What is onychomycosis?

By Cristiano Antonino Last updated Jun 3, 2023

Chances are that at least once in your life you have suffered from onychomycosis, an infection that affects the nails of the feet and hands, and which affects a very large segment of the population

Very common among both men and women, onychomycosis – as its scientific name implies – consists of mycoses that can occur on one or more nails at the same time.

What is onychomycosis?

As already mentioned, onychomycosis is an infection of the nails.

Medical literature has noted that onychomycosis is commonly more common on the toenails of the feet than on the nails of the hands.

In fact, unlike the hands, the feet are almost always confined to poorly ventilated environments full of moisture and sweat.

Poorly breathable shoes, strenuous work that forces one to stand a lot and poor circulation can all contribute to onychomycosis.

Concretely, the nail is infected and colonised by a mycosis (fungus, mould or yeast) that causes the nail to crumble, thicken or change colour.

It is not uncommon, in fact, to observe patients with onychomycosis who have yellow, black or even green nails.

Individuals most at risk

Onychomycosis is an infection that can affect everyone, both adults and children, but a higher incidence has been noted in elderly patients.

Especially men, who often wear closed and tight shoes, preferring materials that facilitate the proliferation of the infection such as synthetic, rubber and non-breathable fabrics.

Patients with diabetes or autoimmune diseases, as well as immunodepression, may be more prone than others to develop onychomycosis.

What are the symptoms of onychomycosis?

The symptoms of an ongoing onychomycosis are quite obvious, so much so that it is usually the patient who goes to his or her own doctor to ascertain the infection.

One of the main symptoms is the colour change of the nail from its natural colour to yellow, green, brown or even black, depending on the depth of the fungus.

It is precisely the type and severity of the fungus that also determines the physical condition of the nail, which in addition to the colouring may appear jagged and thickened.

Even the nail can literally crumble away, causing discomfort and pain.

However, one is always dealing with a very weakened and brittle nail, which in the most severe cases also leads to bad smell and onycholysis – the total loss of the nail.

It goes without saying, therefore, that at the very first signs, it is a good idea to visit your doctor immediately.

Although not a serious condition, if not treated properly the infection can affect the skin and spread to the body.

Diagnosis of onychomycosis

The diagnosis of onychomycosis is made through an objective examination of the nail by the doctor, who may go so far as to ask for a specific test to find out what type of fungus is attacking the nail.

The test is very simple and practically painless for the patient: the doctor takes a small amount of the nail by scraping either its surface or the debris underneath.

Once done, this debris is observed under a microscope to determine the extent of the infection.

Risk factors

Who is most at risk of developing onychomycosis?

Certainly, those who frequent clubs or sports centres without paying attention to the fungi that proliferate in the changing rooms.

It is not uncommon to contract a fungal infection in swimming pools or showers, especially if you walk around barefoot, making it easier for the fungus to penetrate between the nail bed and the nail.

Other risk factors are:

Age – as already mentioned, the elderly develop onychomycosis more easily due to circulation problems and low immune defences.
Diabetes – those who suffer from diabetes are more prone to contracting onychomycosis.
Immune system disorders.
Sweat – those who sweat excessively and those who wear closed shoes, for example, may develop onychomycosis.
Psoriasis.
Athlete’s foot.
Bad footwear habits.

Can onychomycosis be prevented?

Unless there is a genetic and health predisposition, it is possible to brilliantly prevent the formation of onychomycosis.

Among these, one of the most important tips is to keep nails short and always clean, as well as dry.

In fact, humidity is the number one ally of onychomycosis, and it is precisely this that should be avoided as much as possible.

Obviously, wearing synthetic socks and synthetic fabrics in general is not recommended, and it would be good to change socks and stockings every day at the end of the day.

Trauma can also cause onychomycosis, as can contact with irritants.

To prevent onychomycosis, it is a good habit to take care of one’s nails by not eating them or tearing them, always preferring to use a file and scissors.

Antifungal drugs and treatments

Onychomycosis is usually treated through the administration of antifungal drugs.

They should be treated as soon as possible, precisely because they are very contagious.

In addition to perfect hygiene, therefore, the doctor will tell you which medicines to take and perhaps direct you towards buying special, breathable shoes (if the mycosis is on the feet).

Medicines act directly on the fungus, and can be oral or topical drugs.

Topical medicines are usually glazes or ointments to be applied directly on the mycosis.

How long does onychomycosis take to pass?

The pharmacological treatment of onychomycosis is, alas, very long.

To completely eradicate it can take months and months. Medication must be taken consistently and every day.

Nail removal

In extreme and truly serious cases, onychomycosis can lead to nail removal as the only definitive way to cure.

When the nail is too infected, it is removed through minor surgery.

Lifestyle care

As you may have guessed, lifestyle can also have a great influence on the development of onychomycosis.

If you neglect the personal hygiene of your hands and feet, for example, or if you use non-breathable fabrics, the likelihood of developing the fungus increases.

It would then be good to follow a diet rich in vitamin C by taking it through fruit and vegetables, as well as vitamin D, present both in supplement form and in foods such as egg yolk or fish.

Zinc, selenium, magnesium and iron supplements are also excellent, as is the intake of probiotics and ferments found in yoghurt, tofu and buttermilk.

The intake of Omega3, found in oily fish and oil seeds, can also help concretely.

Natural remedies

We recommend taking echinacea, turmeric and uncaria supplements frequently, as well as decoctions made with essential oils of walnut, garlic and hydraste.

For topical use, marjoram, oregano, thyme, cloves, savory, cinnamon and melaleuca are also very good natural remedies.

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