Closeup view of woman foot with beautiful and healthy nails after Canesten treatment

Understanding Nail Fungal Infection

From this article you can learn more about nail fungal infections and its causes. You can also learn about the symptoms, treatment and prevention of nail or skin fungus, and how to avoid spreading them.

What is Nail Fungal Infection?

You don’t often notice a Nail Fungal Infection straight away because it is not painful and because you don’t inspect your feet regularly. However, it is important for you to treat a nail infection as soon as you notice symptoms such as nail fungus and itchy toes, as it will not clear up on its own and may even spread.1

A Nail Fungal Infection (also known as onychomycosis) is mainly caused by dermatophytes, the same fungi responsible for athlete’s foot.2 Toenail fungus is the most difficult to cure of all fungal infections. There are many different causes of nail fungal infections.3

There are many different causes of Nail Fungal Infections. The most prevalent predisposing risk factor is advanced age. Patients over 60 years of age are nearly 20 times more at risk of developing nail fungal infection in comparison with patients younger than 19 years of age

It has been also discovered that men are up to three times more likely to have nail fungal infection than women). Other risk factors include diabetes, diseases that cause poor blood circulation and a weakened immune system.4

Since fungi thrives in warm and moist environments, it's easy to assume that a nail fungal infection would be prevalent in tropical climates. Not true! People living in hot and humid weather don’t wear occlusive footwear that creates ideal conditions for toenail fungus to develop.

Nail Fungal Infections are very contagious. A nail infection does not only occur in places like shower stalls, swimming pools and locker rooms where people are barefoot, but also in nail salons, where the same tools are used for multiple customers. Besides that, nail trauma, which damages the nail-skin natural barrier, can also increase your chances of developing a nail fungal infection.5

Nail Fungal Infection symptoms

A Nail Fungal Infection can affect a small part of your nail, an entire nail or several nails at once. Infection usually starts at the edge of the nail as a white or yellow streak under the tip of your fingernail or toenail. It usually spreads to the middle of a nail, and causes the nail to become discoloured and lifted up. As the infection spreads, your nail usually changes and becomes brittle. It is important to treat the infection as soon as you notice the symptoms as a nail fungal infection won’t clear up on its own. And the longer you wait, the more difficult it will be to cure.

You might be suffering from a Nail Fungal Infection if you notice:

  • White or yellow streaks on your nail6.

  • Thick, rough or brittle nails6.
  • Loss of lustre and shine.

  • Crumbling or jagged nail edges6.

  • Loose or lifted nails6.

  • Area under the nail thickening or hardens6.

  • Changes in the shape of the nails6.

  • Area under the nail thickening or hardens.

  • An odour coming from the infected nail.

Smiling young man standing confidently and wearing grey T-shirt, happy after Canesten nail fungus treatment

Nail fungus treatment

How a Nail Fungal Infection is treated depends on its severity. Even if you feel embarrassed by your infection, it is always advisable to seek help of your pharmacist as soon as you notice the symptoms. If there are only white patches visible on the nail, or not more than 3 toenails are infected, you can use over-the-counter antifungal topical medications to kill the fungus.7,8  

If the infection affects the deeper layers of a nail, repeated application of a medication or prescription-strength drug may be necessary to treat your nail fungal infection.

If the symptoms of nail fungus are severe, a podiatrist can devise a treatment plan that can include: debridement, topical medication or oral medication. In more serious cases, the infected nail can be chemically or surgically removed. Laser therapy can also be recommended for nail fungus treatment.9 

You should see a doctor if your nail fungal infection is severe, if treatment is not effective, or your infection has spread to your other nails. You should also seek advice from a doctor before starting treatment if you are pregnant or have diabetes.10

Skin and foot health Man in grey t-shirt

Nail fungus prevention

Nail Fungal Infections can take a long time to clear because your nail grows slowly. Hence, you will only notice improvement once a new nail has grown through. It is not uncommon for nail infections to return. However, you can take some measures to stop nail fungal infections from recurring. Some simple lifestyle changes can help you to prevent nail fungal infections. The most important thing is to take care of your nails by keeping them well trimmed and clean. You should also practice good hygiene by washing and drying your hands frequently, especially after touching an infected nail, or after treatment.

Other ways of preventing Nail Fungal Infections are:

  • Suffering from athlete's foot? Make sure you treat it as soon as possible, as fungus can spread and affect your toenails, or other areas of the skin, causing a nail fungal infection.11,12

  • Keep your toenails short and trim. The correct way to cut or file them is straight across, not in a rounded shape.

  • When visiting nail salons, bring your own set of accessories. Clippers and nail filers can contribute to a spread of fungal infections if not properly sterilised.13

  • Avoid wearing tight-fitting shoes. This can damage the skin barrier between your toenails and the toes, allowing fungi to invade.13

Nail Fungal Infections are contagious, so it is important you take measures to prevent them from spreading. First of all, you shouldn’t share your clothes, shoes and bed linens with other people. Also, you should always wash your hands thoroughly after touching infected nails or applying a treatment product. You should avoid having manicures and pedicures done in a salon because you can spread an infection further through the salon's tools. Also, use different towels for the infected area and the rest of your body to prevent the infection from spreading. It is advisable to mention your infection to your loved ones so they can be cautious and avoid catching it.13


  1. Check if it's a nail fungal infection, in:
  2. What causes onychomycosis?, in: Eisman, S. & Sinclair, R., Nail fungal infection: diagnosis and management, in: BMJ, 2014
  3. Is Onychomycosis Still a Problem?, in: Ghannoum, M., & Isham, N. (2014). Nail Fungal Infections (Onychomycosis): A Never-Ending Story? PLoS Pathogens, 10(6). doi: 10.1371/journal.ppat.1004105
  4. What Are the Risk Factors for Toenail Onychomycosis?, in: Ghannoum, M., Op.cit.
  5. Ibid
  6. Check if it's a nail fungal infection, in:
  7. Check if it's a nail fungal infection, in:
  8. A pharmacist can help with nail fungal infections, in:
  9. See a GP if… and Treatment for a nail fungal infection from a GP, in:
  10.   Ibid
11, 12.  Check if you have athlete's foot and How you can help treat and prevent athlete's foot yourself, in:
13.  Preventing nail fungal infections, in: