Nail Fungal Infection – The Signs and Symptoms



Nail fungal infections are not the most dangerous of health conditions that affect people these days, but they are quite common – more common than you would believe. In fact, among the various superficial fungal infections which affect different parts of the body, the occurrence of nail fungal infections in North America, Europe and East Asia is said to be 14%, 23% and 20%, respectively. (Ghannoum & Isham, 2014)


Furthermore, it is said that fungal infections are behind a staggering 50 percent of all dermatological conditions which affect nails. Overall, there are over 35 million people worldwide who have suffered from nail fungal infections in some capacity.

Now the knowledge of such statistics do little to prevent or treat the conditions. However, what it does do is console the patients affected by the condition that they are not suffering alone.


What Is It?


Onychomycosis, tinea unguium, or better known as nail fungal infections are superficial dermatological infections caused by dermatophytes.


These nail fungal infections might affect either the fingernails or the toenails, or in extreme circumstances, both. Toenail fungus is by far the most common of all the other fungal infections. Although nail fungal infections are not limited by age, race, sex, or ethnicity, they are considerably more prevalent in adults, especially the elderly (those who fall in the 60 -70 age bracket or above). (Davis, 2016)


Onychomycosis is divided into a number of sub-types, each that affects nails in a different capacity.


They include:

  • Distal Lateral Subungual Onychomycosis (DLSO): The most common type of fungal nail infection which the spread of the infection is from the skin towards the underside of the nail and upwards.
  • White Superficial Onychomycosis (WSO): A rare form of nail fungal infections that affects less than 10 percent of all cases. This infection causes the fungi to directly invade the superficial surface of the nail plate and then moving onto affecting the nail bed.
  • Proximal Subungal Onychomycosis (PSO): The least common subtype of all nail fungal infections. However, while it is not known to affect healthy nails as such, PSO is quite common in patients suffering from AIDS. In this condition, the fungus spreads from the skin around the nail or the cuticle, onto the nail fold and then the nail plate.
  • Endonyx Onychomycosis (EO): Quite similar to DLSO, the Endonyx Onychomycosis subtype reaches the nail via the skin underneath the nail itself. However, the instead of affecting the nail bed first and then moving upwards to the nail plate, in EO, the fungi bypasses the nail bed to directly attack the nail plate.
  • Candidal Onychomycosis: Caused by yeast of the Candida infection and is not classified as a traditional fungal nail infection. Candidal Onychomycosis affects the nail in such a way that it separates entirely from the nail bed.


Signs and Symptoms


Fungal infections, on the nails or otherwise, develop over a period of time. Any initial changes that occur as a result of a nail fungal infection are usually too subtle to be noticed immediately. What’s more, fungal infections aren’t painful until they’ve progressed a considerable extent. While the symptoms of a fungal nail infection usually differ (WebMD, 2017), depending on the subtype of the infection that affects you, the most common signs and symptoms to watch out for include:

  • The presence of a powdery white spot on top of the nail surface (the earliest sign)
  • A minute black spot on or beneath the nail (usually toe nails) – often mistaken for dried blood following a nail trauma.
  • Numerous ridges or lines apparent on the nail’s surface
  • Whitish to Yellowish streaks on top of the nail surface as well as underneath
  • Spreading discoloration ranging from white, yellow, brown or any other color
  • Continuous buildup on pieces of nail and skin fragments and other debris underneath the nail
  • Unusual thickening of the nail
  • Shape distortion of the nail
  • Distinct discoloration which separates the affected nail from the healthy one
  • Brittle, ragged or crumbly appearance of the nails
  • Detachment of the nail from the nail bed
  • The nails chip, break or split very commonly.
  • Foul smell


When to See a Doctor

Nail fungal infections are usually painless and pose no imminent threat to the overall systemic health of an individual. What’s more, the changes that occur as a result of a fungal infection are so subtle and slow that it’s hard to pick up on and identity on an immediate basis, making it even easier to overlook. (American Academy of Dermatology , 2017)

However, as the fungus progresses unchecked, it has the potential to spread to all the finger and toenails to a point where wearing shoes is a particularly painful task. In case normal self-care and hygiene methods have not yielded results in cleaning the nails, or in case the nail becomes increasingly discolored or deformed, it is recommended that you visit a dermatologist for an accurate diagnosis and timely treatment.


Possible Complications


Nail fungal infections, as mentioned earlier, are not painful conditions. However, they do have an adverse aesthetic repercussions that cause people to seek treatment early on. That said, there are a few possible complications to nail fungal infections which have been left untreated. They include:

  • Increasing uncomfortableness when standing, exercising or walking for long durations of time.
  • Unsightly disfiguration of toes and finger nails
  • Paresthesia – the prickling or tingling sensation due to irritation of a nerve
  • Pain and discomfort over time
  • Loss of dexterity
  • Loss of self-esteem due to unsightly disfiguration leading to difficulty in social interactions
  • Total Dystrophic Onychomycosis – the most advanced form of onychomycosis which can cause the fungus to affect the entirety of the nail unit. If left untreated, it can cause permanent disfiguration as well as deep scarring of the nail matrix. (Davis, 2016)



  1. American Academy of Dermatology . (2017, August 16). Nail Fungus . Retrieved from American Academy of Dermatology Web site :
  2. Davis, C. P. (2016, February 2). Fungal Nail Infection Onychomycosis (overview). Retrieved from E Medicine Health Web Site:
  3. Ghannoum, M., & Isham, N. (2014). Fungal Nail Infections (Onchomycosis) : A never-ending story? PLoS Pathogens .
  4. Han, K. M. (2017 , August 16). Introduction to Fungal Nails . Retrieved from Medicine Net Web site :
  5. WebMD. (2017, August 16). Fungal Nail Infections - Symptoms . Retrieved from WebMD Web site:
  6. Yellow Toenails Cured. (2017, August 16). How to Recognize The Early Signs of Toenail Fungus . Retrieved from Yellow Toenails Cured:


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