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Nail Fungus

Nail fungus, or onychomycosis, is a fungal infection of the nail. It is a common problem that may recur even when treated successfully.

How does fungus get in the nail?

Fungus can be picked up when walking barefoot (athlete’s foot). Small cracks in the nail or the surrounding skin allow the fungus to invade and grow. It can spread to other nails through contact with the infected nail.

What does nail fungus look like?

Fungus can infect any nail but is more common in the toenails. Nails with fungus infection are often thickened, discolored, and cracked or fragile. The infected nail may be white to yellow-brown in color. Sometimes, the fungus may invade the nail bed, lifting the nail and debris may build up underneath, resulting in a darkened nail.

OK, the nails are ugly. So what?

It’s not just about having unsightly nails. The fungus can destroy the nail bed and put us at significantly higher risk of bacterial skin infection. For diabetics and those with compromised immune systems, in particular, a little fungal infection of the nail can lead to a big skin infection.

Oh. Is this nail fungus?

Let your doctor take a look. Most diagnoses can be made by inspection. But since there are other conditions and infections that may mimic nail fungus, your doctor may take a nail clipping or scraping to send off for analysis.

How can I get rid of the fungus?

It’s tough. Medicines applied to mildly infected nails have a low cure rate. Antifungal pills for more severe cases require two to three months of treatment and can cause side effects. Removal of the infected nail by a qualified doctor is of last resort and requires good wound care.

Nail fungus can be stubborn but it is possible to clear the infection by working with your doctor and by:

  • Use the treatment exactly as prescribed

  • Apply (or take) the medicine for as long as prescribed

  • Keep all follow-up appointments with your doctor


Even after successful treatment, nail fungus can return. Reinfection rates of up to 25% have been reported.

Minimize the odds of nail fungus reinfection by:

  • Do not walk barefoot in areas like locker rooms or public showers

  • Keep your hands and feet clean and dry

  • Do not share clippers with other people

  • Keep your nails clean and clip your nails short

  • Make sure the nail salon sterilizes its instruments after each use, or bring your own instruments


Tosti A, Elewski BE. Onychomycosis: Practical Approaches to Minimize Relapse and Recurrence. Skin Appendage Disord. 2016 Sep;2(1-2):83-87.

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