A fungal infection of the nail is called onychomychosis. This may be a surface level infection, or it may be a deeper infection of the nail bed. It may affect only one nail or multiple nails, and may affect the skin also, (athlete’s foot for example). Onychomychosis is common in older adults, diabetics and immunocompromised patients, and can be due to infection with fungal dermatophytes and/or moulds and yeasts. Although often regarded as a trivial cosmetic problem, it can affect one’s quality of life as thickened nails can cause pain, reduced mobility or a reduction in activities because of social stigma.

Over-the-counter topical products are only suitable for superficial fungal infections in the top layer of the nail. Most people have a fungal infection that is on the nail bed, so it is important to visit a podiatrist first to find out which type of fungal infection you have.

Although treatment aims to eliminate the offending organism and restore the nail to health and a normal appearance, fungal infections of the toenails are notoriously difficult to erradicate. Treatment is best started when the infection is minor, in one or two nails for example, and is rarely sucessful when all ten nails are invoved, or when fungal infection has been present for a long time.

It is important to note that there is no treatment that can GUARANTEE a complete cure of fungal nails, and approximatly 20-25% of treated onychomychosis will unfortunately relapse due to patient or pathogen factors such as poor circulation, advancing age, diabetes, immunosuppression, severity of the fungal nail infection, mixed infections, and incomplete treatment.

This is why you should consider your anti-fungal treatment as a managment plan rather than a ‘cure’.