How Is a Fungal Fingernail Infection Diagnosed and Treated?

Internal Medicine, Mass General Brigham

Supervised by Suo Lee, MD

Fungal nail infections are diagnosed by looking closely at the nail and doing tests on nail scrapings. They are usually treated with creams or pills that fight the fungus.

Explanation

Doctors start by checking your nail and asking about any problems you have noticed. They might gently scrape a bit of the nail or the skin around it to send to a lab. In the lab, experts use tests like a KOH exam or even grow the fungus in a culture to see if it is present. New tools like special cameras or even computer programs can help check for fungus too. When it comes to treatment, many fungal nail infections are treated with antifungal medicines. Sometimes the medicine is put directly on the nail as a cream or lacquer, but if the infection is more severe or widespread, doctors may prescribe pills that you take by mouth. The treatment can take a long time because nails grow slowly. Keeping your nails dry and trimmed and following your doctor’s advice will help treat the infection.

(References)

Elewski BE. Onychomycosis: pathogenesis, diagnosis, and management. Clin Microbiol Rev. 1998 Jul;11(3):415-29. doi: 10.1128/CMR.11.3.415. PMID: 9665975; PMCID: PMC88888.
Lim SS, Ohn J, Mun JH. Diagnosis of Onychomycosis: From Conventional Techniques and Dermoscopy to Artificial Intelligence. Front Med (Lausanne). 2021 Apr 15;8:637216. doi: 10.3389/fmed.2021.637216. PMID: 33937282; PMCID: PMC8081953.
Falotico JM, Lipner SR. Updated Perspectives on the Diagnosis and Management of Onychomycosis. Clin Cosmet Investig Dermatol. 2022 Sep 15;15:1933-1957. doi: 10.2147/CCID.S362635. PMID: 36133401; PMCID: PMC9484770.

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