If your toenail or fingernail is thick, fragile, separating from the nail bed and brownish, whitish or blackish, you may have a mycotic nail. This fungal infection can affect anyone, but you’re more likely to get it if you have diabetes, psoriasis or athlete’s foot. If you’re older than 70, you have a 50% chance of getting a mycotic nail.
A mycotic nail is a fungal infection that affects your toenails or fingernails. It separates your nail from your nail bed, making it thick and fragile. It may change colors. The word “mycotic” means an infection with a fungus or a disease caused by a fungus. Mycotic nails are also known as onychomycosis.
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Nails are made of a protein-rich tissue called keratin. As new cells grow in your toe or finger, the old ones are slowly pushed forward. They harden and become nails.
Mycotic nails are divided into seven types:
You can ask about what type of nail fungus you have when you see your healthcare provider for a diagnosis.
Anyone can get mycotic nails. However, you might be more likely to get this type of infection if you have one or more of the following conditions:
You’re also more likely to get mycotic nails if you:
You may also be genetically predisposed to mycotic nails. This means that you’re more likely to have mycotic nails if other people in your family do.
About 10% of the general population will have mycotic nails at some point in their life. It gets more common as you age. About 20% of people older than 60 and 50% of people older than 70 get mycotic nails. It’s more common for your toenails to get infected than your fingernails.
Calling paronychia a nail infection is a little misleading. It’s actually an infection of the skin around the nail, not the nail itself.
A mycotic nail doesn’t cause problems with your skin.
Fungal organisms cause mycotic nails. They can get into your toenail or fingernail through small cracks in the keratin or the nearby skin and cause an infection. You should see your healthcare provider if you have a fungal infection.
A variety of organisms can get into your nails and cause an infection, including:
A mycotic nail can become:
You might have a mycotic nail if your toenail or fingernail feels thick and fragile. You may feel cracks in the keratin if you touch the nail.
Fungal infections are contagious. They can be passed from person to person. It’s important to do what you can to keep from passing on your infection. Take some preventative steps, including:
Older adults sometimes experience complications with mycotic nails. They can contribute to cellulitis and, in people with diabetes, foot ulcers. Preventing complications is one of the reasons why it’s so important to see your healthcare provider when you notice symptoms of mycotic nails.
Your healthcare provider will likely diagnose your mycotic nail by looking at it and asking about your symptoms. Some tests might be necessary. Healthcare providers take a nail clipping and either look at it under a microscope then or send it to a laboratory. The lab will do a fungal culture to check for and identify any fungus.
It’s helpful to prepare yourself to answer questions your healthcare provider might ask. Make notes of what your symptoms are and when they started. You may be asked:
Your first instinct when you notice that your nail is infected might be to clip off that part. It’s understandable that you’d want to get rid of it. Healthcare providers recommend that you don’t clip your nail, at least not until your provider tells you it’s ok.
Treating a mycotic nail is not easy. Topical medications — medications you put directly on the nail — rarely help. Antifungal medications you take by mouth are more likely to work. The most common ones include:
Treatment is generally six weeks for fingernails and around 12 weeks for toenails.
Debridement of mycotic nails is where your healthcare provider surgically removes your toenail or fingernail. It might be necessary if the infection cannot be treated with medication. It can take up to a year for a nail to grow back.
Mycotic nails can be cured with treatment. They are not permanent, but can come back again even after treatment. An estimated 10 to 50% of people who have onychomycosis get it again (even after they’ve had treatment). Do your best to follow the outlined prevention steps below to reduce your risk.
A dermatologist specializes in nail and skin disorders. Your primary healthcare provider will likely be able to treat your mycotic nails, but might refer you to a dermatologist if necessary. Don’t forget to ask if you need a referral to the dermatologist.
You should have your mycotic nails diagnosed and treated by a healthcare provider. There’s nothing you can do on your own to get rid of your mycotic nails.
You can eat and drink normally if you have mycotic nails. There’s nothing you can eat or drink to make them worse, and nothing you can eat or drink that will make them better.
You can reduce your risk of developing mycotic nails by taking steps to care for your feet and nails. Steps include:
Do the following if you think a nail is infected:
Fungal infections should be taken seriously. Don’t hesitate to see a healthcare provider.
Mycotic nails won’t go away without treatment. They’ll continue to get worse. In the late stages your nails could crack and completely separate from the nail bed. It can be frightening to see your nails like this and you may feel some pain.
With treatment, fingernails should heal in about six weeks. Toenails may take 12 weeks to heal.
Yes, you can get mycotic nails again after they’re treated. But, there are ways to reduce your risk of getting an infection again.
You may be hopeful that the infection will just go away. But, it’s unlikely that your mycotic nail will heal by itself. You’ll need to see a healthcare provider to get treatment.
You can best take care of your mycotic nails by seeing a healthcare provider and getting treatment. Also, do your best to reduce your risk of getting a fungal infection in your nails.
Although mycotic nails may get thicker than healthy nails, they shouldn’t affect how you move. You may feel some friction against the top of your shoe if your toenail touches it.
It might be helpful for you to brainstorm a list of questions to ask your healthcare provider before you see them. Consider asking the following:
It’s true that some people who have a fungal toe or fingernail infection also get athlete’s foot, which is a fungal skin infection that occurs mostly between your toes. This does happen sometimes, but you won’t get it automatically. Talk to your healthcare provider about this possibility and what you can do to prevent it.
A note from Cleveland Clinic
Healthy nails are smooth — they don’t have any holes or cracks. There’s no discoloration and they don’t peel or break easily. If your nails become fragile, thick and change color, then you might have mycotic nails. This fungal infection should be diagnosed and treated by your healthcare provider.
Last reviewed by a Cleveland Clinic medical professional on 08/23/2021.
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