Fungal nail infection (ringworm of the nails)

Reviewed by Dr Victoria Lewis, consultant dermatologist

What is ringworm of the nails?

The nail thickens, discolours and in advanced stages the nail may become destroyed.

Ringworm of the nail is due to a fungal infection (dermatophyte) similar to the type that causes athlete's foot.

Other scientific terms for ringworm of the nails are: tinea unguium, onychomycosis or dermatophytosis unguium. The fungi that cause ringworm are able to feed on keratin – the main protein in nails, hair and the outer layer of the skin.

How do you get ringworm of the nails?

Ringworm of the nails can occur directly in the nail itself or from an untreated fungal infection of the foot. Fungal infection of the foot can also spread and grow into the nail.

What are the symptoms?

A whitish thickening of the nail and nail-bed.
The nail thickens, discolours and in advanced stages the nail may become destroyed.

Who is at most risk?

Young people, especially if they wear trainers.
Sportspeople.
People who are required to wear close-fitting rubber footwear for their work.
People who live in a warm, humid climate.

How does the doctor make a diagnosis?

Often the diagnosis can be made from the clinical picture alone. Nail clippings or scrapings may be taken for microscopic examination and culture in the laboratory to identify the type of fungus.

How is ringworm of the nails treated?

Ringworm of the nails is best treated with antifungal tablets, such as terbinafine (Lamisil tablets), and/or local fungicides, such as amorolfine (Loceryl nail lacquer) or tioconazole (Trosyl) nail solutions. The treatment may need to be continued for months.

Outlook

Ringworm of the nails can be difficult to cure and may return even after treatment has ended.

Prevention

Wash the feet daily and dry them completely, particularly between the toes, before putting on socks and shoes.
Use only cotton or wool socks and change them at least twice a day and every time they become damp.
Avoid footwear made of artificial material. Choose footwear with breathable material such as leather or cotton.
Sprinkle the feet and the inside of the shoes with a fungicidal powder.

Other people also read:

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Warts and verrucas: we look at how they are treated.

Threadworm (pinworm): find out what it is and how does the infection spread.

Based on a text by Dr Flemming Andersen and Dr Ulla Søderberg, specialist

Last updated 05.07.2011

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