Nail Fungus

Nail fungus, also called onychomycosis, is a common infection of the toenails. It can cause nails to become thick, brittle, discolored, or misshapen, and it rarely clears up on its own. Treatment can improve the look and comfort of your nails and is especially important for people with diabetes or poor circulation.

Podiatrist bandaging a patient's foot
Podiatrist examining a patient's foot with toenail fungus (onychomycosis)

What Is Nail Fungus?

Nail fungus is an infection caused by fungi that grow in and under the nail. It usually starts as a white or yellow spot at the tip of the nail and spreads as the infection goes deeper, causing the nail to thicken, discolor, and crumble at the edges.
 
Thick, misshapen nails can press on the toes in shoes and become painful. For people with diabetes or circulation problems, damaged nails can injure the skin and lead to infection, which is why nail care is part of diabetic foot care.

Treatments For Nail Fungus

Treatment depends on how many nails are involved, how severe the infection is, and your overall health.

Treatment options

  • Nail debridement. Trimming and thinning thick nails to relieve pressure and help medication reach the infection.
  • Topical antifungal medication. Applied directly to the nail for milder infections.
  • Oral antifungal medication. For more extensive infections, when appropriate for your health.
  • Nail removal. Considered for severe, painful, or repeatedly infected nails.

Preventing it from returning

  • Keep feet clean and dry. Change socks when they are damp.
  • Breathable footwear. And rotating shoes so they dry out.
  • Treat athlete's foot. So the fungus does not spread to the nails.
  • Protect your feet. Wear sandals in locker rooms and shared showers.

Nail fungus takes time to clear. A healthy nail must grow out fully, which can take many months for a toenail.

How Nail Fungus Is Diagnosed

Diagnosis begins with an examination of the nails and surrounding skin. Because other conditions, such as nail injury and psoriasis, can look like fungus, a small nail sample may be tested to confirm the infection before treatment.
 
If your nails are thick, painful, or changing, or you have diabetes, have them checked.
Close-up of a person holding a painful foot

Who Is At Risk For Nail Fungus?

Anyone can develop nail fungus, but some factors make it more likely:

Age

Nails grow more slowly and thicken with age.

Diabetes and poor circulation

Make infections more likely and harder to clear.

Athlete's foot

The fungus can spread from the skin to the nails.

Damp, closed shoes

Sweaty feet and shoes create a warm, moist environment.

Shared spaces

Walking barefoot in locker rooms, pools, and showers.

Nail injury

Damaged nails let fungi in more easily.

Frequently Asked Questions

What is nail fungus?

Nail fungus, or onychomycosis, is a fungal infection of the nail. It most often affects the toenails and causes thickened, brittle, discolored, or misshapen nails.

How did I get nail fungus?

The fungi thrive in warm, moist places like locker rooms, pools, and sweaty shoes. They can enter through small cracks in the nail or skin, and athlete's foot can spread to the nails.

Is nail fungus contagious?

It can spread, both to other nails and to other people, through shared floors, showers, towels, and nail tools.

Will nail fungus go away on its own?

Rarely. Without treatment it usually persists and can slowly spread to other nails or worsen.

How long does treatment take?

Toenails grow slowly, so it often takes many months for a clear, healthy nail to grow out fully, even when treatment is working.

Is it really fungus, or something else?

Other conditions, such as nail injury and psoriasis, can look similar. A specialist can confirm the diagnosis, sometimes with a nail sample, before treatment begins.

Why does nail fungus matter if I have diabetes?

Thick, sharp nails can injure the surrounding skin, and the infection can open the door to bacterial infection. With diabetes or poor circulation, that can lead to serious foot problems.

Can nail fungus come back?

Yes. Keeping feet dry, wearing breathable shoes, treating athlete's foot, and wearing sandals in shared showers lower the risk of it returning.

Signs Of Nail Fungus

Nail fungus usually develops slowly. Common signs include:

  • Discoloration white, yellow, or brown nails.
  • Thickening that makes nails hard to trim.
  • Brittle or crumbling nail edges.
  • A changed shape or a nail lifting from the nail bed.
  • Pain or odor especially when wearing shoes.
Person holding the painful ball of the foot

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