Why Do I Keep Getting Nail Fungus?

Medically called onychomycosis, nail fungus causes the nails to become thick, discolored, and crumbling at the edges. As many as 10% of all adults in Western nations have some fungal infection of the nails, and that increases to 20% for those who are over 60. It’s more common, though, to get a toenail infection than a fingernail infection.

At Family Foot and Ankle Center of South Jersey in Cherry Hill, New Jersey, our expert team of podiatrists understands that while nail fungus is not usually medically serious, it can be extremely uncomfortable and unsightly, and the infection has a nasty habit of recurring. Treatment is easiest and most effective when performed early on, so you should make an appointment to come in as soon as you see the warning signs. Here’s everything you need to know about this condition.

Nail fungus symptoms

Nail fungus has a number of telltale symptoms, which include:

Causes and risks

Fungal nail infections can be caused by a number of different fungi, yeasts, and molds. The most common type of nail infection is caused by the dermatophyte (an organism that attacks the skin and nails) Trichophyton rubrum.

When the infection affects the skin between the toes, it’s called athlete’s foot. Toenail infection can start as a case of athlete's foot, then spread from one nail to another, and it’s common for more than one nail on a foot to be affected. Generally, though, the infection doesn’t spread directly from one person to another.

Fungal nail infections are found more commonly in older adults. As the nail ages, it often becomes brittle, dry, and cracked; the cracks allow fungi to enter more easily. Other factors, including reduced blood circulation to the feet (diabetes) and a weakened immune system (autoimmune disorders, chemotherapy) may also play a role.

Fungi thrive in damp, warm, dark places, like the inside of your shoes. That means you’re at greater risk if your feet sweat heavily and you don’t change your socks often enough, if you have a history of athlete’s foot, or if you walk barefoot in damp communal areas like gyms, locker and shower rooms, and swimming pools.

You can help prevent reinfections by:

Treatment options

Your doctor may prescribe oral antifungal drugs or those you apply directly to the nail. In some situations, it helps to combine the two therapies.

Oral antifungal drugs

These drugs clear the nail infection more quickly than topical drugs. They help a new, uninfected nail grow, slowly replacing the infected part.

You usually take these drugs for 6-12 weeks, but you won’t know if it’s been successful until the nail grows back completely — in about 9-12 months.

Oral antifungals drugs also have unpleasant side effects, from skin rash to liver damage, so you’ll probably need occasional blood tests to see how you’re doing. They’re not appropriate for people with liver disease or congestive heart failure.

Medicated nail polish

Ciclopirox (Penlac) is a topical antifungal. You paint it on the infected nails and surrounding skin every day. After seven days, you wipe the layers clean with alcohol and start again. Most people need to use the polish for at least a year.

Medicated nail cream

Medicated antifungal creams work best if you thin the nails first, so the medicine can penetrate the hard nail surface to reach the fungus. You can either use a nonprescription lotion that contains urea, or we can thin them with a nail file or other tool.


There are two types of surgical treatments. The first is a temporary removal of the nail so we can apply the antifungal directly to the infection. However, since some infections don’t respond to medications, we might suggest permanent nail removal if you have a severe infection or are in a lot of pain.

Nail fungus is hardy, and even with treatment, it may be hard to rid yourself of it permanently. Your best option is to do as much preventive care as possible and come into Family Foot and Ankle Center of South Jersey regularly to ensure you don’t have another infection starting up. You can reach us by calling the office at 856-266-9572, or by scheduling an appointment online. We have the resources and expertise necessary to ensure your feet stay as healthy as possible.

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