Nail fungus: Signs and symptoms

What are the signs of nail fungus?

If you get nail fungus, you’re likely to see one or more of the following changes to your nails:

• Part of a nail turns white, yellow, brown, or another color. At first, you may just see a spot of discoloration at the tip of your nail. Without treatment, this discoloration may spread, covering more of the nail.

• Debris builds up under the nail.

• A nail begins to lift up, so it’s no longer firmly attached to the finger or toe.

• A nail turns white, and the surface of the nail may feel soft, dry, and powdery. The nail also thins, so you may be able to scrape off the nail.

• Nails thicken and turn yellow or brown, often this affects all of the fingernails.

• A nail splits or crumbles.

Treatment is important

Without treatment, the fungus can spread and damage more nails.

Having nail fungus is usually painless. At least, it’s painless in the beginning. However, if you put off getting treatment, the fungus can grow. When the fungus worsens on toenails, wearing shoes can become painful.

If you see any changes to a nail, you should see a board-certified dermatologist. When caught early, nail fungus may clear with treatment applied to the nail. As the fungus grows, it becomes more difficult to clear the infection.

Images
Images 1,2, and 3 used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 2014;70:918-23.

Image 4 used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References
Bhatta AK, Keyal U, et al. “Fractional carbon-dioxide (CO2) laser-assisted topical therapy for the treatment of onychomycosis.” J Am Acad Dermatol. 2016;74:916-23.

Gold LFS and Rosen T. “Onychomycosis: Diagnosis, treatment, and prevention strategies.” Dermatology News (A CME/CE certified supplement). March 2016:2-15.

Habif TP, Campbell, JL, et al. “Tinea of the nails.” In: Dermatology DDxDeck. Mosby Elsevier, China, 2006: Card#72.

Lim FH, Kim H, et al. “Toenail onychomycosis treated with a fractional carbon-dioxide laser and topical antifungal cream.” J Am Acad Dermatol 2014;70:918-23.

Verma S and Heffernan MP. “Onychomycosis.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 1817-20.