What Is Tinea Unguium?

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Tinea unguium is a fungal nail infection that most commonly affects the toenails. The condition impacts up to 14% of the population.

Like other fungal infections, fungi, which enter the skin through cracks in your nail and surrounding skin, cause tinea unguium.

This article explains the causes, symptoms, diagnosis, and treatment of tinea unguium.

A healthcare provider looking at toenail fungus

Manuel Faba Ortega / Getty Images

Tinea Unguium Symptoms

Initially, nail fungus is painless; however, if left untreated, it can lead to pain, especially when you wear shoes. Instead, you may notice the following tinea unguium symptoms:

  • Nail discoloration, which might be white, yellow, or brown
  • Debris buildup under the nail
  • Loose nails
  • Nail surface that becomes soft, dry, or powdery
  • Nail thickening
  • Nail splitting

Fungal nail infections commonly occur with fungal skin infections, like athlete's foot or ringworm. If you have one of these conditions, pay close attention to the surrounding skin or nails.

Causes

A fungus causes tinea unguium infections. While anyone can get a fungal nail infection, some people are more likely to acquire an infection, including those with:

Toenail fungus incidence increases with age. Children are the least affected, with 0.6% of kids under 18 having tinea unguium. On the other hand, around 10% to 20% of adults and 15% to 40% of older people experience the condition.

Diagnosis

Healthcare providers can usually diagnose nail fungus by looking at your nail. But to prescribe the proper treatment, your healthcare provider may take a nail sample to send for testing to determine the organism causing the condition.

Treatment

Nail fungal treatment may involve topical treatments, medications, or nail removal. Some people use natural remedies. However, they are usually ineffective for nail fungus.

Topicals

Topical nail fungus treatments are antifungal medications that are applied to the nail. These medications include:

These types of medications are most often used for mild infections. They work by preventing new fungus from growing as the infected nails grow. However, topical medications may not always be the best choice for treatment.

Antifungal Pills

Oral medications orally are reserved for more severe cases of nail fungal infections. Treatment usually lasts three months. Antifungal medication pills include:

These medications have some serious risks and side effects, including liver injury. Some providers may take blood work before and during treatment. Discussing these medications with a healthcare provider and following their instructions carefully is important.

Nail Removal

A healthcare provider may recommend nail removal when other treatments don't work. Sometimes this is done by applying a chemical to your nail. Other times, your nail is surgically removed. A dermatologist (a doctor specializing in skin, nail, and hair conditions) performs nail removal in their office. After treatment, the nail usually grows back.

Laser Therapy

Laser treatment uses heat-producing energy to kill nail fungus. This treatment is sometimes combined with other treatments, like topical antifungals. Laser treatment may be a good alternative for those who can't tolerate stronger medications.

Natural Remedies

Some natural remedies for treating superficial or minimal nail fungal infections include essential oils, like tea tree and clove, and apple cider vinegar. While proponents tout the antifungal properties of these products, there is little evidence to support their use.

Prevention

You can't always prevent a fungal nail infection, but there are some precautions you can take to lessen the likelihood of contracting tinea unguium. Prevention strategies include:

  • Keeping your hands and feet clean and dry
  • Keeping nails short and clean
  • Wearing flip-flops in public showers and pools
  • Not sharing personal hygiene items like nail clippers
  • Carefully selecting nail salons that use good sterilization practices

If you've just recovered from a bout of nail fungus, remove or disinfect the footwear you wore before treatment. The fungus can live in shoes, boots, and slippers and reinfect you after you heal.

Coping

Fungal nail infections require a lengthy treatment—sometimes for a year. Even after completing treatment, many people find themselves susceptible to reinfection. Some people struggle with feeling self-conscious about the appearance of their nails.

To cope with tinea unguium, try the following:

  • Wear clean socks daily and replace them when they get sweaty.
  • Wear shoes that breathe, fit well, and keep your feet dry.
  • Let shoes air out for 24 hours before wearing them again.
  • Sprinkle antifungal powder in your shoes.
  • Sanitize your nail clipper.
  • Keep your hands and feet moisturized.

Additionally, as soon as you suspect a nail fungal infection, see a healthcare provider immediately for treatment. This gives you the greatest chance to catch it early and speed healing.

Summary

Tinea unguium is a fungal nail infection. It is caused by a fungus that enters the skin and nails through cracks or cuts. If you have a nail fungus, your nails may be brittle, discolored, and pull away from your skin.

Nail fungus is notoriously difficult to treat, and treatment may last months or as long as a year. Topical or oral antifungals are standard treatment methods, but laser therapy or nail removal may sometimes be warranted.

A Word From Verywell

People with nail fungus may feel embarrassed about the way their nails look. However, many people experience tinea unguium at some point in their lives, and it's nothing to be ashamed of. Experiment with wearing a variety of fun socks, which may not only boost your mood but also help keep your feet clean and dry.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. American Academy of Dermatology Association. Nail fungus: Signs and symptoms.

  3. Elewski BE, Tosti A. Risk factors and comorbidities for onychomycosis: Implications for treatment with topical therapyJ Clin Aesthet Dermatol. 2015;8(11):38-42.

  4. Muth CC. Fungal nail infectionJAMA. 2017;317(5):546. doi:10.1001/jama.2016.20617

  5. American Association of Dermatology Association. Nail fungus: Diagnosis and treatment.

  6. Gadour E, Kotb A. Systematic review of antifungal-induced acute liver failureCureus. 2021;13(10):e18940. Published 2021 Oct 21. doi:10.7759/cureus.18940

  7. American Academy of Dermatology Association. Twelve ways to prevent another nail infection.

  8. Ghannoum M, Isham N. Fungal nail infections (onychomycosis): a never-ending story?PLoS Pathog. 2014;10(6):e1004105. doi:10.1371/journal.ppat.1004105

By Kathi Valeii
As a freelance writer, Kathi has experience writing both reported features and essays for national publications on the topics of healthcare, advocacy, and education. The bulk of her work centers on parenting, education, health, and social justice.