Fungal infection of the nail, or onychomycosis, is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail’s quality and color, which is often ugly and embarrassing.

In reality, the condition is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair one’s ability to work or even walk. This happens because the resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where people are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete’s foot and excessive perspiration.

Prevention

• Proper hygiene and regular inspection of the feet and toes are the first lines of defense against fungal nails
• Clean and dry feet resist disease
• Washing the feet with soap and water and drying thoroughly
• Shower shoes should be worn when possible in public areas
• Shoes, socks, or hosiery should be changed more than once daily
• Toenails should be clipped straight across so that the nail does not extend beyond the tip of the toe
• Wear shoes that fit well and are made of materials that breathe
• Avoid wearing excessively tight hosiery, which promote moisture
• Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks
• Disinfect instruments used to cut nails
• Disinfect home pedicure tools
• Don’t apply polish to nails suspected of infection—those that are red, discolored, or swollen

Treatment

• Over-the-counter topical anti-fungal medication
• Prescription-strength topical anti-fungal medication
• Oral anti-fungal medication