A nail fungus infection (known by its medical name of onychomycosis) most commonly affects toenails, but it can also occur in fingernails too. It’s caused by a fungus that attacks the nail bed. The first sign is often a small white or yellow spot underneath the nail. From there it spreads into the nail itself and becomes more noticeable.
If you have a fungal nail infection, one of the other main symptoms you’ll notice is that your nails will thicken and become discoloured. They can turn black, green, yellow or white in tone. There may also be soreness or pain present around or on the site of infection.
Your nail may become ragged looking or feel crumbly and this can lead to easy tears and breakages. Your nails might feel jagged and brittle.
A nail fungus infection may need prompt treatment to stop the nail becoming permanently damaged. In some cases it can also come away from the bed itself, so you lose the nail.
Who gets nail fungus?
Whilst nail fungus infections can affect anyone, no matter what their age or stage of life, they’re more common in people over the age of 55.
Certain health conditions can also make you more predisposed to getting them too. If you have diabetes, psoriasis or poor circulation, you can be more susceptible.
Similarly, if you have auto-immune conditions or have a weakened immune system due to prolonged ill health, you may also find you’re more likely to get nail fungus infections.
External factors such as regular hand washing or prolonged contact with water (for instance if you work in a role such as hairdressing) can also make fungal nail infections more likely, as can living in warm or hot climates, where you’re more likely to sweat.
Being a smoker may raise your risk of getting nail fungus infections too.
How common are nail fungus infections?
It’s estimated that, at any one time, 10% of the global population has a nail fungus infection. The rates of infection have increased over the last decade, in predominantly Western countries. This is likely due to an increasingly ageing population and regular lifestyle changes (such as more holidays in warmer climates).
For most people, they aren’t serious, but they can take a while to treat and can often recur once you’ve had one or two infections.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Nail fungus
What causes nail fungus?
In most cases, nail fungus infections are caused by a particular type of fungi known as dermatophytes. They have a particular liking for keratinised tissue (this is basically your hair, nails, and skin), they like to use these bits of our body to feed off and then infect.
Sometimes nail fungus infections can be caused by infections like candida (the overgrowth of yeast in your body). Candida is a condition that can affect many areas of your body in different ways. For instance, it can cause thrush infections and it can also cause skin complaints like angular cheilitis too.
Nail fungus infections are also frequently linked to other skin conditions such as athlete’s foot. This is when the skin on the feet which surrounds the nails and toes becomes itchy and scaly. You’ll often find it flakes off when you take off footwear or socks, or are drying your feet after bathing. If this is left untreated the microspores that it creates attack the nail bed and go into the nail itself, causing the infection.
What are the symptoms of a nail fungus infection?
The first sign you may notice is that you develop a yellow or white spot underneath your nail. Once the infection takes hold, your nail will start to thicken and discolour to a green, yellow or white tone.
Once this has happened, your nails can become ragged in appearance or crumble and break easily at the edge.
Nail fungus infections can infect just one nail, or several nails on one or both feet. They almost always need medical treatment to clear.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Nail fungus
What medications are there for nail fungus?
Treating a nail fungus infection can be done in a number of ways, depending on how quickly it’s caught. Our clinician will talk to you about any other health conditions you have, other medications you are taking and your general overall health before deciding the best course of treatment for you.
There are a range of different treatment options. Firstly, there are tablets like Itraconazole and Terbinafine. They are both the same form of medication (triazoles). These work by getting into your bloodstream to kill the infection at its source.
There are also topical treatments that come in different liquid forms that can be used for milder fungal nail infections. Ciclopirox is similar to a nail polish in that you paint it onto your nail and leave it to sink in and quell the infection. Or you could get a medicated cream, like Jublia, that you rub into your infected nail after soaking.
Is there a ‘best’ treatment for nail fungus?
Generally, oral treatments such as Itraconazole are considered to be the most successful at treating fungal nail infections, especially if they are well established. Ciclopirox and Jublia will help if the infection is relatively mild.
However, nail fungus infections can be tricky to get rid of once they have taken hold, and can sometimes have high recurrence rates. Oral treatments have great success rates in helping with nail fungus infections but often come with a higher risk of side effects. You may perhaps feel nauseous or have indigestion when taking them at first, whilst your body adjusts to the tablets.
Does nail fungus always need treatment?
Yes. A nail fungus infection will rarely disappear without some form of treatment. If the infection is mild then a topical treatment, combined with careful foot hygiene, may be enough to stop the infection from spreading further.
If the infection is deeper, though, or already causing a lot of pain and discomfort, then you should talk to a doctor to discuss different treatment options.
There are things you can do at home as well, to help yourself get better. Important self-care steps include:
making sure you clip your nails regularly (and clean your clippers at the same time too);
keeping your feet clean and dry;
making sure that you always dry thoroughly in-between your toes after bathing or showering; and:
wearing clean cotton socks every day.
If you go regularly to the swimming pool, then try not to walk barefoot around the pool or in the showers.
If you notice you have a case of athlete’s foot, treat this as promptly as possible, then there is less chance of it spreading and causing a nail fungus infection.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Nail fungus
Nail fungus: FAQ
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Do nail fungus treatments always work?
Answer:
Fungal nail infections can sometimes be tricky to treat and they often need longer courses of tablets or topical treatments before you start to improve. Patience is often the key and making sure you take your prescribed treatments regularly. Always talk to a doctor if you have any queries about how your treatment is progressing.
It’s not uncommon for nail infections to reoccur once they have started. However, prompt diagnosis and starting treatment as soon as possible can help.
How are nail fungus infections diagnosed?
Answer:
Nail fungus can often be diagnosed just by looking at the nail. The telltale signs of discolouration and ragged or crumbly nails are often very clear. If they’re not sure, a doctor might take a ‘nail scraping’ (a sample of your nail) to be sent to a lab and analysed in a special dish known as a culture, where they can see what type of fungus is causing the infection.
If you’re in need of advice about diagnosis or treatment of a fungal nail infection then we’re always happy to chat with you and prescribe the right treatment for your needs.
Can nail fungus lead to other problems?
Answer:
It’s always best to try and treat a fungal nail infection before it spreads or causes permanent damage to the nails. In otherwise healthy people, once treated, nail fungus shouldn’t cause any long term issues — though there is every chance it could recur.
In people who are immunocompromised because of long term conditions that need regular medication (for instance, diabetes) or in those who are having other treatments such as chemotherapy, it’s important nail fungus infections are picked up and treated promptly as they can lead to other infections that can spread.
Can you get side effects from nail fungus treatment?
Answer:
Treatments for nail fungus can have side effects. It’s more common to experience these with tablets rather than topical treatments, which are only used on the site of the infection.
Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.
Express shipping 
US clinicians 
