Under the term nail fungus (Onychomycosis, Tinea unguium) one understands a fungal infection of the fingernails or toenails. Nail fungus is a harmless but common disease.

In most cases, nail fungus is caused by so-called dermatophytes. These types of mushrooms feed mainly on carbohydrates and the keratin found in nails. In addition, this infection can also be triggered by various yeasts or molds.

The responsible fungi are transmitted by smear or contact infection. It can be passed on directly from person to person or indirectly via the shared use of inanimate objects. Above all, contaminated surfaces play a decisive role in the transmission of dermatophytes.
For this reason, people who frequently spend time in swimming pools, saunas, communal showers or sports locker rooms are particularly at risk.

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In addition, the risk of developing nail fungus increases with age (especially from the age of 65). In this age group, roughly every second person suffers from nail fungus one or more times. The reason for this is the fact that the structure of the nail substance changes over the years. The nails of the fingers and feet are becoming increasingly brittle, porous and more susceptible to fungal infections. In addition, the decreasing immune strength with age also plays a decisive role in the development of nail fungus.
In addition to the elderly, especially athletes and patients suffering from diabetes mellitus are often affected by nail fungus. Medicines that weaken the immune system can also contribute to the development of fungal infections.


The Symptoms, which if there is a Nail fungus occur primarily after the Type of infection. In medicine one differentiates between five forms of this fungal infection.

In general it can be stated that with mild course any of these nail fungus forms little or no symptoms occur. For this reason, the causative pathogen can multiply over a long period of time before it is recognized as such.

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For patients who may suffer from nail fungus different areas of the nail substance to be affected. Typical infected areas include

  • the nail root
  • the nail bed
  • the solid nail substance itself.

In most cases, the fungal infection begins at the front edge of Nail. From there it spreads frequently over the entire nail plate in Towards the nail root and ultimately infects also the nail bed.
The classic symptoms are:

  • whitish or yellow discoloration the nail plate
  • Strength thickening the nail substance
  • inflammatory processes in the area of ​​the nail bed and the surrounding skin areas
  • (at an advanced stage) brittleness of nails and that Chipping whole layers of nails

Pain from a nail fungus

Nail fungus caused by a Thickening of the nail pain. So the thickened nail presses on the underlying, highly sensitive nail bed.

At Inflammation of the toenail The pain can affect the patient so much that it becomes too Discomfort when walking comes. Extra pressure tight footwear can exacerbate the symptoms. This is the case in around 50% of nail fungus patients.

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It is, however only the top layer If the nail plate is affected and the nail has not yet thickened, it must not necessarily a pain symptom come because the nail itself does not come from annoy is crossed, and no pain sensation is located.

Pain can be caused not only by a thickening of the nail, but also by a Inflammation of the nail bed arise. Since the structure of the nail is fundamentally changed and loosened, you can bacteria and Viruses more easily get into the nail bed underneath and cause inflammation there.

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Often, however, the nail fungus is - in contrast to the Skin fungus- not painful and is therefore mistakenly viewed by those affected as only a cosmetic problem.

Whether or not you experience pain depends on the person localization and the Strength of the infestation from.

Smell of nail fungus

The Nail fungus are divided into, depending on the severity three stages.

One begins in the third and most difficult level Decomposition of the nail and a brown, crumbly substance forms. With this process also goes one unpleasant moldy-sweet smell hand in hand. It comes from the dissolution of the keratins by the nail fungus.

This stage is considered to be particularly difficult and recurrent because of the fungus deep in the nail sits, and already affects the growing nail. Corresponding treatment is correspondingly complicated.

thats why at least now for therapy definitely consult a doctor, since self-therapy no longer promises success at this stage and the infestation is about to spread.

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Itching of a nail fungus

A strong one itching can with advanced nail fungus infestation especially when wearing closed shoes between the toes occur. He is often accompanied by small vesicles on the sides of the toes or fingers.

In the early stages of a fungal nail infection, itching is rather untypical.
Should it still occur, help fungicidal creams to apply up to systemic therapy with Antifungal drugs.

Home remedies such as tiger balm, vinegar (see:), or alcohol may relieve symptoms, but have no proven clinical benefit.

For more information, read our articles Nail fungus home remedies and Treat nail fungus with vinegar

Forms of nail fungus

  1. Distolateral subungual onychomycosis makes about 90 percent all nail fungus out. The symptoms of this form are particularly evident on the toenails. The fungal attack usually begins there at the front edge of the nail substance and slowly spreads from there towards the nail root.
  2. In the proximal subungual onychomycosis the causative pathogens spread from the skin of the nail wall into the nail root and plate. The typical symptoms of this type of nail fungus occur in accordance with this direction of spread in the opposite direction out.
  3. Symptoms of the so-called Leukonychia trichophytica are more of a whitish discoloration of the nail substance. As a rule, this form occurs only in the area of ​​the toenails. In most cases, the nail fungus of this class arises on the basis of one Fungal infection in the spaces between the toes.
  4. Does a patient fall ill with one dystrophic onychomycosisso the symptoms occur already at grade newly formed nail on. Both the structure and the regular function of the nail substance are severely restricted in these cases. In severe forms, the infected nail is completely destroyed.
  5. Those caused by a yeast of the genus Candida caused Onychia et Paronychia candidosa expresses itself mainly through the chronic occurrence inflammatory processes in the area of ​​the nail wall. In addition, irregular structures of the nail plate and / or green-brown discoloration of the nail are among the most commonly observed symptoms.

Using the Extent of symptoms the nail fungus can be divided into different levels. In everyday clinical practice one speaks of Early, average and severe stage nail fungus.

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Nail fungus on the finger

Nail fungus (Technical term: Onychomycosis) usually arises from a warm, moist environment in which the filamentous fungi (Trichophyton rubrumMold or yeasts can also cause nail fungus more rarely.

The keratin-containing Fingernails and spaces between the fingers form an excellent basis for life. A nail fungus infection should always medically treated as it likes to spread to more nails.

Risk factors for a nail fungus are quite general increasing agebecause the Blood circulation the finger decreases (mostly due to arteriosclerosis), and the immune system gets weaker. But also with Go to the swimming pool or the gym there is a risk of infection.

A nail fungus often arises on the basis of one Skin fungus.
Are symptomatic brittle, whitish-yellow discolored fingernails, such as Thickening and inflammation of the nail bed. Also one Breakdown of the nail layers can be an indication of a nail fungus. Although it is not a life-threatening disease, the nail fungus can certainly cause pain and also act as a gateway for other diseases.

If infected with Yeasts will also be regrowing nail infested directly, as this is preferred on Nail wall (the skin on the edge of the nail bed) settle. A chronic process must be with Antifungal drugs (Medicines against fungal attack) can be prevented.

Figure nail fungus

Figure: healthy nail (A) and nail fungus symptoms (B)

Nail - Unguis

  1. Free edge (of the nail) -
    Margo liber
  2. Cover fabric of the nail bed -
  3. Nail plate -
    Lamina unguis
  4. Nail fold - Matric sulcus
  5. "Moondchen" - Lunula
  6. Horny layer of the nail wall -
  7. Distal phalanx -
    Phalanx distalis
  8. Nail root - Margo occultus
    Nail fungus -
    Onychomycosis, Tinea unguium
    Nail fungus symptoms
  9. Brittleness,
    Crumbling of the nail
  10. Thickening of the nail
  11. Whitish, yellow or
    gray-brown spots in the nail
  12. White or yellowish
    Discoloration on the edge of the nail
  13. Dullness of the nail
  14. Chipping of the nail

You can find an overview of all Dr-Gumpert images at: medical illustrations

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