Fungal Nails

  • Medical Author:
    Kyoung Min Han, DPM, AACFAS

    Dr. Kyoung Min Han is a podiatrist (foot and ankle specialist) practicing in Southern California. Dr. Han completed her undergraduate education at the University of California, San Diego, and went on to the New York College of Podiatric Medicine to pursue her medical training. She returned to her native Southern California to complete a three-year foot and ankle surgical residency, followed by subspecialty training in a sports medicine fellowship.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideNail Color and Texture: What Nails Say About Your Health

Nail Color and Texture: What Nails Say About Your Health

What are the symptoms and signs of fungal nails?

Although fungal nails are usually cosmetic concerns, some patients do experience pain and discomfort. These symptoms may be exacerbated by footwear, activity, and improper trimming of the nails.

There are many species of fungi that can affect nails. By far the most common, however, is called Trichophyton rubrum. This type of fungus has a tendency to infect the skin (known as a dermatophyte) and manifests in the following specific ways.

  • Starts at the ends of the nails and raises the nail up: This is called "distal subungual onychomycosis." It is the most common type of fungal infection of the nails (90%). It is more common in the toes than the fingers, and the great toe is usually the first one to be affected. Risk factors include older age, swimming, athlete's foot, psoriasis, diabetes, family members with the infection, or a suppressed immune system. It usually starts as a discolored area at a corner of the big toe and slowly spreads toward the cuticle. Eventually, the toenails will become thickened and flaky. Sometimes, you can also see signs of athlete's foot in between the toes or skin peeling on the sole of the foot.
  • Starts at the base of the nail and raises the nail up: It is called "proximal subungual onychomycosis." This is the least common type of fungal nail (3%). It is similar to the distal type, but it starts at the cuticle (base of the nail) and slowly spreads toward the nail tip. This type almost always occurs in people with a damaged immune system.
  • Yeast onychomycosis: This type is caused by a yeast called Candida and not by the Trichophyton fungus named above. It is more common in fingernails and is a common cause of fungal fingernails. Patients may have associated paronychia (infection of the cuticle). Candida can cause yellow, brown, white, or thickened nails. Some people who have this infection also have yeast in their mouth or have a chronic paronychia (see above) that is also infected with yeast. Continue Reading
Reviewed on 3/8/2016
References
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IMAGES:

1. Getty Images

2. Medscape/iStock/Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology Klaus Wolff, Richard Allen Johnson, Dick Suurmond Copyright 2009, 2005, 2001, 1997, 1993 by The McGraw-Hill Companies. All Rights reserved./"Infectionofcutical" by James Heilman, MD

3. iStock/CDC

4. Medscape – Dr. Antonella Tosti

5. Getty Images

6. iStock

7. iStock

8. iStock

9. Sanna Lindberg / PhotoAlto Agency RF Collections

10. iStock

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