What is Onychomycosis and Nail Treatment?

Onychomycosis is a fungal infection of the nails. Dermatophytes, non-dermatophyte moulds and yeasts are the three major fungi that cause it. In most cases Onychomycosis causes discolouration and deformation of nails. Moreover, some might experience problems like thickening, which could be painful. Onychomycosis also makes nail cutting difficult. If Onychomycosis turns severe, the deformed nails could damage the adjoining tissues and cause secondary bacterial infection.

Types of Onychomycosis

There are five major types including distal and lateral subungual onychomycosis (DLSO), superficial white onychomycosis (SWO), proximal subungual onychomycosis (PSO), candidial onychomycosis and total dystrophic onychomycosis.

1. Distal and lateral subungual

This fungal invasion happens through a break in the skin at the lateral or distal undersurface of the nail. It begins at the hyponychium and gradually affects the nail plate and bed. Distal and lateral subungual onychomycosis can result in linear channels or “spikes” making treatment difficult.

When affected you will notice the following signs on your nails-

  • Thickening and chipping
  • Become dystrophic
  • Changing colours by turning either yellow-white or brown-black  
2. Endonyx subungual

In case of endonyx subungual onychomycosis, the nails turn milky white, and develop indentations and lamellar splitting. In this type of infection the fungus attacks the nail from directly under the skin but does not infect the nail bed. If you notice any signs of endonyx subungual onychomycosis a best dermatologist online consultation would help you detect the condition early and initiate necessary treatment.

3. Proximal subungual

In case of proximal subungual onychomycosis, the fungus invades the proximal nail fold and cuticle. There is a build up under the proximal portion of the nails which causes onycholysis. A white colour appears on the nails that spread distally.

4. Superficial

When affected with superficial onychomycosis the nails get powder-like patches on the surface. The condition may occur on the superficial nail plate or spread from under the nail fold.

5. Total dystrophic

When affected with total dystrophic onychomycosis, the nails get totally destroyed from long-lasting infections. As a result, this condition causes thickening of the nails leading to structural damage. To get more information on Total dystrophic Onychomycosis you can book a best dermatologist online consultation.


Treatment involves removing the fungal infection. By successfully eradicating the fungus the nails usually turn to normal. If you or any of your family members are showing the signs of Onychomycosis, you can consult online dermatologists for diagnosis and treatment. However, if the nails were dystrophic prior to infection, due to trauma or non fungal diseases, the treatment for Onychomycosis will not heal the nails completely.

Both topical and oral agents are available for treating Onychomycosis. Earlier, experts used to prescribe oral antifungal agents like griseofulvin, terbinafine, itraconazole and ketoconazole to treat this condition. However, these drugs caused some side effects including headache, diarrhea, rash and elevated liver enzymes, along with longer treatment period (8-12 weeks). Nail lacquer treatment, a new type of medication which is less toxic and heals faster is now largely in use for treating or preventing Onychomycosis.

Nail lacquers are applied uniformly over the nail plate and a five mm of surrounding skin. It is also applied to the nail bed, hyponychium, and the under surface of the nail plate. Nail lacquers containing antifungal agents provide a hard, clear, water-resistant film. It is resistant to multiple washings and treats Onychomycosis effectively. Multiple research studies are now underway to find the drugs which can be used in medicated nail lacquers for complete treatment of Onychomycosis.

Precautions while using nail lacquer treatment

  • To get best results, it is important to use the medication as directed by health care professionals.
  • Contact with the eyes, skin other than skin immediately surrounding the treated nails and mucous membranes may cause mild, transient irritation and redness.
  • Monthly removal of the unattached, infected nail to be done by health care professionals
  • If you have diabetes or numbness in toes or fingers it is better to inform your doctors for appropriate nail lacquer treatment programs
  • If you notice signs of redness, itching, burning, blistering, swelling, or oozing in and around the area of application informing their doctor will help in addressing these side effects
  • Up to 48 weeks of daily applications and monthly removal of the unattached, infected nail might be needed to see results
  • Nail polish or other nail cosmetic products on the affected nails might tamper with the treatment
  • It is better not to use the medication near heat or open flame as product is flammable

Onychomycosis is a very common condition and there are highly experienced skin specialists who can treat the condition completely. In case you want to know more about this infection you can consult an online doctors from the comfort of your home.

Also read: City Life – Care For Your Skin, Hair, And Nails

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