What is it?

Fungal nail infection is a condition which you may not have heard of, but people often have it without realising.

As the name suggests, fungal nail infection is caused by a fungus. In fact, it's the same fungus that causes athlete's foot. Nearly a third of people who have athlete's foot will eventually develop toenail disease. That's over a million people in this country, so you're not alone if you have it.

How do I know if I've got it?

The problem usually starts at the end and side of the toenail, spreading slowly back towards the base of the nail. The big toenail is most often affected. You'll notice the nail starts to change colour, often becoming creamy white, yellow, or occasionally green in the infected area. The nail itself starts to thicken, beginning with the underside and the end can become slightly raised. It will also become crumbly and may sometimes cause discomfort. Gradually, it starts to split and separate from the nail bed, and eventually it may crumble away completely and the fungus may spread to other nails.

• The infection may spread slowly backwards towards the base of the nail
• It causes the nail to change colour
• The nail crumbles and thickens on the under-side

  The end of nail may become raised

• The nail splits and separates from the nail bed
• The nail may crumble away completely

Who gets it and how do you catch it?

Fungal nail infection affects over one million people in this country. It seems to become more common the older you get, and rarely affects children.

The infection almost always occurs in people who suffer with athlete's foot. The fungus usually attacks the nail from the toe-end or side of the nail, although sometimes it can enter the nail after the nail itself has been damaged.

The same fungus can affect fingernails, but fungal nail infection of the toenails is significantly more common.

How do I treat it?

The fungus won't go away without treatment. But you can do something about it. Your family doctor can now prescribe effective treatments. The treatments which you take by mouth will also cure athlete's foot at the same time as the infected nail. If you have tried treatments for a nail infection in the past with little success, you may find it is now worth going back to your doctor for further advice.

Your doctor may wish to take clippings of your nail before he starts treating you, to make sure that the problem is caused by a fungus.

What else could it be?

It is possible that a nasty-looking nail, as described earlier, may be caused by something else. Other conditions which may look similar are:

• psoriasis

  This is a scaly condition affecting the skin and, occasionally, the nails. It usually only occurs in the nails if the disease also affects other parts of the body. For example, the elbows and knees.

• an in-growing toenail

  This is caused by a splinter of nail piercing the side of the toe and digging into the flesh. If untreated, the nail may look infected.

• minor trauma to the nail

  If nails are repeatedly knocked or traumatised, it may cause the nail to become slowly and progressively separated from the nail bed. This will produce a discolouration of the ends of the nails, as seen with fungal nail infection.

Can it come back?

Sometimes fungal nail infection may come back. This is usually because it may not have been completely treated in the first place, or where athlete's foot has re-infected the nail. Either way, you should visit your doctor who can now treat the condition effectively. Make sure you follow your doctor's advice carefully and complete any course of medication.

How should I look after my nails if I have a fungal nail infection?

You may find it difficult to look after your nails when they have a fungal infection as they become thickened and crumbly.

Use a pair of nail clippers to trim the nail back. Do not file the end of the nail if it has become elevated, as this is likely to spread the infection.

Always clean your nail clippers after use, and thoroughly wash and dry your hands.

• Fungal nail infection is caused by a fungus
• It often occurs in people who suffer with athlete's foot
• It can spread to other parts of the body and other people
• It is likely to get worse without treatment
• Your family doctor can now prescribe effective treatments for fungal nail infection
• The treatments you take by mouth will also cure athlete's foot at the same time as the infected nail

Check points

• Have you noticed your toenails becoming thickened, crumbly and that they've changed colour?
• Have you ever had or do you currently suffer from athlete's foot?

If you answer 'yes' to both of the above, you are likely to have a fungal nail infection. Go and see your doctor, for advice, as it rarely gets better without treatment and is likely to get worse.

For More Information

• A Collection of Photos on WebMd.com: Picture of Fungal Nail Infection