Onychomycosis: Fungus Among Us

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You might not be familiar with the medical term “onychomycosis,” but chances are, you have seen it in your salon. A contagious fungal nail infection, onychomycosis is the most common nail condition seen in her practice, says Shari Lipner, M.D., Ph.D., associate professor of clinical dermatology and director of the Nail Division at Weill Cornell Medicine. But, it is most common among older folks: 10% of the general population has onychomycosis, but half of the people over 70 do, according to the American Academy of Family Physicians.

Onychomycosis generally starts off as mild and may become severe over time, Lipner says. It most commonly affects the toenails, making them look yellow, thickened and lifted off the nail bed with some debris underneath. There may also be scales in between the toes and the bottoms of the feet, but the condition may be visible to laypeople, Lipner notes.

In addition, the skin folds around fungal nails can appear red or irritated, and toenail fungus might cause an odor or itching, says Dr. Nelya Lobkova, a board-certified surgical podiatrist at Step Up Footcare in New York City.

Infected nails do not always appear yellow; they also can turn white or brown. They might look chalky or cloudy in some spots or crack or break in one or more spots, says Angie Seelal, a certified registered physician assistant at Advanced Dermatology PC in New York City.

Although onychomycosis is very common, it is not always easy to diagnose, so leave that to medical professionals, Lobkova says.

“Thickened, discolored and damaged nails could be caused by a variety of conditions that are not fungal as well,” Lobkova continues. The cause could be genetic, or certain medications, particularly chemotherapy drugs, might cause nail discoloration or deformity, she says. Trauma to the nail bed can cause nail thickening and stunted growth as well.

Debris under the nail might also be shampoo, skin cell debris and soap, which, when combined, can have a similar appearance to fungal debris, adds Janet McCormick, nail technician, author and co-founder of Nailcare Academy in Fort Myers, Florida.

Continue reading about how toenail fungus spreads, how it is diagnosed and treated and how you can deal with your clients' fungal infections, in the July/August 2021 issue of our digital magazine.

About the Author 

Virginia Pelley is a freelance writer and editor based in Tampa, Florida.

Sources: Pubmed (NIH) and AAFP (American Family Physician)

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