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Onychomycosis (tineaunguium) is a fungal infection of the fingernails or toes. The fungal infection does not limit itself to the nails, but spreads to the nail bed, matrix or even the plate. Onychomycosis more oftenly affects the toenails than the nails.


Onychomycosis is a common fungal infection that accounts for 20% of the cases related to nail diseases. It most often affects adults and mostly those who are over the age of 60 develop it. The condition usually appears as a yellow or white spot under the toenail or fingernail. As the infection spreads, the nail begins to discolor, thicken as even crumble around the edges.


The symptoms of onychomycosis include:

  • The nail becomes thick and discolored. It appears white, yellow, green or even black
  • The nail becomes brittle as the infection spreads. The brittle nail pieces can break off from the finger or nail completely
  • When left untreated, it leads to pain and inflammation under the nail
  • The skin around the nail becomes scaly and may also turn yellow or white in color
  • There may be a foul smell emitted from the affected nail
  • The shape of the nail becomes distorted
  • The nail loses its shine and becomes very dull
  • This disfiguration becomes a cosmetic problem for most people as infection of the fingernails is visible and causes a lot of social embarrassment

In most cases, if the infection is mild, it does not cause pain or severe disfiguration.


Onychomycosis is usually caused by a dermatophyte fungus. It can also be caused due to a yeast (Candida) or mold infection.

Risk Factors

Age is the biggest risk factor that can lead to onychomycosis. This happens due to reduced blood circulation due to aging. People living in humid or moist environments, wear socks and shoes for long periods that prevents ventilation, walking barefoot near community swimming pools, shower rooms, suffer from cuts and nail injury, have diabetes, circulation problems, weak immune system, etc. are all susceptible to fungal infection.


Onychomycosis requires lab testing of the nail scraping or clippings to differentiate it from nail psoriasis, contact dermatitis, yellow nail syndrome, trauma or melanoma. A culture of the nail scraping, histology report and potassium hydroxide smear, helps determine the type of fungal infection.


The treatment for onychomycosis is a bit difficult, but not impossible. This is because the infection is embedded within the nail and very difficult to reach. One should never self-medicate without proper diagnosis as in most cases, it is a simple case of nail disfigurement and not a fungal infection.

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In case of fungal infection, the doctor may advise:

  • Topical or oral antifungal medications. The oral medications includeterbinafine, itraconazole, fluconazole, etc. Topical agents such as ciclopirox nail paint, efinaconazole,etc. are prescribed.


The treatment may take up to a year as onychomycosis occurs deep within the nail. As the new nail takes a year to grow, the infection may linger till the affected nail is completely replaced.

Onycomycosis is a common fungal infection that can remain asymptomatic or mild in most cases. Such cases may not even require any treatment as the chances for potential complications is very less. One should make sure they dry their feet well after a bath, wear absorbent socks, keep their nails short and trim them regularly to prevent a replace of the infection. For further details, speak to your doctor for more information.

Written by: healthplus24.com team

Date last updated: March 02, 2015

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