HealthInfo Canterbury
Fungal nail infections
Fungal nail infections are common as you get older.
A fungal nail infection occurs when fungus infects a fingernail, toenail or the skin under the nail (called the nail bed). Fungi tend to attack nails that are already damaged through small cuts in the skin around your nail, or through the opening between your nail and nail bed.
You can get a fungal nail infection from sharing personal items such as nail clippers or towels or from walking barefoot in public showers or pools. If you have athlete's foot (a fungal infection between the toes), the fungus can spread from your skin to your nail. Having other health problems such as diabetes or rheumatoid arthritis can also make you more likely to get an infection.
Symptoms of a fungal nail infection
Common symptoms of fungal nail infections include:
- your nail getting thicker
- your nail changing colour (yellow, white, blue, purple or black)
- the skin near your nail itching or cracking
- your nail separating from the nail bed
- pain around the nail area.
Diagnosing a fungal nail infection
Many nail problems can look like a fungal infection, such as an old injury, a bacterial infection or psoriasis. So, it's important to confirm whether it's really a fungal infection, as treatments are different.
To confirm a diagnosis of a fungal infection, your general practice team will usually need take a small sample of nail clipping and send it to be tested. It can take several weeks to get the test results, and there is a reasonably high false negative rate.
Your general practice team can arrange a funded test. Other health professionals can arrange a test for you, but there's usually a charge for this.
Treating a fungal nail infection
You don't always need treatment, and you should discuss the risks and benefits with your general practice team. Treatment options include applying topical medications (cream, ointments or paints) or oral medication (tablets or capsules).
- Treatment with oral antifungal medication is only successful in about 70% to 80% of people, and topical treatment is less effective.
- You need to use topical treatments every day for up to a year.
- Oral antifungal medication interacts with quite a few other medicines, increasing your risk of getting side effects.
- Even after successful treatment, your nail might not look completely normal.
- There is a one in four chance that the fungal infection will come back.
- Treat your environment. For example, by using antifungal shoe spray, hot washing your socks and bleaching your shower floor and nail instruments.
Self-care for a fungal nail infection
If you have a fungal nail infection, there are things you can do to care for your toenail and avoid spreading your infection:
- don't share nail clippers or nail files
- treat other fungal infections such as athlete's foot
- keep your feet cool and dry by wearing breathable footwear
- avoid cotton socks, wear socks made out of acrylic, polyester, wool blend, merino, bamboo, possum and so on
- keep your toenails trimmed
- avoid high heels and shoes with narrow, pointy toes that may injure your nails
- when using communal showers, wear protective footwear
- treat your environment as above.
Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub collaborative. Last reviewed April 2023.
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Review key: HICCA-28239
