Fungal nail infection: Causes, symptoms, and treatments

What causes a fungal nail infection?

A fungal nail infection develops when fungi that usually live harmlessly on the skin multiply and lead to an infection. They thrive in warm, moist areas of the body like the feet. These fungi are also responsible for athlete’s foot infections. Certain factors make you more prone to developing a fungal nail infection. These include:

• Wearing closed shoes that make your feet hot and sweaty

• Walking barefoot in warm, humid, public areas like swimming pools and changing rooms

• Putting socks and shoes on when your feet are still damp

• A weakened immune system from medication or a health condition

• Having an existing medical condition such as diabetes or psoriasis

What symptoms should I look out for?

There are usually signs of an infection in the nail itself. Look out for appearance changes around the edge of the nail, particularly a distinct colour change. The affected nail could turn white, black, green, or most commonly a yellowish colour. Another common symptom of infection is the thickening of the nail. It can become distorted, making it difficult to trim. You may also notice a change in texture, as the nail can become crumbly and brittle. With some infections, the skin around the affected nail may become sore, itchy, and inflamed.  

What treatments are available for a fungal nail infection?

You should speak to a pharmacist if your nail changes, is painful, or you think you may have an infection. They may suggest non-prescription antifungal medication that you apply directly to the nail(s) in question to treat the infection and you can buy them directly from them. You can also try nail softening creams that will soften the area and allow you to gently scrape away the affected part of the nail.

If topical treatments don’t work, your GP may prescribe antifungal tablets to combat the infection. To do this, they’ll need to take a sample of the nail to determine what kind of infection you have.

Laser treatment is another option for fungal nail infections. However, this isn’t available on the NHS and can be expensive. Evidence of how effective laser treatment is at treating infections is limited as published studies have only followed up with patients up to three months after treatment.

We would recommend trying non-prescription treatments first, and if these aren’t successful or you’re experiencing pain, talk to your GP about next steps.

What can I do to avoid getting a fungal nail infection?

There are things you can do to help reduce the risk of getting an initial infection, or having one come back after treatment. These include:

• Wearing well ventilated footwear that allows your feet to breathe

• Keeping your feet clean and dry

• Wearing flip flops in communal areas like gym changing rooms and swimming pools

• Treating athlete’s foot early to prevent it spreading to the nails

• Consider using an antifungal spray to disinfect trainers and other closed shoes