How to tell fungus apart from other problems
Symptoms of many nail conditions look similar — yellow discolouration, thickening, separation from the nail bed. Below is a comparison of features that can help with an initial distinction.
- Yellow discolouration — occurs with fungus, injury and nail psoriasis alike
- White patches — typical of the superficial white form of fungus and of injuries; less common with psoriasis
- Thickened nail plate — occurs with fungus, injury and psoriasis
- Crumbling from the free edge — a very characteristic sign of fungus; less common with injury or psoriasis
- Separation from the nail bed (onycholysis) — can occur with any of these conditions
- Inflammation around the nail — more common with injury, less so with fungus or psoriasis
- Pitting (tiny pinprick-like indentations) — a feature typical of nail psoriasis; absent in fungus and injury
- Odour — can accompany fungus; absent with injury or psoriasis
Which fungi cause nail fungus?
Nail fungus — known as onychomycosis — is caused by different groups of fungi, and the treatment approach depends on the pathogen involved.
- Dermatophytes (Trichophyton rubrum, T. mentagrophytes) — responsible for the vast majority of cases. They spread in public places: swimming pools, saunas, gyms, hotels
- Yeasts (Candida) — most often affect fingernails, particularly with prolonged contact with water (washing dishes, care work)
- Moulds (Aspergillus, Fusarium) — less common, but often harder to treat
Why does treating nail fungus take so long?
A toenail can take over a year to grow out fully — and treatment needs to work throughout that whole time so a new, healthy nail can grow in without the fungus. That's why results appear only gradually, as the healthy nail plate grows out "from the bottom".
- Antifungal lacquers need regular application over many months
- Oral antifungal medication is taken over several months under a doctor's supervision
- Improvement only becomes visible as the healthy nail plate grows out
What we do in the podiatry clinic
In our podiatry clinic, we take a comprehensive approach to nail fungus — combining mechanical treatment of the affected nail plate with topical preparations.
Mechanical treatment of the nail
- Reduced fungal mass — the preparation absorbs deeper and more effectively
- Removal of the infected plate — relieves pressure on the nail bed
- Potentially shorter treatment time
Antifungal lacquer application
After mechanical treatment, the podiatrist applies antifungal lacquer and shows you how to apply it yourself at home. Follow-up visits take place regularly to assess treatment progress.
- Ciclopirox (Batrafen) — a broad-spectrum preparation, effective against both dermatophytes and Candida
- Amorolfine (Loceryl) — applied once a week, particularly effective against dermatophytes
When does a podiatrist refer you to a dermatologist or doctor?
Some cases of nail fungus require oral antifungal treatment — this decision is made by a doctor. A podiatrist can recognise situations that call for medical consultation and refer you accordingly.
- Involvement of more than half the nail surface
- Fungus affecting several nails at once
- Coexisting skin fungus (e.g. athlete's foot)
- No improvement after several months of using lacquers
- Immunosuppression — conditions or medications that weaken immunity
Preventing recurrence at home
Nail fungus tends to recur — particularly if the source of infection isn't eliminated. A few simple daily hygiene habits significantly reduce the risk of reinfection.
- Cotton or breathable socks — changed daily
- Wear only your own footwear — never share shoes with others
- Protective flip-flops in public places: swimming pools, saunas, gyms, hotels
- Dry your feet thoroughly after bathing, especially between the toes
- Antifungal shoe spray — worth using as a preventive measure
- Single-use nail file — one kept separately for the affected nail, another for healthy nails