Understanding Onychomycosis: Causes, Symptoms, and Progression
Onychomycosis is the medical term for a fungal infection of the toenail bed and the hard nail plate above it. Many cases are caused by a group of fungi called dermatophytes. Dermatophytes are a common cause of onychomycosis, and the same fungi cause athlete’s foot and ringworm elsewhere on the body. One species, Trichophyton rubrum, is the most frequent culprit in toenail infections. These organisms feed on keratin, the protein that gives your nail its structure, which is why the infection changes both the color and the texture of the nail over time.
The condition tends to progress through stages rather than appear all at once. In the early stage, you might notice a small yellow or white spot near the tip of the nail. The nail may also feel slightly brittle, but the change is easy to miss at first. As the infection spreads, it enters a moderate stage. The nail thickens, its shape becomes distorted, and a chalky buildup of debris collects underneath the nail plate.
If left untreated, the infection can become serious. Your nail could lift away from the skin underneath, break at the edges (called ‘fraying’), or be sore when you walk, particularly in closed shoes. Toenail infections are common. According to the CDC, as many as 14% of the population can be affected by fungal nail infections, and toenails are affected far more often than fingernails. Some things that can put you at risk include wearing tight or non-breathable shoes, a previous nail injury, frequent use of public showers or locker rooms, diabetes, and poor circulation to the feet.
It helps to remember that this is a living organism established in tissue, not surface grime. Washing your feet more often may not remove it. A professional diagnosis and a medically guided treatment plan are often recommended rather than repeated attempts at home cleaning.