In addition to the main signs and symptoms listed above, there are a number of secondary signs and symptoms that may point to onychomycosis. These include difficulty walking or exercising, broken or crumbling nails, reddened skin or swelling of the soft tissue around the nail, speckled or raised nails, difficulty standing for long periods of time, ragged edges or powdery patches on the nail, roughened or otherwise deformed nails, separation of the nail from the nail bed, and fingernail or toenail pain. On the topic of pain, pain that is felt underneath the nail or around the nail is particularly important. While the pain associated with onychomycosis is usually not severe, if the condition is left untreated and the skin becomes inflamed, the intensity of the pain can increase significantly.
Onychomycosis can also present itself as subungual hyperkeratosis, lateral onychomycosis, proximal onychomycosis, onycholysis, and dermatophytids. Subungual hyperkeratosis refers to scaling under the nail, which is due to excessive keratinocyte proliferation in the hyponychium and the nail bed. Lateral onychomycosis refers to yellow or white streaks in the middle of the nail plate, a symptom that is very common among sufferers of nail fungus. Proximal onychomycosis refers to the formation of yellow spots at the bottom of the nail, which then spreads from there. Onycholysis is when the infected nail separates from the nail bed, another very common symptom. Lastly, dermatophytids are fungus-free skin lesions that look very much like allergic reactions, resulting in itchy rashes on parts of the body that are not directly affected by onychomycosis.
Some people discuss the signs and symptoms of onychomycosis in stages, from a mild inconvenience in the early stages to a severe infection that can lead to toe or foot amputation in the advanced stages. Because an early-stage infection of onychomycosis is rarely more than an aesthetic change, many sufferers dismiss it. There is usually a change in texture and color, with spots or white lines that develop on the nail’s surface. The moderate stage is characterized by the thickening of the nail, to a point where it can become painful, especially when doing activities that involve the hands or feet. The most severe stage, or advanced fungal nail infection, includes more color changes, nail thickening, pronounced ridges, scaly skin, and a foul smell. Onychomycosis responds best to treatment during the early stages, so it’s important to seek treatment immediately