Fungal Nail Infection (Onychomycosis)

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KEY POINTS

• Fingernails and toenails can get infected with fungus. Medical terms for the infection are onychomycosis or tinea unguium.
• If the infection is mild, your child’s healthcare provider may prescribe medicine you can put on the nail. For more severe infections, your provider may prescribe an antifungal medicine to be taken by mouth. It can take many weeks or months to treat nail fungus, and it often returns.
• Follow the full course of treatment prescribed by your child's healthcare provider. To help prevent fungal infections, keep your child's hands and feet as dry as possible.

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What is a fungal infection of a nail?

Fingernails and toenails can get infected with fungus. Medical terms for the infection are onychomycosis or tinea unguium.

What is the cause?

Fungus grows best on warm, damp skin. The fungus that infects the nail usually spreads from infected skin close to the nail.

Nail infections are more common and may be harder to treat in people who have diabetes or poor circulation, and in people whose immune systems are weakened by HIV, cancer, or other health problems.

What are the symptoms?

Symptoms may include:

• Thickened, white, yellow, or brown nails
• Brittle nails that may crumble, flake, or lift up off the finger or toe

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Infection can be confirmed with lab tests. A small, scraped sample of the nail may be tested in the lab for fungus.

How is it treated?

Treatment is not always needed. If the infection is mild, your child’s healthcare provider may prescribe medicine you can put on the nail. For more severe infections, your child’s provider may prescribe an antifungal medicine to be taken by mouth.

Your child may need to take the medicine until the nail grows all the way out and there is no longer any sign of the fungal infection. This usually takes about 6 months for fingernails and 12 months for toenails.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your child’s healthcare provider:

• How long it will take to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

How can I help prevent a fungal nail infection?

Fungus grows best on warm, damp skin. To prevent fungal infections, it's important to keep your child’s hands and feet as dry as possible. It may help for your child to:

• Avoid biting his or her nails.
• Wear gloves if daily activities put your child’s hands at risk for getting scratched, poked, or irritated.
• Wear cotton or athletic socks that wick moisture away from your child’s foot.
• Change socks every day, or more often if the socks become damp.
• Wear sandals or shoes that let your child’s feet breathe. This means avoiding rubber or plastic shoes unless they have openings. Canvas or leather shoes are usually a better choice.
• Air out your child’s shoes when they are not being worn. It is helpful to have more than 1 pair of everyday shoes and to switch shoes every day.
• Provide shower shoes, such as flip-flop sandals, when your child takes a shower in a locker room or other shared shower stall.
• Disinfect shower and locker room floors.

If your child has nail infections often, talk to your child’s healthcare provider about checking for diabetes.