Symptoms
The first sign of nail fungus is usually a small spreading white or yellow spot on the nail. Table 01 Because nail fungus rarely heals by itself, you should seek out medical treatment at the first sign of infection. Many people fail to seek treatment initially because the symptoms of nail fungus may appear to be nothing more than a blemish. If you suspect that you have a nail fungus, you should seek treatment because these infections can persist indefinitely when left alone. As importantly, treatment is likely to be more successful the earlier the infection is caught.
There are two common types of fungal nail infections. The first is infection of the nail bed under the nail. This type of nail fungus is the most common type of infection. The infection starts at the free edge of the nail plate and extends to the nail bed under the nail plate. It spreads from the tip or side of the nail and moves back. Typical symptoms include thickening or deformity of the nail, discoloration (green, yellow, brown, or black), and separation of the nail from the nail bed. In some cases, the skin around the nail may become itchy, red, or swollen. As the infection spreads, it becomes painful, and the pain may be severe. The nail may have a foul smell of decay.
The second common type of fungal nail infection affects the nail plate itself. In this type of nail fungus, the fungus directly attacks the nail plate rather than first infecting the tissue underneath. Initially, the nail looks white and crumbly in a speckled pattern, but eventually the spots may join to include the entire nail.
Table 1. Symptoms of Nail Fungus
Discoloration of the nail plate or bed Nail thickening or deformity Separation of the nail plate from the bed Inflammation of the surrounding skin Pain Foul smell Risk Factors
Nail fungus becomes more common with age. The apparent reason for this increased risk is that as people age, their nails begin to grow more slowly and start to thicken, making them more susceptible to attack by fungi.
Nails that are kept moist and warm have a higher risk of developing fungal infections. People who perspire heavily, work where their hands are frequently in water, wear tight socks or shoes that don’t provide ventilation, or who frequent locker rooms, swimming pools, or other public bathing facilities have a higher risk of developing fungal infections.
Nail and hair salons can spread fungal infections. Because the fungi that cause nail infections can be spread by contaminated instruments such as scissors, nail files, and razors, it is important to frequent only those nail and hair salons that have the highest standards of cleanliness and hygiene. Instruments should be properly sterilized between uses on different clients. Good hand washing habits are as important as in a doctor’s office.
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I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!
