Apart from its unsightly appearance, onychomycosis can cause considerable pain and make walking difficult.

Who is most at risk

• Older people: the risk of fungal infection increases with age.
• People with diabetes: they often combine a weakened immune system, poor circulation in the legs and reduced sensation, which prevents them from noticing minor injuries — entry points for fungi.
• Athletes: because of shared showers and changing rooms, and sports shoes that favour the growth of fungi.

Symptoms

The fungus usually starts at the front edge of the nail and spreads across the whole nail plate, changing its structure. Typical symptoms are:

• brittle nails
• white streaks or spots
• whitish to yellowish-brown discolouration
• thickening of the nail plate
• inflammation

Treatment

When only the surface layer and less than half of the nail is affected, the infection can be treated topically with antifungal tinctures or nail lacquers. If the fungus has penetrated deeper, systemic treatment with tablets or capsules is needed. The dermatologist chooses the right preparation based on the results of the culture.