What Causes Nail Fungus?
Onychomycosis happens when cuts or cracks in the skin allow for fungi to get between the nail and skin, causing an infection, explains Lucy Chen, M.D., a dermatologist at Riverchase Dermatology in Miami. On top of infection, you can also experience discoloration, thickening, and separation from the nail bed. (Related: How to Strengthen Your Nails)
Unfortunately, the simple truth is that everyone is exposed to the microorganisms that cause these infections, says Dana Stern, M.D., a New York City-based dermatologist and nail health expert at Nu Skin. So, why do some people develop full-on nail fungus and others don’t? “The causes are multi-factorial but some of the more common factors that put you at risk for fungal infections include older age, diabetes, suppressed immunity, poor circulation, excessive sweating, and irregular growing nails,” notes Dr. Stern.
The Most Common Types of Nail Fungus
The most common type of nail fungus is known as distal subungual onychomycosis, and is caused by a fungi known as a dermatophyte, says Dr. Chen. It can show up on fingernails or toenails, and manifests as a yellow-ish area on the nail that can ultimately lead to splitting, crumbling, or even separation of the nail from the skin as it gets worse, she says. It’s also worth noting that this is the same fungi that causes athlete’s foot, a fungal infection that can spread from the skin to the nail, adds Dr. Stern.
White superficial onychomycosis is the second most common; it leads to white spots on the surface of the nail, which can ultimately spread to resemble a white chalky powder covering the entire nail, says Chen. (Related: What It Means If You Have Peeling Nails (Plus, How to Fix Them))
How to Prevent Nail Fungus
Even though the fungi responsible for these nail infections are pretty much everywhere, there are a few universal things you can do to aid in prevention. Both derms warn that it’s important to be cautious at the nail salon. “A client with fungus can spread it to other clients if proper disinfection precautions aren’t followed when it comes to porous tools such as emery boards and toe separators, as well as pedicure footbaths,” says Dr. Stern.
Not picking at your nails is also paramount, as well as wearing footwear in wet communal areas, such as locker rooms and swimming pool decks, points out Dr. Chen. And since most fungal infections of the toenails start with a fungal skin infection that spreads to the nail, it’s important to protect the skin. (If you’re looking for protective, waterproof footwear for gym showers or for wearing around a hotel pool, shop this guide of outdoor sandals.)
The Best Nail Fungus Treatments
And if you do end up with a nail fungal infection? The bad news is that it can be challenging to completely banish it; the infections are often persistent and even if they are effectively treated, can often have high recurrence rates, explains Dr. Stern.
The other tricky part is that the infection needs to be diagnosed properly, and comparing your nail situation to your Google search isn’t the way, she says. Not every nail problem is caused by a fungus — some conditions may appear similar, such as nail psoriasis and nail trauma, according to the American Academy of Dermatology Association. Derms have the expertise to determine what’s causing your nail problem and to recommend the right treatment, including various oral and topical medications that could be highly effective.
While it’s best to get a diagnosis from a professional, if you are traveling or simply don’t have time to book an appointment with your derm right now, there are many over-the-counter anti-fungal ointments and creams that can treat fungal nail infections, says Dr. Chen. The catch? If you don’t see improvement after two months for fingernails or four months for toenails, see a dermatologist, advises Dr. Stern.
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