Skin Conditions: Nail Problems

Nail Fungus

Nail fungus, or onychomycosis, is a condition that occurs when a microscopic fungus enters either a fingernail or toenail. Fungal infections occur in toenails more often than in fingernails.

Anyone can get nail fungus, but infections are more common in people over the age of 60. Nail fungus is especially common in people with diabetes or circulation problems. For people who have diabetes or a weakened immune system, nail fungus can present serious risks.

What Causes Nail Fungus?

Usually, nail fungus occurs when fungus enters the nail through a small trauma (cut or break) in the nail. Nail fungus is not caused by poor hygiene. Nail fungus can be spread from person to person. If you notice an infected nail, don't pick at it or even trim it, as both of these activities can cause the fungus to spread. It may be hard to determine exactly where or how a fungal infection is obtained. However, a warm, wet place (for example, a locker room) is a good place for a fungus to grow.

What Are the Symptoms of Nail Fungus?

A nail fungus infection can make your nails thick and discolored. Uncommonly, you may feel pain in your toes or fingertips.

How Is Nail Fungus Diagnosed?

Your doctor may be able to tell if you have a nail fungus infection by looking carefully at your nails. He or she may scrape some tissue from your nail and send it to a lab in order to determine for certain what kind of infection you have.

How Is Nail Fungus Treated?

Treatment may include topical creams or oral medications (antifungal drugs), but topical antifungal agents may only help treat very mild cases. Rarely, surgery may be required. Removal of the infected nail can be performed to permit direct application of a topical antifungal.

Toenail infections are more difficult to treat than fingernail infections because the toenail grows more slowly. In addition, a damp, warm environment of a shoe or boot can encourage fungal growth.

How Can I Prevent Getting Nail Fungus?

• Avoid walking barefoot in public areas, such as locker rooms
• Keep the inside of your shoes dry and change your socks frequently (100% cotton socks are recommended)
• Wear proper fitting shoes (shoes with a wide toe area and ones that don't press your toes)
• Use absorbent or antifungal powder

Ingrown Toenails

Ingrown toenails can occur when the corner or side of the nail grows into the flesh of the toe. In many cases, ingrown nails occur in the big toe. The end result of this common condition is pain, redness and swelling. Infection can occur in some cases.

What Causes Ingrown Toenails?

Some common causes of ingrown toenail include cutting the nails too short or not straight across, injury to the toenail, and wearing shoes that crowd the toenails.

How Can Ingrown Toenails Be Treated?

In mild cases, ingrown toenails may be treated with a 15-20-minute soak in warm water. Dry cotton can be placed under the corner of the nail. Talk to your doctor if you are experiencing increasing pain, swelling and drainage of the area. Minor surgery can be performed to remove the part of the nail that is poking into the skin.

How Can Ingrown Toenails Be Prevented?

You can prevent ingrown toenails by:

• Wearing shoes that fit properly
• Keeping your toenails at a moderate length and trimming them straight across
• Wearing protective footwear

Reviewed by doctors at The Cleveland Clinic Department of Dermatology.