Nail Fungus

  • Basics

    Fungal infection of the nails, also known as onychomycosis, is a common problem among Americans. It is estimated that between 2% and 14% of the population has fungal nail infections, with the frequency of such infections increasing with age. Few children have fungal nail infections, while as many as 25% to 40% of people over the age of 60 do. Fungal infections of the fingernails are more common in men; fungal infections of the toenails are more common in women.

    Nail fungus is becoming more common in the U.S. The rise in nail fungus is thought to be due to a combination of increased detection as well as increased risk of infection. Factors that contribute to this increased risk include aging of the population, spread of HIV/AIDS, tight footwear, vigorous physical activity, and use of communal swimming pools, locker rooms, etc.

    Nail fungus is more than a cosmetic problem. It can be painful and interfere with daily activities such as walking, playing sports, writing, typing, and other activities that require manipulating small objects or repetitive finger use. An international study conducted by dermatologists found that nail fungus had a significant impact on the quality of life of people with the disease. The main problems identified were embarrassment, functional problems at work, reduction in social activities, fears of spreading the disease to others, and pain.

    Nail fungus must be treated with medication once it occurs. Rarely, surgery may be necessary.

  • Causes

    As the name implies, the disease is an infection of the nail caused by a fungus. Fungi are small, parasitic, plant-like organisms such as molds and yeasts. Two types of fungi commonly cause nail infections. The first type is called a dermatophyte, which means “plant that lives on the skin”. The second type, which occurs infrequently in the U.S., is a yeast. Many different yeasts may cause onychomycosis.

    In temperate areas of the world, most nail infections are caused by dermatophytes. In the tropics, yeasts are the most common cause. In both cases, the fungi digest keratin, which is the major protein in nails, hair, and skin. The nails respond by overproducing keratin, which causes them to thicken and separate from the underlying skin.

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