the most effective treatment options. Good nail care—including proper trimming, moisturizing regularly, and scheduling periodic check-ups—is essential for preventing nail fungus and maintaining overall nail health.
If you have a mild fingernail or toenail fungal infection, over-the-counter antifungal products like PROclearz Fungal Shield can effectively treat the condition and prevent recurrence. BRITE NOW is a brush-on treatment can help improve the appearance of damaged or discolored fungal nails until the infection is resolved.
If symptoms persist or worsen, consult your healthcare provider for personalized advice and treatment tailored to your specific condition.
References
1. Bodman MA, Syed HA, Krishnamurthy K. Onychomycosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 9, 2024.
2. Battista T, Scalvenzi M, Martora F, Potestio L, Megna M. Nail Psoriasis: An Updated Review of Currently Available Systemic Treatments. Clin Cosmet Investig Dermatol. 2023;16:1899.
3. What is nail psoriasis, and how can I treat it? American Academy of Dermatology Association. Accessed November 21, 2024.
4. Brescini L, Fioriti S, Morroni G, Barchiesi F. Antifungal Combinations in Dermatophytes. Journal of Fungi. 2021;7(9):727.
