How to effectively treat nail fungus?

Onychomycosis, also known as nail fungus, is a common fungal infection that most often affects toenails but can also occur on fingernails. It may cause thickening, discoloration, and weakening of the nail. When detected early, it can be effectively treated with proper care. Let’s explore the causes, symptoms, and treatments for this nail infection.

Onychomycosis: a common fungal nail infection

Onychomycosis is an infection caused by microscopic fungi, mainly dermatophytes that attack the keratin of the nail. In some cases, yeasts such as Candida may also be responsible for a nail infection (1). Toenails are about 10 times more frequently affected than fingernails because the warm, moist environment of feet favors fungal growth. Early signs include yellowish or whitish discoloration, nail thickening, and in some cases, gradual separation of the nail from the nail bed, which can become painful. Big toenail fungus (onychomycosis of the big toe) is especially common and may worsen if left untreated.

What causes nail fungus? Dermatophytes or Candida—how to tell the difference?

Dermatophytes are the most common fungi responsible for nail fungus infections, especially Trichophyton rubrum. They primarily attack the keratin of the nail and cause thickening and yellowish discoloration.
In contrast, Candida infections, which are less common on nails, tend to affect fingernails, especially in people whose hands are frequently immersed in water or in those with weakened immune systems. These infections often result in deformed, brittle, and sometimes painful nails (1).

Risk factors for toenail and fingernail fungus

Several factors can increase the risk of onychomycosis (2):

• Warm and humid environments: wearing closed shoes, excessive sweating, or walking barefoot in public areas (pools, gyms) promotes fungal growth.

• Poor hygiene: insufficient nail and foot care routines make it easier for fungus to develop.

• Underlying health conditions: diabetes, circulation problems, or a weakened immune system raise susceptibility to fungal nail infections.

• Repeated microtrauma: nails weakened by repeated impacts, especially in athletes, are more prone to fungal infections.

How to treat nail fungus?

The treatment of onychomycosis depends on the severity and the exact cause of the infection. It is essential to consult a dermatologist, who may perform a clinical exam and, if necessary, a mycological test to identify the responsible fungus. This step allows for a targeted and effective treatment plan.
A combined approach is often recommended, including (3):

• Daily hygiene care: Proper hygiene is the first step when dealing with toenail or fingernail fungus. Using dedicated products such as MYCOGEL, formulated with ciclopirox olamine, is recommended for daily cleansing. This cleansing gel gently washes skin prone to fungus while limiting fungal growth. It is ideal as a complement to topical or oral treatments.

• Careful maintenance of the affected area: trimming nails short, wearing breathable shoes, and avoiding sharing personal items (files, scissors, towels) help limit fungal spread.

• Topical antifungal treatments: medicated solutions or nail lacquers applied directly to the nail are effective for moderate cases. A topical-only treatment may be sufficient when less than half of the nail surface is affected (2).

• For severe onychomycosis or when multiple nails are affected, a doctor may prescribe oral antifungal medication.

Whether it’s toenail fungus or fingernail fungus, the therapeutic approach is similar, though the duration differs. Toenails grow more slowly than fingernails, meaning treatment usually takes longer.
Toenail infections are also typically more resistant, often requiring stronger antifungal medication.
For fingernails, a topical treatment may be sufficient if addressed quickly.
To prevent recurrence, strict hygiene measures are essential: change socks daily and wash them at 60°C, dry feet thoroughly after washing, and avoid walking barefoot in public areas such as pools or locker rooms. These precautions are especially important for athletes, who are more exposed to this type of infection (1).