Ask a nurse

Keep your feet happy

How to prevent a fungal infection of a nail

Bare feet.

Winnipeg Health Region
Wave, March / April 2017

What is a fungal infection of a nail?

Fingernails and toenails can get infected with fungus; however, fungal infections tend to occur in toenails more often than fingernails. They usually start on the big toe, and can affect one or more nails. Medical terms for the infection are onychomycosis or tinea unguium. People who have a toenail infection might also have a condition known as “athlete’s foot,” which is a fungal infection that affects the skin on the feet. (That’s because certain types of fungi can cause both of these problems.)

What is the cause?

Fungus grows best on warm damp skin. The fungus that infects toe and fingernails usually spreads from infected skin close to the nail.
Nail infections are more common and may be harder to treat in people who have diabetes and/or poor circulation, and in people whose immune systems are weakened by HIV, cancer, or other health problems.

What are the symptoms?

Symptoms may include:

  • Thickened, white, yellow, and/or brown nails
  • Brittle nails that may crumble, flake, and/or lift off the finger or toe
  • Pain, especially with walking

How is it diagnosed?

Your health-care provider will ask about your symptoms and medical history and examine you. Your health-care provider may collect some nail clippings for examination by solution and/or staining. A sample of the nail may also be sent off to a lab to be tested for fungus. 

How is it treated?

If the infection is very mild, your health-care provider may prescribe medicine you can put on the nail. For more severe infections, your provider may prescribe an antifungal medicine to be taken by mouth.

You may need to take the medicine until the nail grows all the way out and there is no longer any sign of the fungal infection. Medicines put on nails usually take about 12 months to work, whereas medicines taken by mouth usually take about three months to work, but sometimes longer. Some people who take these medicines need to have blood tests. That’s because these medicines can affect the liver.

If you don’t want to or can’t take antifungal pills, your health-care provider and/or pharmacist can review other possible treatment options with you. These might include having surgery to remove your nail.

Before starting any of these treatments, you should know that:

  • It can take many months for your nail to look normal again.
  • There is a chance that the treatment won’t work. The infection might not get better, or it might come back. If either of these things happen, your health-care provider can try another treatment and/or send you to a specialist.

How can I help prevent a fungal nail infection?

Because fungus grows best on warm, damp skin, it’s important to keep your hands and feet as dry as possible. It may help to:

  • Avoid biting your nails.
  • Wear gloves if your work or daily activities put your hands at risk for getting scratched, poked, or irritated. It may help to wear gloves if your hands are in water much of the day. Take the gloves off several times a day to make sure your hands are dry.
  • Avoid sharing nail tools, such as clippers and scissors.
  • If you have nail infections often, get checked for diabetes.
  • Keep your feet clean and dry.
  • Wear cotton or athletic socks that wick moisture away from your feet.
  • Change your socks every day, or more often if the socks become damp.
  • Put an antiperspirant medicine on your feet to prevent sweating. 
  • Wear sandals or shoes that let your feet breathe. This means avoiding rubber or plastic shoes unless they have openings. Canvas or leather shoes are usually a better choice.
  • Air out your shoes when you aren’t wearing them. It is helpful to have more than one pair of everyday shoes and to switch shoes every day.
  • Wear something such as flip-flop sandals (and clean them often) when you take a shower in a locker room or other shared shower stall, where you might be exposed to a fungus.
  • Disinfect shower and locker room floors.

Should I take antifungal medications if I want to get pregnant or if I am already pregnant?

If you want to get pregnant, let your doctor or nurse know. He or she might recommend that you not take certain antifungal medicines during pregnancy.

Sarah Jayas is a registered nurse and team leader with Health Links - Info Santé, a telephone health information service with the Provincial Health Contact Centre at Misericordia Health Centre.

The information for this column is provided by Health Links – Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health-care professional. You can access health information from a registered nurse 24 hours a day, seven days a week by calling Health Links – Info Santé.

Call 204-788-8200 or toll-free 1-888-315-9257.

Wave: January / February, 2017

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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