Fungal Infection of the Nail (Onychomycosis or Tinea Unguium)

Fungal infections of the nail (also known as onychomycosis) are very common and can co-exist with fungal infection of the feet.  Toe nails are more commonly affected than finger-nails because of the sweaty nature of wearing shoes or by walking barefoot on wet areas in public spaces such as changing rooms or swimming pools.  People at risk include those who work in wet dirty areas, have poor immune system (such as on cancer treatment) or have diabetes which is poorly controlled.

Symptoms & Signs

Most fungal nail infections are not serious.  However, they may be itchy or cause discomfort due to the nail becoming discoloured (yellow colour), thickened, brittle and can become cracked or even break off.

Prevention

Fungal skin infection tend to recur even after successful treatment because of the lifestyle or risk factors.  Try to follow these useful tips can help prevent the infection from recurring or developing in the first place;

• Wash your feet and bathe regularly before sleep
• Change out of your wet clothes or socks where possible
• Keep your toenails short and clean
• Apply powder to keep your skin dry and reduce dampness throughout the day
• Avoid shoes or clothes made of nylon or plastic because they make your feet or body sweaty
• Avoid walking barefoot on wet areas in public places which may be dirty
• Avoid going to nail salons which do not sterilise their instruments such as nail clippers or nail files

Treatment

Like other fungal infections, fungal infections of the nails may even be more difficult to cure completely because they tend to recur unless you take precautions to avoid the risk factors such as personal hygiene as well as having a healthy diet and lifestyle.  Treatment may take several months to work because nails are very slow growing. Treatment options include;

Anti-fungal nail polish which contain lactic or acetic acid (such as Emtrix, SFN10) or amorolfine (such as Loceryl 5%) 

Anti-fungal creams (for small areas of infection) such as Ketoconazole 2% or Econazole 1%

Oral anti-fungal medicines may be required where the infection is quite deep or treatment has failed with topical nail treatment.  The most common anti-fungal medication include;

• Fluconazole
• Itraconazole
• Butenafine
• Terbinafine

You need to finish the entire course of the medication and NOT STOP prematurely otherwise there may be a risk of recurrence.  While on treatment, adopt good hygiene and keep the infected area dry and clean.  DO NOT go swimming or share towels, in case you spread the infection to other people.  If your condition does not improve despite using the treatment above, you may need to see an Orthopaedic Foot Specialist to have the nail infection removed using surgery. 

Consult your Doctor or Pharmacist for treatment advice

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If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.