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Fungal Infection of the Nails (Fungal Infections)
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Fungal Infection of the Nails

John Kraft and Charles Lynde, MD, FRCPC

If you’ve noticed a change in the color, tone, or texture of your nails, this may be due to a fungal infection. Almost 50% of all changes to the nails are due to fungal infection of the nail, or onychomycosis. Men are more commonly infected, possibly due to their greater exposure to locations where fungi breed, such as the gym. The toes are more commonly infected, as fungus tends to form on nails that grow slower. Fungus can spread from nail to nail, and can spread to the foot.

Once infected, the nails undergo some changes. The nail commonly thickens, and becomes discoloured or yellow as the fungus multiply and feed on the keratin in the nail. Slow growth of the nail is also common. The nail plate and the nail bed often become separated, and crumbled remains of hyperkeratotic debris accumulate below the nail, making the nail area more accessible for fungal growth.

Fungal infection is not just a cosmetic inconvenience. The nail can become a source of pain when cutting nails, or during athletic activities. If you suspect that you may have a fungal infection, visit a dermatologist for a proper diagnosis.

Some home treatments and preventative measures include the regular use of antifungal or absorbent powders on the feet and footwear. Regular and proper drying of the feet after bathing or showering helps. Cotton socks should be worn with protective footwear. If you do have a fungal infection, it is also recommended that you discard your old footwear to prevent a recurring infection of the feet. This is important as recurrence is extremely common, and can be frustrating to treat.

Treating nail infections can be challenging, as most topical treatments cannot penetrate the nail, although new formulations such as Penlac™ or Ciclopirox can still take effect over the nail. Lacquer has also had some effect on early stage fungal infection, and is often used in conjunction with more traditional systemic medications for fungal treatment. Systemic antifungal medications such as fluconazole, itraconazole, ketoconazole, and terbinafine are considered the most effective treatment however, they can have some serious side-effects, and as such, your dermatologist will advise caution in the use of these medications. For more information about anti-fungal drugs, visit

Finally, not all changes such as thickening of the nail are the result of a fungal infection. The following may appear like fungal infections:

Physical causes:

  • Contact irritants and reactions
  • Ingrown nails
  • Other physical trauma

Skin Diseases:

  • Dermatitis
  • Lichen Planus
  • Psoriasis


  • Hyperthyroidism

See your dermatologist at the earliest opportunity as proper diagnosis is critical in effective treatment.


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