A guide for patients with fungal nails

What causes fungal nails?

A fungal nail infection is caused by the same types of fungus that cause athlete’s foot.

What does a fungal nail look like?

In mild cases, the nail will have small off-white or yellowish streaks or patches. In severe cases the nail will be thick and crumbly with dark yellow or brown streaks. Pieces of nail sometimes break away leaving ruts or holes. You may notice a musty smell when the nail is cut.

How do you get a fungal nail?

There are a number of reasons that make some people more likely to get the infection, including:

• poor hygiene
• naturally sweaty feet, or wearing shoes or boots that make feet hot and sweaty such as wellingtons, heavy boots or steel-capped shoes
• health problems such as diabetes
• toes so close together sweat can’t dry out. This may be caused by a toe deformity or wearing shoes that cramp the toes
• untreated athlete’s foot
• nails that are of poor quality or have been damaged.

How do you prevent a fungal nail?

• Treat athlete’s foot straight away.
• Wash feet daily using a mild soap and dry thoroughly, especially between the toes.
• When using communal areas, for example, changing rooms or swimming pools, make sure you wash your feet with a mild soap and dry thoroughly before you put your shoes and socks on.
• Wear socks and shoes made from materials that breathe.
• Wear shoes that have enough room to allow air to circulate.
• Avoid walking around bare-footed in communal areas.
• Change socks, stockings or tights daily.
• Allow shoes to dry out for at least 24 hours before wearing them again.
• Never share towels, shoes or socks.
• If you suspect one of your nails has a fungal infection, cut this nail last to reduce the chance of spreading it to the other nails.
• Wash your nail scissors or nippers after use.

How do you treat a fungal nail?

Fungal infected nails are harmless, but people are often keen to treat them for cosmetic reasons. Treatment may take many months and is not guaranteed to be successful.

To help you can:

• keep the nail filed down if it is thick and painful
• apply surgical spirit, in mild cases, to the affected area daily or ask your pharmacist for an antifungal preparation in mild cases
• see your GP who, in severe cases, may be able to prescribe a stronger treatment to apply directly to the nail, or a course of antifungal tablets
• ask to see a podiatrist who may recommend removal of the nail.