What is nail fungus?
Nail fungus, also known as onychomycosis, is a fungal infection that affects the toenail or fingernail.[1]
What are the main signs and symptoms of nail fungus?
This infection causes nails that are brittle, thickened, painful, and have a brown/yellow discoloration. If untreated, these symptoms will worsen until the nail has completely disintegrated.[1]
How is nail fungus diagnosed?
A thorough examination from a healthcare provider is recommended. They will usually take a sample of the infected nail for analysis. Depending upon the severity of the infection, a more in-depth analysis may be ordered.[1]
What are some of the main medical treatments for nail fungus?
The main medical treatments are antifungal drugs. These drugs may be taken orally or applied directly to the nail.[2]
Have any supplements been studied for nail fungus?
In vitro (lab-based) and animal studies have tested supplements on other types of fungal infections, but no research has tested if these supplements treat nail fungus specifically in humans. Compounds like monolaurin (which is derived from coconut oil), or certain flavonoids (e.g., liquiritigenin) may have general antifungal effects.[3][4][5] Overall, more human evidence is needed before any supplement can be recommended for treating nail fungus.
How could diet affect nail fungus?
Currently, there is no research connecting diet and nail fungus.
Are there any other treatments for nail fungus?
Treatments that do not use antifungal drugs are limited. However, laser therapy (a treatment in which the nail is exposed to a powerful light source) has the potential as an alternative treatment for nail fungus.[6]
What causes nail fungus?
Fungal infections can occur anywhere on the body and typically develop in dark, warm and moist environments. For instance, if one is constantly wearing shoes that often get wet, this may increase the risk of developing nail fungus.[1]
Frequently asked questions
Nail fungus, also known as onychomycosis, is a fungal infection that affects the toenail or fingernail.[1]
This infection causes nails that are brittle, thickened, painful, and have a brown/yellow discoloration. If untreated, these symptoms will worsen until the nail has completely disintegrated.[1]
A thorough examination from a healthcare provider is recommended. They will usually take a sample of the infected nail for analysis. Depending upon the severity of the infection, a more in-depth analysis may be ordered.[1]
The main medical treatments are antifungal drugs. These drugs may be taken orally or applied directly to the nail.[2]
There are many definitions that describe the level at which nail fungus has been cured. A clinical cure is a 100% visually clear nail. A mycological (i.e., fungus-oriented) cure is a negative KOH preparation (a test used to diagnose fungal infections) and a negative fungal culture. Therefore, nail fungus is determined completely cured if there is both a clinical and mycological cure.[1]
After treatment, the affected nail may appear normal. However, this does not rule out the possibility of a fungal infection. Thus, it is not uncommon for nail fungus to return after treatment. Moreover, if the fungal infection is severe enough, it may cause permanent damage to the nail, which results in the affected nail never returning to its original appearance.[1]
After being treated with antifungal drugs, preventative measures should be taken to prevent reoccurrence. These measures include topical antifungal treatments and removing any other potential sources of infection.
Although the nail may appear healthy, the fungus may not be fully eradicated. For that reason, antifungal creams are recommended to be applied to the affected nail to prevent further fungal growth.[9]
It is also recommended to either throw away or disinfect footwear and socks. Be sure to wash socks in hot water. Proper disinfection is important, as cold water washes have been shown to be ineffective in eradicating the fungus that causes nail fungus.[10] To disinfect shoes, treatments include terbinafine spray, ozone gas, or ultraviolet light.[11][12][13]
Other preventative actions include keeping nails cold and dry, avoiding walking barefoot in public places, keeping nails short, treating other family members with nail fungus, and meticulous nail hygiene.[1]
In vitro (lab-based) and animal studies have tested supplements on other types of fungal infections, but no research has tested if these supplements treat nail fungus specifically in humans. Compounds like monolaurin (which is derived from coconut oil), or certain flavonoids (e.g., liquiritigenin) may have general antifungal effects.[3][4][5] Overall, more human evidence is needed before any supplement can be recommended for treating nail fungus.
While the market abounds in “hair and nails” products, reliable studies on nails are scarce. Benefits to nails from supplements are most often anecdotal or inferred from studies on hair. Preliminary evidence suggests that minoxidil might help with nail growth; vitamin B7 (biotin) might help with brittle nails, triangular worn-down nails, trachyonychia, or habit-tic deformity; and vitamin E might help with yellow nail syndrome and brittle nails. Current evidence suggests that supplementation with calcium, copper, iron, selenium, silica, zinc, vitamin A (retinoids), vitamin B12, or vitamin C doesn’t improve nail health or appearance in non-deficient people.[7][8]
Currently, there is no research connecting diet and nail fungus.
Treatments that do not use antifungal drugs are limited. However, laser therapy (a treatment in which the nail is exposed to a powerful light source) has the potential as an alternative treatment for nail fungus.[6]
Fungal infections can occur anywhere on the body and typically develop in dark, warm and moist environments. For instance, if one is constantly wearing shoes that often get wet, this may increase the risk of developing nail fungus.[1]
The development of nail fungus results from the interaction of environmental and genetic factors. Environmental factors consist of conditions that allow for fungus to grow. Examples include humid environments and tight-fitting shoes.[1] Genetically, certain mutations related to impaired immune function may increase the risk of developing nail fungus.[14] This may explain why some people do not develop nail fungus while being exposed to the same environmental factors.
Other things such as older age, psoriasis, nail trauma, peripheral vascular disease, smoking, and immune suppression also increase the risk of developing nail fungus.[1]
References
- ^Gupta AK, Stec N, Summerbell RC, Shear NH, Piguet V, Tosti A, Piraccini BMOnychomycosis: a review.J Eur Acad Dermatol Venereol.(2020-Sep)
- ^Bodman MA, Krishnamurthy KOnychomycosisStatPearls.(2022-05)
- ^Seleem D, Chen E, Benso B, Pardi V, Murata RMIn vitro evaluation of antifungal activity of monolaurin against Candida albicans biofilms.PeerJ.(2016)
- ^Lee JY, Lee JH, Park JH, Kim SY, Choi JY, Lee SH, Kim YS, Kang SS, Jang EC, Han YLiquiritigenin, a licorice flavonoid, helps mice resist disseminated candidiasis due to Candida albicans by Th1 immune response, whereas liquiritin, its glycoside form, does not.Int Immunopharmacol.(2009-May)
- ^Gharibpour F, Shirban F, Bagherniya M, Nosouhian M, Sathyapalan T, Sahebkar AThe Effects of Nutraceuticals and Herbal Medicine on Candida albicans in Oral Candidiasis: A Comprehensive Review.Adv Exp Med Biol.(2021)
- ^Gupta AK, Simpson FNewly approved laser systems for onychomycosis.J Am Podiatr Med Assoc.(2012)
- ^I R ReidCalcium supplements and nail qualityN Engl J Med.(2000 Dec 14)
- ^Noah Scheinfeld, Maurice J Dahdah, Richard ScherVitamins and minerals: their role in nail health and diseaseJ Drugs Dermatol.(2007 Aug)
- ^Gupta AK, Elewski BE, Rosen T, Caldwell B, Pariser DM, Kircik LH, Bhatia N, Tosti AOnychomycosis: Strategies to Minimize Recurrence.J Drugs Dermatol.(2016-Mar)
- ^Hammer TR, Mucha H, Hoefer DInfection risk by dermatophytes during storage and after domestic laundry and their temperature-dependent inactivation.Mycopathologia.(2011-Jan)
- ^Feuilhade de Chauvin MA study on the decontamination of insoles colonized by Trichophyton rubrum: effect of terbinafine spray powder 1% and terbinafine spray solution 1%.J Eur Acad Dermatol Venereol.(2012-Jul)
- ^Gupta AK, Brintnell WCSanitization of contaminated footwear from onychomycosis patients using ozone gas: a novel adjunct therapy for treating onychomycosis and tinea pedis?J Cutan Med Surg.(2013)
- ^Ghannoum MA, Isham N, Long LOptimization of an infected shoe model for the evaluation of an ultraviolet shoe sanitizer device.J Am Podiatr Med Assoc.(2012)
- ^Gupta AK, Simpson FC, Brintnell WCDo genetic mutations and genotypes contribute to onychomycosis?Dermatology.(2014)