Onychomycosis is a fungal infection that affects the nail, causing changes in its texture, color, and thickness. Although many perceive it as a mere cosmetic nuisance, it is in fact an infectious disease that, if left untreated, may progress, spread, and lead to complications. Early diagnosis and appropriate management are crucial for nail health and for preventing the spread of infection.
What are the first signs?
Fungal nail infection typically manifests with alterations in the nail plate, such as:
- Yellowish or brown discoloration
- Thickening and roughness
- Brittle texture or detachment of the nail plate from the nail bed
- Unpleasant odor, particularly when toenails are affected
Onychomycosis often begins in a single nail and, over time, may spread to others. Specific forms, such as proximal subungual onychomycosis or white superficial onychomycosis, present with distinct clinical features that also guide appropriate treatment.
Why is early treatment important?
Treating onychomycosis is not simply a matter of aesthetics. If neglected, it may cause:
- Spread to surrounding tissues or fingernails
- Permanent alterations of the nail matrix
- Transmission to other individuals through shared surfaces
- Complications in people with weakened immune systems, diabetes, or atopic dermatitis
Managing the infection requires time and persistence. The earlier treatment begins, the higher the chances of complete nail restoration.
What are the most common risk factors?
Fungal growth is favored by conditions of moisture, warmth, and poor ventilation. Risk factors include:
- Frequent use of unsuitable footwear, particularly tight or synthetic shoes
- Prolonged time in damp environments, e.g., many hours in closed shoes
- Toe or finger injuries
- Preexisting skin conditions or fungal infections of the nails
- Exposure to communal showers, swimming pools, or locker rooms
Diagnosis: why we do not rely solely on appearance
Although the signs and symptoms of onychomycosis are characteristic, confirmation requires laboratory testing (microscopy or culture from a nail sample). This is essential to rule out other nail disorders or benign tumors and to identify the specific fungal species.
Treatment is tailored to each case
Management of onychomycosis depends on the extent of infection, the patient’s overall health, and the fungal type involved. Available options include:
- Topical treatments, such as medicated nail lacquers
- Oral antifungal therapy for more extensive cases
- Combination approaches with antifungal medication and regular nail care
- In resistant cases: systemic therapy or even surgical removal of the affected nail
Successful treatment requires adherence to therapy, regular follow-up, and measures to avoid reinfection.
Prevention: the key to healthy nails
To prevent onychomycosis and its recurrence, it is recommended to:
- Trim nails carefully without causing trauma
- Avoid detachment of the nail plate
- Maintain proper hand and foot hygiene
- Use antifungal powders or sprays in footwear
- Avoid sharing personal items (towels, nail files, clippers)
When to see a dermatologist
Onychomycosis may appear trivial, but often it is not. If changes in nail color, shape, or texture are observed — especially when accompanied by pain, inflammation, or persistence — specialist evaluation is essential. At our dermatology clinic, individualized treatment protocols are applied, tailored to each patient’s needs.