Understanding Tinea Unguium

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Tinea unguium is caused by a fungus. Several different types of fungus can grow on the nails.

The condition is much more likely to occur on the toenails. It can spread from one nail to another. You are more likely to get tinea unguium if you:

• Have another fungal infection, such as athlete’s foot

• Have sweaty feet

• Share nail clippers with a person who has a fungal infection

• Swim often

• Walk barefoot in damp areas, such as locker rooms

• Use communal or shared showers

• Wear artificial nails

If you have an infected nail, it may become:

• Brittle

• Thick

• Hard

• Discolored, yellow to brown

• Irregular, in a curled down or distorted shape

• Separated from the nail bed

The nail may also have crumbling white or colored material under it.

If left untreated, the fungus may spread to the nail bed, which is the skin under the nail. The nail may

also fall off.

Tinea unguium is diagnosed by looking at nail clippings under a microscope. Medical treatment is not needed for all people. It's helpful for those who have cellulitis on their legs or feet that comes back again and again. It's also helpful for people who have diabetes plus risk factors for cellulitis, a weak immune system, nail pain, or concerns about how their toenails look.

With correct treatment, tinea unguium may be cured. But it often takes several months as the nail grows. It's common for tinea unguium to return even after treatment.

Treatments include:

• Good hygiene. Keep feet and nails clean and dry. If the infection is on the toenails, check that your shoes fit correctly.

• Medicine. Over-the-counter antifungal products, such as creams, generally don't cure the infection, but they may ease symptoms. If you have a severe infection, or the infection won’t go away, you may need to use a prescription-strength antifungal antibiotic on the nail, or take an antifungal antibiotic by mouth. The oral antibiotic usually needs to be taken for 3 to 4 months for the most benefit. Some of these oral medicines can have side effects, but they are usually manageable. The oral medicines may not be recommended for those with liver or heart problems.

• Surgery.  The nail may be removed both surgically or nonsurgically with a chemical applied to the nail. This treatment will need wound care and there is still a high chance the fungus will return.

• Laser. A special type of laser directed at the nail itself can kill the fungus

• Photodynamic treatment. Certain special light therapies can be used to kill the fungus.

Call your healthcare provider right away if any of the following occur:

• Pain that gets worse

• Symptoms that don’t get better, or get worse

• New symptoms