Nail fungus: what you need to know about nail fungus

Nail fungus: what you need to know about nail fungus

Onychomycosis is a common problem that can be treated effectively. Find out what there is to know about fungi that affect the nail, from symptoms to treatment

Onychomycosis is a nail disease that can be caused by a variety of microorganisms, although in most cases the culprits are dermatophytes, or a group of fungi that feed on the keratin present in the tissues. This pathology is very widespread, so much so that it affects – according to official estimates – about 10% of the world population. Although it can affect both the hands and the feet, there is a prevalence of the problem among the latter, especially in the big toes, which is the finger most subjected to the pressure of footwear and microtraumas caused by movement.

In the presence of nail fungus, it is essential to receive a correct and timely diagnosis, so as to intervene immediately with the right therapy.


  • What it is and how to recognize it
  • Causes
  • Diagnosis
  • Treatment

What it is and how to recognize it

Onychomycosis is a mycotic type infection (therefore, caused by a pathogenic fungus) that affects the nail plate, or the lamina that includes both the nail itself and the surrounding tissues.

Onychomycosis has obvious aesthetic consequences. When the pathogenic fungus attacks the nail plate or the nail bed (the part underneath the surface plate), in fact, the nail takes on a particular appearance, specifically causing:

  • a variation of the coloring. The nail loses its natural color becoming yellow, white or brown;
  • thickening and brittleness of the nail, which also has jagged edges;
  • a deformation of the nail.

Typical symptoms of onychomycosis also include:

  • localized pain in the nail and surrounding tissues, which can even involve the entire finger (it is often described as "burning in the phalanx");
  • unpleasant smell;
  • accumulation of keratin under the nail surface.


There are categories of people more prone to nail fungus, which can therefore be affected more frequently and more easily by onychomycosis. Some pathologies and disorders, in fact, are closely linked with the predisposition to develop fungal nail infections: these include diseases of the immune system, cardiovascular problems, diabetes and psoriasis.

Some medicines are also responsible for a greater predisposition to fungal infections, especially in the case of prolonged drug therapies, such as immunosuppressants, antibiotics or corticosteroids used for example in some chronic inflammatory diseases.

There are, then, external conditions that can favor the appearance of fungi on the nail. For example, trauma to the toes, the use of shoes that are too tight (which do not allow the foot to breathe) or direct contact with a contaminated surface: the latter is a very common occurrence for those who attend gyms and swimming pools. . In fact, shared changing rooms are fertile ground for mycoses in general as fungi proliferate in hot and humid environments.


The diagnosis of onychomycosis must be made by a dermatologist or podiatrist but it is still very important that the lesions are checked at first glance by the attending physician. In fact, even the latter can detect the symptoms related to an onychomycosis, prescribe a curative therapy and request any in-depth examinations, such as the mycological examination, which allows to identify the fungus responsible for the infection through the collection and l analysis of a sample of an infected nail.


Treatments for onychomycosis are simple to use and usually effective, although it should be considered that the timing of resolution of the problem is closely linked to the severity of the infection. Therefore, it is important to intervene promptly, as soon as you notice the characteristics of the fungal infection such as color change, thickening or particular nail fragility. It should also be considered that, once established, the infection is difficult to eradicate and is prone to relapse even after prolonged treatments.

In any case, as general advice, it is good to keep your nails short, use comfortable shoes with a wide tip, and wash and dry your feet carefully. From a therapeutic point of view, however, for the treatment of onychomycosis include:

  • oral antifungals (terbinafine and itraconazole), which are by far the most effective drugs for eradicating the infection, especially in the most problematic cases;
  • antifungals for topical use, for example in the form of enamel, whose effectiveness in the most severe cases can be increased if used as an adjuvant to oral drugs.

In general, topical treatments are recommended for mild to moderate infection while oral treatments should be considered for moderate to severe disease. The specialist will decide the type of treatment, depending on the type of fungus and the severity of the lesion.

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