Fungal nail infection

What causes fungal nail infection?

Most fungal nail infections happen because of the same fungus that causes athlete's foot. This fungus thrives in warm, dark, damp places, and your feet are the perfect spot for it to grow and spread. Once it settles in, it can lead to an infection under or around the nail.

You're more likely to get a fungal nail infection if:

• your feet stay warm and damp most of the time
• you wear shoes that make your feet hot and sweaty
• you don't keep your feet clean and dry
• your nails have been damaged in some way
• your immune system is weakened
• you have certain health conditions, such as diabetes, psoriasis or peripheral arterial disease

How does fungal nail infection spread from person to person?

Fungal nail infections can pass from one person to another, so you're more likely to catch it if you walk barefoot in shared spaces like communal showers and gyms.

A pharmacist can help if you think you have a fungal nail infection. You should speak to a pharmacist if the look of your nail bothers you or it's painful.

The pharmacist will be able to recommend the best treatment for you.

Contact your GP practice if you have a fungal nail infection and:

• the infection is severe and treatment has not worked
• the infection has spread to other nails
• you have diabetes, since foot problems can be more serious if you have diabetes
• you have a weakened immune system, for example if you have had an organ transplant or are having chemotherapy

A fungal nail infection rarely clears up on its own without treatment. That said, treatment can take a while, and it can sometimes come with side effects.

Antifungal nail medicine

A pharmacist may recommend an antifungal nail treatment that you paint onto the nail.

It needs to be used regularly for a few months before you notice any improvement.

Continue using it until you're advised to stop. Stopping too soon could let the infection come back.

Antifungal tablets

If pharmacy treatments haven't worked, your doctor may prescribe antifungal tablets.

Before starting, your doctor will take a sample from your nail to identify the type of infection.

You may also need a blood test, both before and during treatment, to make sure your liver is working properly.

Antifungal tablets may need to be taken for up to 6 months.

Possible side effects of the tablets include:

• headaches
• an itchy rash
• stomach ache
• nausea
• diarrhoea

Antifungal tablets aren't suitable for everyone. They can't be used if you have liver or kidney disease, and they may not be recommended during pregnancy or while breastfeeding.

Nail removal

In some cases, a badly infected nail may need to be removed. This is a minor procedure carried out under local anaesthetic, so the area is numbed beforehand.

Prevention

There's quite a bit you can do to lower your chances of getting a fungal nail infection.

Helpful habits

• Treat athlete's foot straight away, so it doesn't spread to your nails
• Keep your nails trimmed short
• Put on clean, fresh socks every day
• Wear flip-flops or sandals when showering at the gym or a public pool
• Get rid of old, worn-out shoes and replace them
• Wash your towels regularly

Best avoided

• Don't wear shoes that leave your feet hot and sweaty
• Don't share towels, socks or shoes with anyone else
• Don't walk barefoot around public pools, showers or locker rooms
• Don't share nail clippers or scissors with anyone else