Onychomycosis is a fungal infection of the nails. It is common on the toenails of some adults.

Who gets onychomycosis ?

Generally adults, and some older children, get onychomycosis, particularly if they have tinea pedis or athlete’s foot, a superficial fungal infection of the feet.

How do I know if I have it ?

There are several different ways the nail can appear when infected with fungus. A common presentation is that the nail appears discolored (e.g. white or yellow) and thickened, with scale under the tip of the nail. There is also a superficial form, in which the nail gets a white appearance where there is infection, often at the distal edge of the nail, without much textural changes. Additionally, sometimes the affected nail/s can lift off of the finger as a result. It is best diagnosed by a health professional such as a dermatologist. A sample in certain cases can be sent to support the diagnosis.

How can I treat it ?

Onychomycosis has traditionally required oral antifungal therapy for a period of months. Now newer topical medicines, if covered by ones insurance, can be used daily for about 1 year with good results. It is important to note that even after prolonged treatment and seeming eradication, onychomycosis has a high recurrence rate. Therefore, it is important to consider the risks and benefits of moving forward with treatment. Also, once a decision is made to treat it, it is important to take some measures to try to prevent recurrence, see section below.

How can I prevent it ?

One can potentially prevent onychomycosis by preventing fungal infection of surrounding skin. For the hands, it is important to avoid prolonged exposure to a moist environment, e.g. continuous use of non-breathable gloves. If one needs to wear gloves for occupational reasons, it is important to periodically air out the hands whenever possible. In the case of toenail fungus, it is important to treat any athlete’s foot present and prevent new infection by periodically using topical anti-fungals on the feet (e.g. every 2 weeks), having others in the household evaluated for foot fungus, and avoiding direct contact with potentially contaminated environments (e.g. gym floors). Additionally, it may help to keep the nail and surrounding skin healthy by avoiding topical irritants and frequently using a moisturizer, to prevent breaks in the skin which allow for fungal entry.

When should I see a dermatologist about it ?

You can see a dermatologist for your onychomycosis at any time, to confirm the diagnosis and consider treatment options.