In this guide
- Most fungal nail infections are a form of ringworm, the CDC says.
- Testing a nail sample helps get the right treatment.
- Products that treat nail fungus are drugs, not cosmetics.
Key takeaways
- Fungal nail infections can make nails change color, thicken and break easily, and are much more common in toenails.
- They spread through shared surfaces and objects, such as damp floors and towels.
- A healthcare provider can test a small nail sample before choosing a treatment.
- A Pennsylvania nail technician is required to refuse a client they believe has a contagious condition.
A nail that turns yellow, thickens or starts to crumble is easy to hide under a coat of polish. It is also easy to ask a technician to buff it down and move on. Neither helps if the cause is an infection. This guide explains what the CDC says about fungal nail infections, why a salon is not the place to treat them and who to see instead.
What a fungal nail infection is
The CDC explains that ringworm is a common infection of the skin, scalp or nails caused by fungi, not a worm. Athlete’s foot, jock itch and most fungal nail infections are forms of it. The medical name for a fungal nail infection is onychomycosis.
On the nails, the CDC describes three signs: nails may change color, become thick and break easily. The infections are much more common in toenails than in fingernails, although fingernails can be infected too. The most common fungi behind ringworm have the scientific names Trichophyton, Microsporum and Epidermophyton.
How it spreads
According to the CDC, the fungus can get into cracks in the nails or the surrounding skin. Ringworm spreads easily, through skin-to-skin contact with an infected person or animal, through shared objects like towels and bedsheets, and through shared surfaces like locker room and public bathroom floors.
The CDC lists several risk factors that will sound familiar to anyone who wears winter boots or works out:
- using public showers or locker rooms without protective footwear;
- wearing tight shoes and socks;
- sweating heavily;
- close contact with infected animals.
Anyone can get ringworm, but the CDC notes that people with weakened immune systems may be more at risk and may have more trouble fighting it off.
Why testing comes first
Not every thick or discolored nail is fungal. The CDC points out that ringworm symptoms look like those of other skin and nail conditions, and that testing helps make sure you get the right treatment. For a nail, a healthcare provider may take a small nail sample or skin scraping to test.
You can start with your primary care provider, a dermatologist or a podiatrist; the CDC names all three. Treatment depends on where the infection is and how serious it is. Some forms of ringworm can be treated with non-prescription antifungal medicine; others need prescription treatment.
Tip: Do not put a steroid cream on a rash that could be ringworm. The CDC warns that steroid creams, found in many over-the-counter rash products, can make ringworm worse.
Where the salon fits in
Nail polish and salon products are cosmetics. The FDA makes the distinction clearly: a nail product intended to treat a medical problem such as nail fungus is a drug, not a cosmetic. A manicure or pedicure can make a nail look tidier, but it does not treat an infection.
Pennsylvania’s salon rules also draw a line. A licensed technician must refuse to serve a client they believe has an infectious, contagious or communicable disease, unless the client can show a physician’s certification that they do not. The Cosmetology Law makes it a summary offense for a licensed technician to knowingly serve someone with a contagious or infectious disease. So a technician who will not work on an infected-looking toenail is following the law.
It works in the other direction too. The rules require tools that touch clients to be sanitized immediately after each use and towels to be clean for every client, which is how a well-run salon keeps one client’s infection from reaching the next. Our guide to Pedicure Safety in Pennsylvania: What the Rules Require and What to Watch For covers what to look for in the pedicure chair.
Prevention that fits everyday life
The CDC’s prevention advice is simple and works year round:
- Keep skin clean and dry.
- Wear protective footwear in public showers and locker rooms.
- Change socks and underwear every day.
- Do not share towels, socks or sports gear.
- Wash your hands after touching pets.
- Keep fingernails short and clean.
In a Pittsburgh winter, add one more: let boots dry out fully between wears. Our guide to Hands and Nails Through a Pittsburgh Winter has more on the season.
Going back to the salon
Once a healthcare provider has looked at the nail and you are on treatment or cleared, tell your technician what was going on before your next appointment. Bring any advice your provider gave you about polish or enhancements while the nail grows out. And if you believe an infection began with a salon visit because of poor hygiene, the Pennsylvania Department of State takes complaints; Filing a Complaint About a Pennsylvania Nail Salon or Technician explains how.