Nail fungus – symptoms, causes and risk factors

Nail fungus

Nail fungus is a common condition which begins as a yellow or white spot under the tip of your toenail or fingernail. As the fungal infection goes deeper, nail fungus can cause your nail to crumble, thicken or to discolor at the edge. This condition can affect several nails but usually not all of your nails. If this condition is mild and it does not bother you, then you may not need treatment. But if your nail fungus is painful and it has caused thickened nails, then you can take self – care steps and medications which can help you. In many cases the treatment of the nail fungus is successful, but it often comes back. This condition is also called tinea unguium and onychomycosis. When the fungus affect the areas between your toes and the skin of your feet, then this condition is known as tinea pedis or Athlete’s foot.

Symptoms of nail fungus

You may have onychomycosis also known as nail fungus, if your nails are:

  • A dark color, caused by debris building up under your nail
  • Dull, with no shine
  • Distorted in shape
  • Brittle, crumbly or ragged
  • Thickened

Infected nails also may separate from the nail bed which is a condition known as onycholysis. You may feel pain in your fingertips or toes and you can also detect a slightly foul odor. If you have taken self – care steps and you have noticed that they did not worked out, then you need to visit your doctor as soon as possible. If you have diabetes and you think that you are developing a nail fungus, then you need to visit your doctor.

Causes of nail fungus

Dermatophyte fungus is the most common cause for nail fungal infections. [1] Molds and yeasts can also lead to nail fungus infections. Fungi are microscopic organisms. They do not need sunlight to survive. There are some fungi which have beneficial uses. But also there are other fungi which cause infection and illness. Fungi live in moist and warm environments which is including showers and swimming pools. If your nails are exposed to warm and moist conditions, then fungi can cause you problems. Fungi can invade your skin through cuts which are so tiny and you cannot see them. Also fungi can invade your skin through a small separation between your nail and nail bed [2]. This occurs more often in toenails than the fingernails because:

  • Toes usually have less blood flow than do fingers, making it harder for our bodies immune system to detect and stop the infection
  • Toenails often are confined in a dark, warm, moist environment, particularly inside your shoes, where fungi can thrive

Risk factors: There are many factors which increase your risk of developing nail fungus such as

  • Having diabetes, circulation problems, a weakened immune system, or in children Down syndrome [3]
  • When you are having a minor skin or nail injury or a skin condition such as psoriasis [4]
  • Having Athlete’s foot [5]
  • Walking barefoot in damp communal areas such as shower rooms, gyms and swimming pools

Nail fungus - symptoms, causes and risk factorsNail fungus

  • Living with someone who has nail fungus
  • Wearing socks and shoes that hinder ventilation and you do not absorb perspiration
  • Working in a humid or moist environment or in a job where your hands are often wet such as housekeeping or bartending [6]
  • If you are a male, especially if you have a family history of nail fungal infections
  • Perspiring heavily [7]
  • Being older, owning to reduced blood flow, more years of exposure to fungi and slower growing nails

Complications: There are severe cases of nail fungus which can be painful and they can cause permanent damage to your nails. This can lead to other serious infections which can spread beyond your feet if you have a suppressed immune system due to diabetes, medications or other conditions. People, who suffer from diabetes, may have reduced blood circulation and nerve supply in their feet. Also you are at greater risk of a bacterial skin infection, also known as cellulitis. Any minor injury to your feet in which is also included a nail fungal infection, can lead to a more serious complications. If you suffer from diabetes and you think that you are developing a nail fungus, then you should see your doctor.


[1] Ghannoum M, Isham N. Fungal nail infections (onychomycosis): A never-ending story? PLOS Pathogens. 2014;10(6):e1004105.

[2] Newman T. What you need to know about nail fungal infection. Medical News Today. 2017. Retrieved from

[3] Winston JA, Miller JL. Treatment of onychomycosis in diabetic patients. Clinical Diabetes. 2006;24(4):160-6.

[4] de Oliveira Praeiro Alves NCP, Moreira TA, Malvino LDS, et al. Onychomycosis in psoriatic patients with nail disorders: Aetiological agents and immunosuppressive therapy. Dermatology Research and Practice. 2020.

[5] Crawford F. Athlete’s foot. BMJ Clinical Evidence. 2009;2009:1712.

[6] East Coast Podiatry. Tropical climate causing fungal nail. 2018. Retrieved from

[7] Yau M. How to treat fungal nail effectively. The Pharmaceutical Journal. 2018. Retrieved from


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