Everything You Need to Know About Proximal Subungual Onychomycosis

Written by Medicover Team and Medically Reviewed by Dr Chetana Panabaka , Dermatologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Proximal subungual onychomycosis is a type of fungal infection that affects the nails. This condition primarily impacts the health of the nails and surrounding skin, leading to changes in their appearance and texture. The infection can cause discomfort and affect the overall wellbeing of an individual, as it may lead to self-consciousness or embarrassment due to the visible changes in the nails.

It is important to seek medical advice for proper diagnosis and treatment to address the effects of proximal subungual onychomycosis on health and prevent potential complications.

Types of Proximal Subungual Onychomycosis

Proximal Subungual Onychomycosis typically presents in different forms, each characterized by distinct patterns of nail changes and symptoms.

White Superficial Onychomycosis (WSO): A type of proximal subungual onychomycosis characterized by white patches on the nail plate.
Distal Lateral Subungual Onychomycosis (DLSO): Fungal infection that starts at the tip or side of the nail and progresses towards the cuticle.
Total Dystrophic Onychomycosis (TDO): Infection that affects the entire nail, leading to thickening, discoloration, and crumbling.
Endonyx Onychomycosis: Fungal infection that occurs within the nail plate, causing whitening without nail plate separation.
Candidal Onychomycosis: Nail infection caused by Candida species, leading to nail plate discoloration and thickening.

What Are the Symptoms of Proximal Subungual Onychomycosis?

Proximal subungual onychomycosis typically presents with specific symptoms affecting the nails.

Yellow or white discoloration of the nail plate
Thickened or brittle nails
Nail lifting from the nail bed
Pain or discomfort around the nails

What Causes Proximal Subungual Onychomycosis?

Proximal subungual onychomycosis is commonly caused by dermatophyte fungi entering the nail through the proximal nail fold.

Fungal infection
Trauma to the nail
Poor nail hygiene
Chronic moisture exposure
Immune system disorders

When Should You See a Doctor for Proximal Subungual Onychomycosis?

You should consult a Dermatologist if you notice persistent nail discolouration, thickening, nail separation, or pain around the affected nail. Early treatment can help prevent the infection from spreading and reduce the risk of permanent nail damage.

You should see a doctor if you have:

Persistent yellow, white, or brown nail discoloration
Thickened or brittle nails
Nail deformity or nail lifting
Pain or discomfort around the nail

Get medical help immediately if:

Signs of a severe skin infection
Swelling, redness, or pus around the nail
Rapid worsening of symptoms, especially in people with diabetes or weakened immunity

These could be signs of a serious complication like Proximal Subungual Onychomycosis, which needs urgent care.

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How is Proximal Subungual Onychomycosis Diagnosed?

Proximal subungual onychomycosis is typically diagnosed through a combination of clinical examination and laboratory tests.

Microscopic examination of nail clippings
Fungal culture test of nail clippings

What is the Treatment for Proximal Subungual Onychomycosis?

Proximal subungual onychomycosis is commonly treated by addressing the underlying fungal infection to improve the health and appearance of the affected nail.

Oral Antifungal Medications:

These medications are taken by mouth to treat the fungal infection from within the body. They are often prescribed for severe cases of proximal subungual onychomycosis.

Topical Antifungal Treatments:

Creams, gels, or solutions applied directly to the affected nail can help combat the fungal infection. They are often used for mild to moderate cases of proximal subungual onychomycosis.

Laser Therapy:

Laser treatment targets and destroys the fungus infecting the nail. It is a non-invasive option that can be effective in treating proximal subungual onychomycosis.

Surgical Nail Removal:

In severe cases where other treatments have failed, surgical removal of the affected nail may be necessary to allow for the application of antifungal medication directly to the nail bed.

Combination Therapy:

Combining different treatment modalities, such as oral medications with topical treatments, can provide a more comprehensive approach to treating proximal subungual onychomycosis, improving the chances of successful eradication of the fungal infection.

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What Are the Risk Factors for Proximal Subungual Onychomycosis?

Proximal subungual onychomycosis is commonly associated with factors such as diabetes, compromised immune function, and a history of nail trauma.

Risk factors for Proximal Subungual Onychomycosis:

Aging
Diabetes
Poor circulation
Weakened immune system
Trauma to the nail
Prolonged exposure to moisture
Athlete's foot or other fungal infections
Family history of fungal nail infections

What Complications Can Proximal Subungual Onychomycosis Cause?

If left untreated, proximal subungual onychomycosis can lead to progressive nail damage and secondary infections. People with diabetes or weakened immune systems may face a higher risk of complications.

Permanent nail deformity
Chronic nail pain and discomfort
Spread of fungal infection to other nails
Secondary bacterial infections
Difficulty walking or performing daily activities

How Can Proximal Subungual Onychomycosis be Prevented?

Good nail hygiene and reducing exposure to fungal environments can help lower the risk of developing proximal subungual onychomycosis. Early treatment of fungal infections is also important.

Keep nails clean and dry
Avoid sharing nail care tools
Wear breathable footwear
Treat athlete's foot promptly
Protect nails from injury
Maintain good foot hygiene

Frequently Asked Questions

1. How do you treat proximal subungual onychomycosis?

Treatment usually involves oral antifungal medications, topical antifungal therapies, nail care, and management of underlying conditions that increase the risk of infection.

2. What is the cause of proximal subungual onychomycosis?

Proximal subungual onychomycosis is caused by fungal organisms, most commonly dermatophytes, that invade the nail through the proximal nail fold and spread into the nail plate.

3. How do you treat proximal onycholysis?

Treatment depends on the underlying cause and may include keeping the nail dry, avoiding trauma, treating fungal or bacterial infections, and managing skin conditions affecting the nail.

4. Can onychomycosis go away on its own?

No. Onychomycosis usually does not resolve without treatment and may gradually worsen or spread to other nails over time.

5. Is proximal subungual onychomycosis contagious?

Yes. Fungal nail infections can spread through direct contact or by sharing contaminated items such as nail clippers, footwear, socks, or towels.

6. Can proximal subungual onychomycosis go away on its own?

It rarely clears without treatment. Early diagnosis and antifungal therapy improve the chances of successful treatment.

7. Who is most at risk for proximal subungual onychomycosis?

People with diabetes, weakened immune systems, poor circulation, HIV infection, nail trauma, or a history of fungal infections are at increased risk.

8. How long does treatment for proximal subungual onychomycosis take?

Treatment often takes several months because nails grow slowly. Complete clearance may require 6 to 12 months or longer, depending on the nail involved.

9. What are the symptoms of proximal subungual onychomycosis?

Symptoms may include nail discoloration, thickening, brittleness, nail deformity, separation of the nail from the nail bed, and debris beneath the nail.

10. How is proximal subungual onychomycosis diagnosed?

Diagnosis is usually confirmed through nail examination, microscopic testing, fungal culture, or laboratory analysis of nail samples to identify the causative fungus.