Fungal nail infections are a common condition, typically causing nails to become discoloured, thickened, and brittle. They most often affect the toenails and are caused by fungi that grow and spread in warm, moist environments. In some cases, fingernails can also be affected.

The infection may involve one or several nails and can worsen over time, sometimes leading to the nail becoming damaged or crumbly. Mild cases do not always require treatment, but if symptoms such as pain, thickening, or discomfort develop, treatment can help improve the condition and relieve symptoms.

Fungal nail infections are caused by fungi (dermatophytes, yeasts, or moulds) that grow in warm, moist environments. These organisms can infect the nail when they enter through small cracks in the nail or surrounding skin.

Common Causes

• Warm, damp conditions (e.g. sweaty feet, tight shoes)
• Poor foot hygiene
• Minor nail or skin damage, allowing fungi to enter
• Walking barefoot in communal areas such as swimming pools, gyms, and showers
• Existing fungal skin infections, like athlete’s foot spreading to the nail

Risk Factors (Who is more likely to get it)

• Older adults
• People with diabetes
• Reduced circulation (e.g. peripheral vascular disease)
• Weakened immune system
• Nail trauma or repeated pressure on nails
• Frequent exposure to water or moist environments

Fungal nail infections often develop slowly and may start after a skin infection like athlete’s foot spreads to the nail.

Fungal nail infections usually develop gradually and may affect one or more nails.

Common symptoms

• Discolouration of the nail (yellow, brown, or white)
• Thickened nails
• Brittle, crumbly, or ragged edges
• Distorted nail shape
• Loss of shine or dull appearance

Other possible symptoms

• Build-up of debris under the nail
• Nail lifting away from the nail bed (onycholysis)
• Unpleasant smell in some cases
• Pain or discomfort, especially when wearing shoes or walking

Symptoms often start mild but can worsen over time if left untreated, potentially affecting multiple nails.

Self-care & prevention

• Keep nails clean, dry, and trimmed
• Avoid sharing nail tools
• Wear breathable footwear
• Treat athlete’s foot promptly
• Avoid walking barefoot in communal areas

Treatment depends on how severe the infection is and how many nails are affected. Fungal nail infections can take time to clear, so consistency is key.

Topical treatments (mild to moderate cases)

Applied directly to the nail:

• Antifungal nail lacquers (e.g. amorolfine)
• Antifungal solutions or creams

Best for: Early or mild infections or when only part of the nail is affected

Treatment duration: Often 6–12 months (until the nail grows out)

Oral antifungal medications (more severe cases)

Prescription-only treatments:

Terbinafine
Itraconazole

Best for: Severe or widespread infections and Thickened/multiple nails affected

Treatment duration: Typically 6 weeks (fingernails) or 3–6 months (toenails)

Requires pharmacist/doctor assessment due to potential side effects and interactions

Nail removal (in some cases)

• Partial or complete removal of the nail

Usually considered if other treatments haven’t worked