Signs and Symptoms of Nail Fungus: How to Recognize Onychomycosis
Nail fungus, medically known as onychomycosis, is a common condition affecting millions of people worldwide. It can impact both fingernails and toenails, though toenails are more frequently affected due to their enclosed, moist environment. Nail fungus isn’t just a cosmetic concern it can lead to discomfort, pain, and even complications if left untreated. As a skin therapist, I frequently encounter clients who are unsure whether changes in their nails indicate a fungal infection or another nail condition. Recognizing the signs and symptoms of nail fungus is essential for early intervention and effective treatment.
Understanding Nail Fungus
Nail fungus occurs when fungi invade the nail plate or nail bed, feeding on keratin the protein that makes nails strong. Several types of fungi can cause infection: dermatophytes, which are the most common culprits responsible for most nail infections; yeasts such as Candida, which often cause infections in fingernails, particularly in people with frequently wet hands; and non-dermatophyte molds, which are less common but can infect nails, especially after trauma. The infection often develops gradually, and initial changes may be subtle, making early detection critical for successful treatment.
Common Signs and Symptoms of Nail Fungus
Nail fungus can present in a variety of ways depending on the type of fungus, the affected nail, and the severity of the infection. Below are the most common signs and symptoms.
1. Nail Discoloration
One of the earliest signs of nail fungus is discoloration. Nails may turn white or yellow, which is common in distal subungual onychomycosis. They may also become brown or dark, which can indicate a more advanced infection or mold-based infection, or even greenish if a secondary bacterial infection develops. Example: Sarah, 32, noticed a small white spot on her toenail, which she initially ignored. Over several months, the spot spread, and the nail began turning yellow and brittle.
2. Thickened Nails
Infected nails often become thicker than usual, making them harder to trim and uncomfortable in shoes. Thickening can be gradual and may initially affect only the tip of the nail. Advanced thickening can lead to crumbling nails and pain when walking or wearing shoes. Example: John, 45, developed thickened toenails after years of neglecting minor nail trauma. The thickened nails caused discomfort while exercising.
3. Brittle or Crumbly Nails
Nail fungus can cause nails to break, crumble, or peel easily. This is particularly common in severe or long-standing infections. Fingernails may split or chip at the edges, while toenails may develop cracks, leading to increased susceptibility to further infections. Example: Maria, 28, noticed her fingernails splitting at the tips and peeling, which was caused by Candida nail infection from frequent hand-washing and exposure to water.
4. Distorted Nail Shape
Fungal infections can cause changes in nail shape, such as warping or curving of the nail, raised or uneven nail surfaces, or separation of the nail from the nail bed, also called onycholysis. Example: David, 60, experienced nails lifting from the nail bed, creating a gap where debris accumulated, worsening the infection.
5. Nail Odor
In some cases, fungal nails emit a mild, unpleasant odor, especially in advanced toenail infections. This occurs due to the accumulation of fungal debris under the nail. Odor can intensify if secondary bacterial infections develop. Example: Lisa, 50, noticed a slight odor from her toenails, prompting her to seek treatment for long-standing fungal infection.
6. Pain or Discomfort
While early nail fungus may not be painful, advanced infections can cause tenderness when pressure is applied, pain when walking, wearing shoes, or performing manual tasks, and increased sensitivity to trauma. Example: Ahmed, 55, ignored his thickened toenails for years. Eventually, the nails became painful when pressing against his shoes.
7. White or Yellow Spots on the Nail Surface
Superficial white or yellow patches often appear first. They can spread deeper into the nail if untreated. This is common in white superficial onychomycosis and is typically easier to treat in early stages. Example: Emily, 30, noticed faint white patches on her big toenail. Early treatment with topical antifungal therapy prevented progression.
8. Detachment of the Nail from the Nail Bed
In severe cases, nails may separate partially or completely from the nail bed, a condition known as onycholysis. This creates space for fungi and bacteria to grow and can cause discomfort while increasing the risk of reinfection. Example: Peter, 42, had advanced toenail fungus causing the nail to lift from the nail bed. Laser therapy combined with oral antifungal medication helped restore nail health over several months.
9. Nail Surface Changes
Nails may develop ridging, pitting, or roughness due to fungal invasion. These surface irregularities make nails more prone to damage and can mimic other conditions like psoriasis, making diagnosis important. Example: Hannah, 36, noticed fine ridges on her fingernails. Testing confirmed a mild fungal infection, which was treated successfully with topical therapy.
10. Spread to Other Nails or Skin
Fungal infections are contagious. If untreated, they can spread to other nails on the same hand or foot, to surrounding skin causing athlete’s foot or fingertip infections, or even to family members through shared surfaces or tools. Example: Raj, 40, developed toenail fungus in one nail, which later spread to adjacent toes because he wore the same socks repeatedly without proper hygiene.
Types of Nail Fungus and Their Specific Symptoms
Nail fungus can manifest differently depending on the fungal type. Distal subungual onychomycosis usually causes thickened, yellowed nails starting at the tip. White superficial onychomycosis appears as white patches on the nail surface. Proximal subungual onychomycosis begins near the cuticle and is often found in immunocompromised individuals. Candida nail infection usually results in red, swollen, and tender nails, particularly in the fingernails.
Early vs. Advanced Symptoms
Recognizing early symptoms is key to effective treatment. Early symptoms may include small discoloration, faint white or yellow spots, or mild nail roughness. Advanced symptoms involve thickened, brittle nails, pain, odor, nail lifting, and widespread involvement. Example: Sophia, 29, caught her infection early and resolved it with topical therapy. David, 65, waited years and required a combination of oral medication and laser therapy.
When to Seek Professional Help
Seek a professional evaluation if you notice persistent discoloration or thickening, brittle, crumbling, or lifting nails, pain, odor, or discomfort, or a rapidly spreading infection. Benefits of professional care include accurate diagnosis, customized treatment plans with topical, oral, or laser therapy, and guidance on preventing recurrence. At Lasting Impressions Laser, we provide comprehensive assessment and treatment for nail fungus, ensuring the best results and healthier nails.
Conclusion
Nail fungus can manifest in various ways, from subtle white spots to thick, discolored, or painful nails. Recognizing the signs and symptoms early is critical for successful treatment. Nail fungus affects appearance, confidence, and comfort, but with professional intervention and proper care, it can be effectively managed. If you notice changes in your nails, don’t ignore them. Early detection, proper hygiene, and expert guidance from professionals like those at Lasting Impressions Laser can restore nail health, prevent complications, and give you confidence in your hands and feet again.
