Mycotic Nail Fundamentals

Mycotic nails are nails that are infected with a fungus. The nail may be discolored, yellowish-brown or opaque, thick, brittle and separated from the nail bed. In some cases the nail actually may be crumbly.

How is this caused?

Mycotic infections of nails are caused by a fungal organism that is found in the atmosphere. This organism thrives in the dark, moist, warm environment of shoes, which promotes fungal growth. Prior injury to the nail may predispose the nail to developing a fungal infection. Also, a fungus can be passed from one person to another by sharing shoes or other personal items. Chronic athlete’s foot can result in toenail infection, as can shoes that are moist, tight, and prevent air circulation.

Preventing mycotic nails is difficult. The fungal organisms that cause these infections are ubiquitous and difficult to control. You should maintain good hygiene by alternating shoes, changing hosiery on a daily basis and treating injuries to the nails or toes promptly. Wearing properly fitted shoes and avoiding tight constrictive shoes may also be helpful in preventing injury to the nail and nail plate which may predispose the nails to mycotic infections. Appropriate regular care to the toenails may also be helpful in avoiding fungal infections.

How is this treated?

Mycotic nail infections are difficult to treat. If you notice an infected nail they should not try to remove that part of the nail, since this can cause the infection to spread. Two standard forms of treatment are available:

  • Antifungal creams, lotions, and gels can be applied to the affected area. Treatment can last several weeks and maintaining a fungus-free nail requires long-term use.
  • Antifungal pills (oral medication) can cure an infection but have dangerous side effects, such as damage to the liver. Thus, they are only used when the infection is severe or difficult to treat. The pills are taken once or twice per day for a couple of weeks to several months.

Treatment for fungal infections in the nails may also include periodic removal of the damaged portion of the nail and thinning out of the thickened nails to prevent pain to the patient.

What are the risks of treatment?

Even after treatment, fungal nail infections can recur.

Reviewed by a Cleveland Clinic medical professional.

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