Severe Nail Fungal Infections: When Should I See A Doctor?

Severe Nail Fungus InfectionSevere Nail Fungal Infection: When Should I See A Doctor?

How Does a Nail Fungus Start?

Nail fungus infection is a common dermatological disorder that begins either under the nail or in the nail itself. It is mostly caused by a dermatophyte fungus, though there are cases that it is caused by Candida yeast as well.

Also called onychomycosis, the condition affects both fingernails and toenails, though it is more prevalent in toenails. Fungi thrive in warm and moist environments, which perhaps describe a lot of footwear. Nail fungus infection can also start with the same dermatophyte fungus that causes athlete’s foot, the Trichophyton. So when a person has athlete’s foot, it’s also likely that the fungal infection would spread to the nails.

Fungal infection gives nails an abnormal appearance. The first sign of it may be a discolored dot on the nail or the skin under the nail. There may be white or yellow streaks on the nail, a crumbling corner or tip of the nail, flaking on the nail’s surface, yellow spots at the bottom of the nail, and scaling under the nail. The infected nail may also be thickened or brittle, and it may detach from the nail bed. In some cases, there may also be odor coming from the infected nail.

When to Call a Doctor for Severe Nail Fungal Infection

Nail fungal infections can be treated without going to the doctor. They can be successfully and easily cured with over-the-counter (OTC) medications. Many topical ointments, though, get a bad rap because they are thought to be ineffective in treating nail fungus. However, newer topical solutions that have 10% undecylenic acid and nail-penetrating essential oils are proven to provide effective, safe, and fast cure.

For severe cases of nail fungal infections, it’s best to see a doctor for best possible treatments. These include worst case scenarios of onychomycosis, in which patients deal with discomfort or increased pain and swelling, other infections, red streaks extending from the area, discharge of pus, and fever with no other cause.

It’s also best to go to a doctor if the fungal infection appears to be spreading to the surrounding skin. Other people also seek a doctor’s advice even if their nail condition is a moderate case because the appearance of the infected nail bothers them.

A general practitioner may be able to handle nail fungal infection cases. However, it is recommended to seek a dermatologist to pinpoint the problem. A dermatologist can give proper diagnosis on skin and nail conditions, and therefore will be able to identify the fungal infection and what type it is.

To determine the cause of the problem and diagnose a fungal nail infection, the doctor may take a sample of the skin and nail fragments from the infected nail. If that cannot be taken easily, then the doctor may lightly scrape the nail or shave off a piece of the nail. The samples will then be used for tests to determine what caused the infection.

The samples may undergo potassium hydroxide (KOH) preparation test to find out if the infection is caused by fungi. As most nail fungal infections are caused by a dermatophyte fungus, the doctor may prescribe treatment based on this. However, different medicines work and function better than the others against certain types of fungus. Hence, the doctor may do a fungal culture.

The fungal culture test can show which type of fungus is present. This can take several weeks for a culture to produce results since fungi grow slowly. Although this test takes a long time, it can help in accurately determining the type of fungal infection, and therefore the doctor can properly prescribe treatment based on the results.

How to Treat Severe Nail Fungal Infection

Some people opt not to do anything about their nail fungal infection because they are not bothered by it at all, or at least they have adapted to live with the condition. However, it is recommended that the infection is treated immediately because it might get worse.

For severe nail fungal infection cases, treatment is necessary. In such cases, the infection may even spread to other parts of the body and will compromise the overall health of the patient.

Doctors are likely to prescribe oral fungicidal medicines to treat severe nail fungal infections depending on the patient’s condition, medical history, other ailments, and restrictions. While oral treatments are generally considered effective, but they are slow in delivering results and they come with side effects. Therefore, doctors take into consideration their patients’ individual health records in prescribing oral fungicidal medications.

It’s not the most common solution, but surgery is also sometimes recommended for extreme cases of onychomycosis. A part of the nail (debridement) or the entire nail (avulsion) can be removed in the surgery, which can be done in a clinic or in the doctor’s office. By removing the nail, the fungi infection is also removed, allowing a new and healthy nail to grow back. It takes time for the new one to grow fully, though, and the fungi may even return during the recuperation period.

This is where topical solutions come in. While the new nail is growing, topical ointments may be applied on the nail bed and surrounding skin to prevent the recurrence of fungi. It is also recommended to apply topical treatments in conjunction with oral medications in treating onychomycosis to speed up the recovery and maximize the effect.


Severe cases of nail fungus infection require treatment. While some people do not mind living with mild to moderate cases of onychomycosis, it’s a different story with acute onychomycosis. Treatment is necessary not just to correct the cosmetic aspect of the infected nails, but to stop the spread of the infection to other parts of the body as well.

It is especially necessary to treat nail fungus infection if the patient is suffering from other health conditions, like diabetes and heart conditions. These people may develop potentially serious complications caused by seemingly harmless nail fungi infections.

Go to a doctor or specialist for proper diagnosis and treatment. Healing starts with proper diagnosis.

Posted in Nail Fungus
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Global Nail Fungus Executive Team:
Sandy Getzky - Executive Coordinator Pat-B

Sandy is an experienced manager of medical research operations and authority content creation.

Pat B. - Head of Research Pat-B

Pat holds a PhD in Natural Health and has been a Registered Nurse for 35 years.Certifications: American Herbalist’s Guild, Registered Herbalist, Awarded: 2012. Licenses: Registered Nurse, State of New York, Awarded: 2011. Registered Nurse, State of Florida, Awarded: 1975

Diana Arevalo - Contributor and Research Coordinator Pat-B

Diana is a registered Nutritionist-Dietitian. Graduated with a degree in Nutrition and Dietetics.

Gary Smith - Medical Presenter Pat-B

Gary is a professional medical presenter with over 35 years in this industry.

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The Global Nail Fungus Organization was founded with one goal: Fight Nail Fungus. We work towards this goal by providing resources, education, and solutions to the 35 million people currently suffering from finger and toenail fungus in America and the millions more around the world.