Fungal Nail Infections

What are fungal nail infections?

Fungal nail infections, also known as onychomycosis, are infections that usually affect the toenails, but can also affect fingernails. They cause the nails to become discolored, thickened, and brittle. Fungal nail infections are usually not serious however, they can take a long time to treat.

What causes fungal nail infections?

Fungal nail infections can be caused by fungi, yeast, bacteria, or molds. The most common type of fungi that causes nail infections belongs to the dermatophyte group. These are types of fungi that grow on skin, or other body surfaces.

These fungi may be present on your body or may have been spread through contact with another person. Fungi tend to grow and thrive in warm, damp environments, which is why infections often occur on toenails and feet in general.

How common are fungal nail infections?

These infections are quite common and usually affect 3-5% of people in the general population. However, the risk of infection increases with age with studies showing a prevalence of 15-20% in people aged 40 and older.

What are the symptoms of fungal nail infections?

Fungal nail infections may affect one or more toenails and fingernails and can present in a number of ways:

• Changes in nail colour – nails may turn yellow, white, grey, or brown
• A white or yellow opaque streak can appear across the nail
• Scaling on the underside of the nail
• White patches and pits may cover the top of the nail
• Yellow spots may appear at the base of the nail
• The nail plate may thicken and change in shape
• Nail pain or discomfort
• Nails may become brittle or crumbly
• The skin near the nail may become itchy, or cracked
• The nail may separate from the nail bed

Who is at risk of getting fungal nail infections?

There are certain risk factors that may increase your chances of getting fungal nail infections, these include:

• Having damaged nails
• Sharing personal items (e.g. nail clippers, socks, shoes, or towels)
• Walking barefoot in public places (e.g. showers or pools)
• Smoking
• Having health conditions such as diabetes, psoriasis, cancer, or peripheral arterial disease
• A weakened immune system
• Wearing tight-fitting, closed-toe shoes that can make your feet sweat
• Fungal infections of the skin (e.g. Athlete’s foot)
• Poor circulation in the legs
• Having wet feet or hands often during the day, or spending a lot of time in the water

How are fungal nail infections diagnosed?

To diagnose nail fungus, a healthcare professional may examine your nails and the surrounding skin. Usually, they will be able to identify the infections simply by looking at your nails.

However, sometimes your doctor may need to take some samples from underneath a nail, or by trimming off part of your nail. They may even scrape off a bit of skin.

These samples will be sent to a lab where they can be examined under a microscope to find out the cause.

How do you treat fungal nail infections?

How severe your infection is will dictate what treatment is best for you. At HealthExpress, we offer a range of treatment options. Nail lacquers are available for mild cases, and Terbinafine tablets for more serious cases or if multiple nails are affected.

It is important to use the treatment that your doctor prescribes, even if your symptoms go away before you complete the treatment. Check out the comparison table below to see which treatment is right for you.

How long do fungal nail infections last?

Fungal nail infections don’t usually resolve on their own. They may persist for months or even years, and can become worse over time.

While treatment isn’t always needed, it’s worth considering if the infection is causing pain or discomfort, or is spreading to other nails. Starting treatment early can help prevent further damage and improve the appearance of your nail.

Fungal nail infections are easier to treat in the early stages. If you notice changes in your nails, don’t wait too long to explore treatment options.

Dr. Anup JethwaClinical Lead

What happens if it is left untreated?

If left untreated, fungal infections can worsen and may spread to other nails or skin. The nails may become more brittle, thicker or distorted in shape and may lift from the nail bed, which can cause pain.

In some cases, the infection may lead to a bacterial infection requiring further treatment. This is why you should contact a doctor and begin treatment as soon as you first notice symptoms.

How can I prevent fungal nail infections?

To reduce your risk of getting these types of infections, it’s important to practise good foot hygiene. Try to incorporate some of the following lifestyle changes:

• Keep your nails clean and trimmed
• Make sure to wash and dry your feet well, and check them regularly for cuts and scrapes (especially if you are a diabetic)
• Treat any other fungal infections (e.g. athletes foot) as soon as you notice them
• Wear breathable footwear e.g. flip flops
• Wear clean socks every day
• Alternate between shoes and give them 24 hours to air out before wearing them again
• Avoid walking barefoot in communal areas
• Don’t share personal items, such as nail clippers with others

Can I buy fungal nail infection treatments over-the-counter?

Yes, you can buy some fungal nail infection treatments over the counter (OTC), however, the options are limited to topical treatments such as Amorolfine.

Amorolfine may be suitable for mild nail infections and may take up to 12 months to fully treat the infection.

Prescription options can be considered for more serious cases. For example, Terbinafine is stronger than OTC treatments and usually takes up to 6 months to treat the infection.

Can I buy fungal nail infection treatment online?

Yes, you can buy both Terbinafine tablets and Amorolfine nail lacquer online at HealthExpress. All you have to do is follow these simple steps:

• Choose the medicine that you think will work the best for you.
• Fill out our online consultation form. It should only take 5-10 minutes.
• Our doctor will review the form and determine if the treatment is best for you.
• If they approve, the doctor will issue an e-prescription for the treatment.
• Our licensed pharmacy will dispatch the treatment in discreet packaging to your doorstep with free delivery.