Fungal Nail Infection

Fungi, the plural of fungus, are microscopic organisms that live everywhere - in plants, soil, and even on your skin.


While there are millions of species, only around 300 can cause infections with the skin or nails – so usually they don’t cause problems unless they get into the skin through a cut or lesion, or they begin to multiply more quickly than normal.

Fungal nail infections, which are also called Onychomycosis or tinea unguium, affect the fingernails or, most commonly, the toenails. Infected nails can show discolouration; be brittle and prone to breakage, or can be thicker than usual.

While fungal skin conditions can usually be managed with over-the-counter treatment available at the chemist, it’s often necessary to treat fungal nail infections with prescription medications, and in severe cases, some or all of an affected nail may need to be removed.

Fungi are known to thrive in warm, damp conditions, and because of that, sweaty or moist areas of the skin that aren’t exposed to much airflow tend to be the most common sites of fungal infections – this is why fungal nail infections commonly present in the toenails, because our feet are frequently in shoes and socks.

It’s rarer to have fungal nail infections in the fingernails, and sometimes this can be related to occupational conditions – for example, hairdressers or farmers who often have wet or damp hands. It’s also worth noting that a change in appearance of the fingernails may be a symptom of an underlying condition, so it’s valuable to visit a GP before trying over-the-counter medications to treat a suspected fungal infection in the fingernails.

The condition is prevalent in older people, and almost every elderly person will have a degree of fungal nail infection, but children hardly ever get it.

Symptoms of Fungal Nail Infection

While there are some tell-tale signs of a fungal nail infection – like discolouration or flakiness – the condition may not initially present with obvious visible symptoms.

Signs of fungal nail infection may be;

The nail can turn white, brown, yellow, green or black, which may appear in patches of the nail, cover the whole surface, or appear to change shape as the nails grow.

The affected nail may develop an unusual shape or texture (for example, growing into a curved-over shape instead of being fairly flat), and be difficult to properly trim.

Placing pressure on, or otherwise using the affected toe or finger may be sensitive.

Pieces of the nail may crumble, break off or come away completely


Sometimes, the skin near the site of a fungal nail infection may also develop fungal skin infection, and become itchy, cracked, red or swollen.

Causes of Fungal Nail Infection

Most fungal nail infections occur as a development of the fungi that causes athlete’s foot, or tinea pedis, which affects the skin on the feet, and frequently between the toes.

Typical symptoms of athlete’s foot include itching, burning or stinging sensations either between the toes, or on the soles of the feet; red, scaly, dry, peeling or flaky skin, which may develop cracks or blisters; and in some cases, infection can spread to other areas of the body – like the nails.

People who visit nail salons may be more at risk of developing fungal nail infections as a result of unsterilised, or improperly sterilised equipment.

There are several factors that can increase the risk of fungal nail infections, such as;

  • Living in a damp, or warm climate
  • Heavy sweating
  • Not keeping the feet clean and dry
  • Sharing clothing, shoes, towels, bedding or nail equipment, like clippers
  • Wearing footwear that it tight, and isn’t breathable
  • Walking barefoot in places where fungal infections can easily be spread, such as swimming pools, communal showers, and locker rooms
  • Having a weakened immune system
  • Having certain health conditions, like psoriasis, diabetes, or peripheral arterial disease.

While most fungal nail infections are not serious, and some may respond to over-the-counter treatments, they often don’t, and their appearance – especially in the fingernails - can be a symptom of another more serious condition, so it may be wise to seek advice from a doctor or pharmacist.

If a fungal nail infection has been confirmed, it’s important to reduce the risk of spreading it – either in yourself, or to other people. Some ways to reduce risks include;

  • Ensuring the hands and feet are kept clean and dry
  • Wearing footwear made of natural, breathable materials, and clean socks made of natural fibres (like cotton)
  • Replacing old footwear that may be contaminated
  • Keeping nails short and not sharing clippers or scissors
  • Not sharing towels, socks or shoes with others
  • Making sure towels are washed regularly on a ‘sanitise’ setting
  • Getting footwear to wear in places where fungal infections can easily be spread, such as public pools, showers, and locker rooms

Treatment for Fungal Nail Infection at Derma

While your GP can be very helpful in diagnosing and treating fungal nail infections, we are more than happy to see patients who prefer to consult a private dermatology specialist.

Your appointment will begin with a skin check and medical history, which will allow the dermatologist to diagnose the infection or any skin conditions that may be co-occurring.

Together with the dermatologist, you will discuss the latest and most effective treatments and explain all potential side-effects, enabling you to select the best option for you.

It’s possible that fungal nail infections can be controlled using treatments available from chemists, but depending on your condition, prescription treatment – such as antifungal tablets or antifungal nail paints may be necessary.

Some creams may be prescribed to soften parts of the nails so that the doctor can perform a  to remove infected parts of the nail, stopping the infection from spreading.

The dermatologist will let you know whether it is beneficial to continue with any over-the-counter treatments, or if it is advisable to stop.

In very severe fungal nail infections, it may be necessary to remove the nail entirely, which your dermatologist will discuss with you.

Whatever your needs, you can rest assured that Derma will provide the very best care for your skin, with access to the latest research and treatments.

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