Fungal Nail Infections - What Happens

What Happens

Fungal nail infections generally progress very slowly. The rate at which a fungal infection progresses depends on:

• Your overall health and susceptibility to the infection.
• The level of humidity and heat in your environment.
• The type of nail infected. Fungal nail infections of the toenail have more time to grow and spread because toenails grow more slowly than fingernails.

You may first notice a fungal nail infection when a nail or skin under the nail (nail bed) becomes discolored, damaged, thickened, or broken. If not treated, a fungal infection is likely to worsen and spread to other parts of the nail, the nail bed, and possibly the surrounding skin. Over time, the whole nail may become infected and damaged and may eventually fall out.

Fungal nail infections can be treated successfully; however, some types are more easily treated than others. The most common type, distal subungual onychomycosis, can be a lifelong infection and hard to treat. Another type, white superficial onychomycosis, can be easily treated. Even after treatment, your nails may continue to look irregular in shape and appearance. It can take a year or longer before they return to normal.

Fungal nail infections often return. Of people successfully treated with antifungal pills, 15% to 20% develop another infection in the next year.⁴ After treatment, take steps to prevent reinfection, such as using antifungal creams and keeping your feet dry.

If a fungal nail infection is making it difficult to walk, you may have decreased blood circulation in your extremities, such as feet and toes. This can worsen foot ulcers in people with diabetes and ulcers caused by poor circulation (venous skin ulcer).

Bacterial infection can develop as a complication of a fungal nail infection. A common bacterial infection, acute paronychia, causes inflammation and swelling of the skin and tissues near a fingernail or toenail.

Quality of life

Although a fungal nail disorder is not dangerous to your health, it can affect your quality of life. You may avoid some activities because of the appearance of your nails and fear of spreading the disease to others. Pain may limit your activities and interfere with work. You may worry about treatment, because insurance companies sometimes consider the condition a cosmetic problem and limit coverage of treatment options.