Onychomycosis (Nail Infection)

Onychomycosis is a nail infection primarily caused by a fungus that mostly affects toenails, but can also affect fingernails. It can cause your nails to become thick, discolored, and more likely to crack and break. Onychomycosis can also be caused by a bacterial infection, or a combination of both fungus and bacteria. Studies have shown that bacteria alone are involved in as many as 34% of toenail infections, and bacteria and fungi combined are involved in as many as 49% of these infections.

About 10% of people have a nail infection (also called a mycotic nail) at some point in their lives, but this infection becomes more common with age. About 20% of people over age 60 and 50% of people over age 70 get mycotic nails.

You may be more likely to get this type of infection if you have diabetes, athlete’s foot, a weakened immune system, or a nail injury.

Nail infections are contagious. You can get a nail infection if you walk barefoot in areas like locker rooms or public showers, or if you get a pedicure in a nail salon.

Medical specialties that treat nail infections

Nail infections can be treated by a primary care physician, a podiatrist, or a dermatologist.

How nail infections are treated

Nail infections are difficult to cure, and typically don’t go away without treatment. The most effective treatments for fungus are prescription antifungal pill taken by mouth. Topical treatments such as antifungal sprays and creams rarely help, unless they are used in combination with pills. For bacterial infections, an antibiotic pill may be prescribed. In both cases, it is important to carefully follow the prescription instructions and use the complete supply of antifungals and/or antibiotics, even if your symptoms begin to clear up before you are treated.

It can take several months for a nail infection to clear up; however, it’s not unusual for the infection to come back again even after treatment.

In severe cases, when the infection can’t be treated with medication, your doctor may recommend surgery to remove the nail.


  1. Joyce A, Gupta AK, Koenig L, Wolcott R, Carviel J. Fungal Diversity and Onychomycosis: An Analysis of 8,816 Toenail Samples Using Quantitative PCR and Next-Generation Sequencing. J Am Podiatr Med Assoc. 2019;109(1):57-63. doi:10.7547/17-070
  2. https://www.merckmanuals.com/home/skin-disorders/nail-disorders/onychomycosis
  3. https://www.cdc.gov/fungal/nail-infections.html
  4. https://my.clevelandclinic.org/health/diseases/21712-mycotic-nails#symptoms-and-causes
  5. https://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/syc-20353294
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