Fungal Nail Infection (Onychomycosis)

What is onychomycosis?

Onychomycosis is a fungal infection of the fingernail or toenail. It is also called tinea unguium.

How does it occur?

Fungus grows best on warm, damp skin. The fungus that causes this infection usually spreads from infected skin close to the nail. Children are more likely to get this infection if they have diabetes or a problem with the immune system. Most children with onychomycosis are normal and healthy. Other risk factors include contact with animals, contact sports, or swimming.

What are the symptoms?

Infected nails are thickened and yellow or brown. They are more brittle than uninfected nails. They may lift, crumble, or flake.

How is it diagnosed?

Your healthcare provider will examine the nail. Your provider may take a scraping of the nail and send a sample to the lab for tests.

How is it treated?

If the infection is very mild, your child's provider may prescribe medicine you can put on the nail. For more severe infections, your child's provider may prescribe an antifungal medicine to be taken by mouth. Griseofulvin is used most often to treat fungal infections in children. Common side effects include headaches and stomach upset. Griseofulvin may make your child's skin more sensitive to the sun, and increase the risk of a rash or sunburn.

Your child may need to take the medicine until the nail grows all the way out and there is no longer any sign of the fungal infection. This usually takes about 6 months for fingernails and 12 months for toenails.

How can I help prevent onychomycosis?

To keep fungal infections from occurring or to keep them from coming back once they have been treated, it's important to keep your child's hands and feet as dry as possible. It may help to:

• Put an antiperspirant medicine on your feet to prevent sweating.
• Have your child wear cotton socks because the cotton absorbs sweat and keeps the feet dry. Change socks often.
• Wear shoes that breathe well.
• Avoid going barefoot in public places where you might be exposed to a fungus, such as shower stalls at the gym. Wear shower shoes and clean them often.