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

Is it possible to prevent fungal nails?

No one knows where a specific person catches the fungus, as it is everywhere. However, since the fungus does thrive in warm moist areas (like sweaty feet), there are certain areas one should avoid or use with caution. Shower floors, locker rooms, and swimming pools are suspected of being sources of the fungus, although there are no studies proving this fact. Nail polish and acrylic nails also make the nail less "breathable" and make the nail more susceptible to fungal infection. Fungi are everywhere -- in the air, the dust, and the soil. Hygienic measures such as spraying socks and footgear sound sensible, and perhaps these measures can even help a little bit. However, avoiding tight, nonbreathing shoes or steering clear of athletic facility floors may very well be the best prevention available. Daily washing of the feet and drying between the toes can help to prevent nail fungus. The fungi carried on the coats of pets, like cats and dogs, don't often cause nail fungus. Wearing white socks does not help.

What is the prognosis of fungal nails?

Curing fungal nails can be difficult and treatment can take up to 18 months. Relapse and reinfection are common (40%-70% reinfection rate). Trying to remove or modify your risk factors, if possible, is essential to preventing reinfection. People who have medical illnesses that predispose them to fungal nails can have an even more difficult time eradicating the fungus.

Reviewed on 2/13/2017
References
REFERENCES:

Baran, R., R.J. Hay, and J.I. Garduno. "Review of Antifungal Therapy, Part II: Treatment Rationale, Including Specific Patient Populations." J Dermatolog Treat 19.3 (2008): 168-175.

Brillowska-Dabrowska, A., S.S. Nielsen, H.V. Nielsen, and M.C. Arendrup. "Optimized 5-Hour Multiplex PCR Test for the Detection of Tinea Unguium: Performance in a Routine PCR Laboratory." Med Mycol. 48.6 Sept. 2010: 828-831.

Bristow, I.R., and M.C. Spruce. "Fungal Foot Infection, Cellulitis and Diabetes: A Review." Diabet Med 26 (2009): 548.

de Berker, D. "Clinical Practice. Fungal Nail Disease." N Engl J Med. 360.20 May 14, 2009: 2108-2116.

Derby, R., P. Rohal, C. Jackson, et al. "Novel Treatment of Onychomycosis Using Over-the-Counter Mentholated Ointment: A Clinical Case Series." J Am Board Fam Med 24 (2011): 69.

Gaburri, D., J.M. Chebli, A. Zanine, A.C. Gamonal, and P.D. Gaburri. "Onychomycosis in Inflammatory Bowel Diseases." J Eur Acad Dermatol Venereol. 22.7 JulY 2008: 807-812.

Garcia-Doval, I., et al. "Clinical Diagnosis of Toenail Onychomycosis Is Possible in Some Patients: Cross-sectional Diagnostic Study and Development of a Diagnostic Rule." Br J Dermatol. 163.4 Oct. 2010: 743-751.

Ginarte, M., Garcia-Doval, I., et al. "Observer Agreement in Toenail Disorders: Implications for Diagnosis and Clinical Research." Br J Dermatol. 160.6 June 2009: 1315-1317.

Gupta, A.K., L.E. Lynch, N. Kogan, and E.A. Cooper. "The Use of an Intermittent Terbinafine Regimen for the Treatment of Dermatophyte Toenail Onychomycosis." J Eur Acad Dermatol Venereol. 23.3 Mar. 2009: 256-262.

Kondori, N., A.L. Abrahamsson, N. Ataollahy, and C. Wennerås. "Comparison of a New Commercial Test, Dermatophyte-PCR Kit, With Conventional Methods for Rapid Detection and Identification of Trichophyton rubrum in Nail Specimens." Med Mycol. 48.7 Nov. 2010: 1005-1008.

Litz, C.E., and R.Z. Cavagnolo. "Polymerase Chain Reaction in the Diagnosis of Onychomycosis: A Large, Single-Institute Study." Br J Dermatol. 163.3 Sept. 2010: 511-514.

Nair, A.B., S.R. Vaka, S.M. Sammeta, H.D. Kim, P.M. Friden, B. Chakraborty, and S.N. Murthy. "Trans-ungual Iontophoretic Delivery of Terbinafine." J Pharm Sci. 98.5 May 2009: 1788-1796.

Shemer, A., B. Davidovici, M.H. Grunwald, H. Trau, and B. Amichai. "Comparative Study of Nail Sampling Techniques in Onychomycosis." J Dermatol. 36.7 Jul7 2009: 410-414.

Shemer, A., H. Trau, B. Davidovici, M.H. Grunwald, and B. Amichai. "Onychomycosis in Psoriatic Patients - Rationalization of Systemic Treatment." Mycoses. 53.4 July 2010: 340-343.

Sigurgeirsson, B., J.H. Olafsson, J.T. Steinsson, N. Kerrouche, and F. Sidou. "Efficacy of Amorolfine Nail Lacquer for the Prophylaxis of Onychomycosis Over 3 Years." J Eur Acad Dermatol Venereol. 24.8 Aug. 2010: 910-915.

Smijs, T.G., and S. Pavel. "The Susceptibility of Dermatophytes to Photodynamic Treatment With Special Focus on Trichophyton rubrum." Photochem Photobiol. 87.1 Jan.-Feb. 2011: 2-13.

Sotiriou, E., T. Koussidou-Eremonti, G. Chaidemenos, Z. Apalla, and D. Ioannides. "Photodynamic Therapy for Distal and Lateral Subungual Toenail Onychomycosis Caused by Trichophyton rubrum: Preliminary Results of a Single-Centre Open Trial." Acta Derm Venereol. 90.2 Mar. 2010: 216-217.

Takahata, Y., M. Hiruma, Y. Shiraki, Y. Tokuhisa, T. Sugita, and M. Muto. "Treatment of Dermatophyte Onychomycosis With Three Pulses of Terbinafine (500 mg Day for a Week)." Mycoses. 52.1 Jan. 2009: 72-76.

Thomas, J., et al. "Toenail Onychomycosis: An Important Global Disease Burden." J Clin Pharm Ther. 35.5 Oct. 2010: 497-519.

Walling, H.W. "Subclinical Onychomycosis Is Associated With Tinea Pedis." Br J Dermatol. 161.4 Oct. 2009: 746-749.

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

Subscribe to MedicineNet's Newsletters

Get the latest health and medical information delivered direct to your inbox!

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Health Solutions From Our Sponsors