A health condition that causes toenails or fingernails to become thick, fragile, whitish or blackish, or to separate from the nail bed, is called mycotic nails. It is a fungal infection that can affect anyone. For instance, there is a 50% chance of getting mycotic nails if you are over 70. Sometimes, this disorder is called onychomycosis.
The nails are made of a protein-rich structure (keratin). When new cells grow in the toes or fingers, the old cells are slowly pushed forward. Usually, nails help add strength to the tips of the fingers and toes, protect from infections, and aid in fine motor movements (including picking things up).
Generally, this is a common disease that occurs more frequently in older adults. Moreover, approximately 10% of people will develop mycotic nails at least once during their lives.
Types of Mycotic Nails
Healthcare professionals have divided this condition into 7 types. Examples include:
- Distal (lateral) subungual onychomycosis – It is one of the most common types of mycotic nails, and it often starts on the distal edge or sides of the nail. Sometimes, it can spread and turn your nail white, brown, or yellow.
- Proximal subungual onychomycosis – In such cases, the infection starts from the proximal nail fold. The most common fungi that cause this type of mycotic nail in the U.S. are called T. rubrum.
- Superficial onychomycosis – In such cases, the disease negatively affects the superficial layers of the nail (the top ones). However, the infection spreads deeper, and the nail may turn white. It is usually caused by T. mentagraphytes.
- Endonyx onychomycosis – People who develop this type of mycotic nail will notice changes in the interior of the nail plate (the tissue underneath the hard part of the nail).
- Totally dystrophic onychomycosis – This is an advanced stage of the distal or proximal types. Usually, the nails have extra-thick layers because of extra keratin.
- Yeast onychomycosis – This type of mycotic nail infection is caused by Candida and usually affects the fingernails. In rare cases, it may indicate a problem with your immune system.
- Fungal melanonychia – This form of mycotic nail happens rarely, and it is often caused by the following fungi types. These include Scytalidium, Alternaria, and Exophiala.
What Are The Symptoms of Mycotic Nails?
Most of the time, the symptoms of this condition can be noticed with the naked eye because of the nail changes. These include:
- Nail discoloration (including white, brown, or yellow)
- Pain
- The nail may separate from the nail bed
- Cracked, thick, or fragile nails
If any of the previous symptoms occur, do not hesitate to visit a doctor.
Causes
This nail disorder happens due to fungal organisms that get into your toenails or fingernails. They often enter the nail through small cracks in the nail (keratin). In some cases, it may happen due to skin infections. In any case, you should visit a doctor if you suspect you may have a nail infection. Check some examples of fungi that often cause mycotic nails below:
- Dermatophytes (they cause about 80% to 90% of mycotic nails)
- Nondermatophyte molds (this form of fungi causes between 2% and 10% of mycotic nails)
- Yeast (about 2% to 11% of mycotic nails)
- Epidermophyton floccosum
- Microsporum species
- Trichophyton interdigitale, mentagrophytes, rubrum, and tonsurans
Risk Factors
While mycotic nails can affect anyone, the following factors may increase your risk even more. Check some of them below:
- Psoriasis
- Nail injury or surgery
- Problems with blood circulation
- Weakened immune system
- Diabetes
- Smoking
- Wear shoes without ventilation
Recently, experts have found some genetic changes that can make you more prone to mycotic nails.
What Are The Potential Complications of Mycotic Nails?
People who develop mycotic nails may also experience some complications, especially if they leave this infection untreated. Check some complications below:
- Physical nail damage – The nail can become thick, brittle, or separated from the nail bed. In rare cases, it may lead to total nail loss.
- Pain and mobility problems – These include deformed nails and pain that can make it difficult to wear shoes or walk.
- Spread of the infection to other parts of the body – This fungal infection may spread to surrounding skin, causing athlete’s foot and other health problems.
- Secondary bacterial infections – One example is cellulitis that may occur when the nearby skin is damaged. In general, to treat bacterial infections, people need antibiotics.
- Serious risks for people with chronic health conditions – While it happens rarely, some people who already have a weakened immune system, poor circulation, or diabetes may experience a severe infection of the bones (such as osteomyelitis).
- Long-term health problems (such as paronychia)
The previous list does not contain a complete list of complications. However, your physician may recommend some tips or medicines to reduce the risk or even prevent them.
How to Prevent Mycotic Nails?
While it is not always possible to prevent mycotic nails, you can consider the following tips to reduce the risk. For example:
- Avoid sharing your nail clippers
- Regularly wash your hands and feet with soap and warm water
- Avoid walking barefoot in public showers or locker rooms
- You should always make sure that the nail salon sterilizes the instruments
- Clip your nails short
If you think a nail is infected, it is recommended to put an antiseptic ointment on the affected area, bandage it, and call your physician to schedule an appointment.
Diagnosis
Most of the time, healthcare professionals diagnose mycotic nails by performing a visual examination of the nails and asking questions about the symptoms and medical history. Sometimes, they may also perform some tests to rule out other disorders that cause similar symptoms. Commonly, the doctors perform a fungal culture.
Treatment
While most people clip off the affected part of the nail once they notice it, doctors recommend avoiding clipping your nails until your doctor confirms they are not infected. In general, it is challenging to treat mycotic nails because topical medications rarely help. Most people get rid of this infection by taking oral antifungal medications. These include Itraconazole, Terbinafine, or Griseofulvin. The infection often clears within 12 weeks.
Frequently Asked Questions
What is the difference between a mycotic nail and a nail infection (paronychia)?
It is important to understand that paronychia, a nail infection, is misleading because it affects the skin around a nail. However, a mycotic nail does not cause problems with the skin. Discuss it with your physician for more details.
What do mycotic nails feel like?
If you develop this fungal infection, you will feel that your toenails or fingernails are thick and fragile.
Are mycotic nails contagious?
Typically, most fungal infections are contagious (including mycotic nails). It means this infection can easily pass from one person to another. Ask your healthcare provider if you have additional questions.
