The symptoms of the condition primarily involve aesthetic effects to either finger or toe nails. They can vary widely depending on the severity of the infection and the time it has been left untreated.
There is no pain associated with the condition in most cases, however if it is left untreated it may develop. Additionally, some people may experience related psychosocial symptoms as a result of the appearance of their nails and dermatophytids may also develop in other areas of the body.
Each of these aspects of onychomycosis symptoms will be covered in greater detail below.
The physical changes to the nail area are usually the first signs of the condition to appear. Common signs that may be noticeable around the nail area include:
- Discoloration of nail to white, black, yellow or green
- Thickening of nail
- Brittle nails that chip or break easily
- Discoloration of nail bed and skin around the nail to white or yellow
- Dry or scaly skin around nail
- Foul smell
These signs are not present in all individuals, but most people affected by the condition will experience several of these. Particularly when the infection continues to grow without treatment, the severity of the signs may worsen considerably.
The majority of people who suffer from onychomycosis do not report any pain related to the infected nails and physical symptoms are the main concern. However, when left untreated the condition can worsen and the skin around the nail can become inflamed.
This can cause individuals significant pain, particularly underneath and around the nail. The severity of the pain depends greatly on the extent of the inflammation caused by infection and varies significantly. In most cases when adequate treatment has been used to help control the infection, pain does not cause a considerable problem.
In addition to the direct effects associated with the infected nails, individuals may experience significant psychosocial problems. This is due to the appearance of the nails and anxiety related to social interactions as a result.
It occurs more often when the fingernails are affected, as they are usually in full view of other people. Individuals may feel self-conscious about the reaction other people may have to the appearance of their nails, which can make them feel anxious about social interactions.
Infected toenails are usually associated with less psychosocial effects, as they can be hidden from sight in social situations more easily.
Occasionally people affected by onychomycosis may also notice dermatophytids, which are skin lesions that affect another part of the body away from the nail area. This is not a secondary fungus infection but instead thought of as an allergic skin reaction as a result of exposure to the nail fungus.
Dermatophytids usually present as a red rash on the skin that can cause significant itchiness. The most common presentation is on the hands of people that have onychomycosis on the toenails, although it may occur on any area of the body.
Assessing the physical signs and symptoms of the condition is the way the initial diagnosis of onychomycosis is usually made. Following clinical examination, laboratory tests of nail and skin samples may be needed to confirm the diagnosis and choose a suitable treatment.