Nail & Skin Disorders

Exposing Onychomycosis

Better known as a fungal infection, this unsightly nail condition can cause nails to become brittle, yellow, and worse, even cause pain. Find out what causes it and what you can do in the salon to help minimize the risk of your clients getting it.

What It Is

A fungal infection is one of the most unattractive and difficult nail conditions to get rid of. Doctors call it onychomycosis; you and your clients consider it an ugly nuisance.

According to the American Academy of Dermatology, onychomycosis accounts for 50% of all nail disorders. In salons, Doug Schoon, vice president of science and technology for Creative Nail Design, says that figure is drastically lower, more like 5%, to be precise.

Although most people know what fungus is and looks like, they don’t know exactly what it is. A fungus is a microorganism derived from the plant family. Fungal infections differ from bacterial and viral infections in that fungal infections are chronic, not always tender, slow growing, and frequently localized.

Two classes of fungi, yeasts and dermatophytes, play major roles in fungal infections of the nails. Dermatophytes break down keratin — the protein that makes up hair and nails — and absorbs its nutrients. One dermatophyte in particular, trichophyton rubrum, reportedly is responsible for more than 80% of onychomycosis.

Yeast infections can develop under the proximal nail fold, under a nail plate that has separated from the nail bed, and between the nail plate and lifted artificial product.


Onychomycosis is characterized by a yellow or whitish discoloration of the nail, thickening of the nail, separation of the nail plate from the nail bed, and brittle nails.

That thickening you may see is actually the nail plate coming apart, says Schoon. Dermatophytes are breaking down the keratin bonds that hold the nail plate together, giving the nail a thicker appearance.

And long before a person has any symptoms of onychomycosis, or contributing factors such as athlete’s foot, she may not even realize that fungus is present on her feet or nails, says Tammy Brown, D.P.M., of JT Enterprises Corporation.

If left untreated, a fungal infection will worsen, cause pain, become tender, and may even spread to other nails and even the other foot or fingernails. However, the condition isn’t life threatening.

“Fungus never spreads to the inside of the body,” says Nancy Satur, M.D., of North Coast Dermatology Associates in Encinitas, Calif. “It’s slow-growing and not very aggressive in terms of the type of infection it is. It won’t enter your bloodstream, but it may cause thick, misshapen nails, which can be problematic when wearing certain types of shoes.”


However, according to Jessica Luu, D.P.M., of JT Enterprises Corporation, in patients with weak immune systems such as uncontrolled diabetics or individuals with HIV, a fungal infection can cause infection to enter the bloodstream and in rare cases, cause the infection to spread throughout the body, possibly leading to death.


The number of people suffering from this nail condition is rising, probably due to a number of factors, including an aging population, a health craze causing many athletes to develop fungal infections in their toenails, and the increasing commonality of diseases such as diabetes, which create ideal conditions for a fungal infection. Also, some people are more genetically susceptible than others of developing onychomycosis.

True fungal infections are much more common in toenails than fingernails. “Toenails are prone to more friction, sweat, and moisture than fingernails,” explains Dr. Satur. The feet are also more susceptible to fungal infections because they spend so much time in socks and shoes, which foster the dark, moist environment fungi thrive in.

How To Treat It

A decade ago, doctors advised patients to live with their fungal infections, calling it more of a cosmetic problem than an actual medical condition. Today, that stigma is changing.

The prescription medications being offered today are also different from drugs offered in the past. While no treatment offers a 100% cure rate, many of them, including Lamisil and Sporanox, have a higher cure rate than their predecessors. Topical treatments such as Penlac, which is applied like a nail lacquer, have also proven successful for some people.

Although some people claim their fungal infections have disappeared with the use of an over-the-counter treatment, there is no solid evidence that these work.

Considerations Nail Techs Should Take

Despite its unattractive appearance, nail techs can still work on clients with fungus, says Dr. Satur. As long as you disinfect or dispose of your implements between clients, you and your clients should be fine.

To be sure, you might want to recommend your clients see a doctor before performing any services on the infected nail or nails.

When you’re working with an infected nail, you can safely file it down, clip only what is beyond the free edge, and apply polish. Avoid applying any artificial enhancement on the infected nail.

You should also advise your client to seek medical attention at the first sign of a problem, but never give her an opinion on the cause of her condition. That should be left to a medical professional who can properly diagnosis her condition.

Today, more and more people are discovering they no longer have to live with a fungal infection. Nail techs are in the perfect position when it comes to clients suffering from onychomycosis — and even those who are not.

Since you most likely see their feet more up close than anyone else, you are at the advantage of catching sight of something early and recommending they see a medical professional.

Besides offering them soothing foot and hand treatments, you can educate your clients on preventive foot care so they can avoid developing a pesky fungal infection.

Plus, pedicures are good for people with athlete’s foot. In mild cases, pedicures can actually help get rid of organisms. Just be sure the client’s feet have no open sores or oozing, says Schoon.

Keeping Fungus Away

Even though most of your clients may not suffer from a fungal infection, it’s still a good idea to recommend preventive measures. Here are some tips you may want to share with your clients:

  • Always keep feet covered in public areas such as showers.
  • Wash feet daily and dry thoroughly to avoid trapping moisture. Don’t forget to dry in between the toes.
  • Wear socks, such as ones made out of cotton, that wick away moisture. If feet feel damp, change socks.
  • Invest in a good foot powder or spray. Apply to shoes and feet daily.
  • Keep toenails neatly trimmed, always cutting straight across.
  • Always keep feet covered in public areas such as showers.
  • Wash feet daily and dry thoroughly to avoid trapping moisture. Don’t forget to dry in between the toes.
  • Wear socks, such as ones made out of cotton, that wick away moisture. If feet feel damp, change socks.
  • Invest in a good foot powder or spray. Apply to shoes and feet daily.
  • Keep toenails neatly trimmed, always cutting straight across.

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