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Fungal Infection of the Toenails  
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Copyright © Nucleus Medical Media, Inc.

Definition  

Onychomycosis is an infection of the nail. The infection occurs more often on toenails than fingernails.

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Causes  

Onychomycosis is caused by a fungus. The fungi that cause onychomycosis survive in warm, moist environments. It is spread through direct contact with the fungus.

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Risk Factors  

Anyone can get fungal nail infections. Factors that increase your chance of onychomycosis include:

  • Wearing shoes that trap in moisture and warmth, such as workboots
  • Increased age
  • Having athlete's foot
  • Having an injury to the nail
  • Type 1 or type 2 diabetes
  • Circulatory disorders, such as peripheral vascular disease (PAD)
  • Immune system disorders, such as HIV
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Symptoms  

Onychomycosis can affect one or more nails. It most commonly occurs on toenails.

Onychomycosis may cause:

  • Thickened nail that is difficult to cut
  • Brittle or ragged nail
  • Discolored or unsightly nail
  • Pain in the nail when doing ordinary activities
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Diagnosis  

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may need to be referred to a doctor who specializes in skin and nail disorders (a dermatologist). The doctor may scrape or clip the nail to send a sample for testing. Results make take several weeks.

Tests on the nail sample may include:

  • Culture
  • Examination under a microscope
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Treatment  

Nails grow slowly. It can take up to a year to have a completely clear nail. Onychomycosis can be difficult to treat and may return after treatment. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Medications  

Antifungal medications are used to treat onychomycosis. Medications may be oral or topical.

Surgery  

Surgery to remove the nail is sometimes done in severe cases. A new nail grows in its place unless the nail matrix that makes the nail is destroyed.

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Prevention  

To help reduce your chance of onychomycosis:

  • Keep your feet clean. Dry them completely after washing.
  • Keep your hands dry and wear rubber gloves when cleaning.
  • Keep nails short and clean. Trim them straight across.
  • Do not trim or pick at the skin near your nails.
  • Avoid injuring your toenails.
  • Avoid shoes that are too tight.
  • Wear absorbent cotton socks. Change them if they become damp.
  • Avoid walking barefoot around swimming pools, locker rooms, and other public places.
  • Avoid artificial nails. They can trap moisture.
  • If you have diabetes, see your doctor about steps you can take to control your blood sugar.