Nail Fungus Fact Sheet

What is Nail Fungus? 

Nail fungus or onychomycosis occurs when fungi infect one or more of your nails. A nail fungal infection may begin as a white or yellow spot under your toenail. As the nail fungus spreads deeper into your nail, it may cause your nail to discolor, thicken and develop crumbling edges and may become painful. Infection with nail fungus occurs more in toenails than in fingernails because toenails are often confined in a dark, warm, moist environment inside your shoes — where fungi can thrive. 

 

How can I tell if I have nail fungus? 

You may have a nail fungal infection if one or more of your nails are: 

  • Thickened  

  • Brittle, crumbly or ragged 

  • Distorted in shape  

  • Discolored nail (yellow or brown) 

What are the risk factors? 

  • Sweaty feet/ Working in a humid or moist environment 

  • Walking barefoot in damp public places, such as swimming pools, gyms and shower rooms 

  • Having athlete's foot (tinea pedis) 

  • Having a minor skin or nail injury, a damaged nail or another infection 

  • Having diabetes, circulation problems or a weakened immune system (ex: HIV/AIDS) 

What are the treatment options available? 

There are many treatment options available, however it is important to note that the appearance of a healthy nail can take up to 12 months or more and patients must use the medication as directed until the infection is resolved. 

  • Currently there are five oral medications to prescribed treat nail fungus, terbinafine (Lamisil), itraconazole (Sporanox), griseofluvin (Gris-Peg), and, fluconazole (Diflucan). 

  • Topical medications include Fungoid Tincture (miconazole nitrate), Penlac® Nail Lacquer (ciclopirox), and, ketoconazole (nizoral) with DMSO. There is a nail lacquer in clinical trials from NexMed that may soon be available. 

 

For better results, both oral and topical treatment options should be supplemented with regular trimming and debridement of the nails.  

Remember: Resolution of the fungal infection of the nails is a lengthy process that can easily take one year to resolve. Be patient and continue to use the medication as directed throughout the process.