While onychomycosis or toenail fungus most often affects adults, children can also develop this unsightly condition. However, it’s rare in kids—only 2.5% of all nail fungus infections are found in children.
Causes of Fungal Toenails
Kids get toenail fungus for many of the same reasons as adults. However, since they rarely go to locker rooms or salons they are more likely to get it due to the following:
- Adults in the home who have toenail fungus
- Kids who use nail tools used by an adult with toenail fungus
- Kids with a weak immune system (such as diabetes or psoriasis)
- Wearing cotton socks (they don’t wick away moisture) and shoes that don’t breathe (e.g. rubber boots)
- Kids with athlete’s foot (the fungus that causes athlete’s foot also causes toenail fungus)
Diagnosis
Because it’s rare, nail fungus in children is often missed by providers. However, it’s looks similar to nail fungus found in adults. Signs of fungus include:
- Nails that have turned yellow or white
- Painful skin around the nail
- Thicker nails that become brittle
To ensure it’s fungus, ask your doctor to send nail clippings for testing. Sometime trauma to the nail can look like toenail fungus.
Treatment of Toenail Fungus in Children
Topicals
Because children’s toenails grow much faster than adult’s they are more likely to respond to topicals than adults do. Topicals such as amorolfine, ciclopirox, and Jublia have been shown to be effective, although the latter is much more expensive. Like all topicals they would need to be applied on a daily basis to work.
Oral Medications
Oral agents, such as terbinafine, itraconazole, and fluconazole have been reported to have good efficacy and a low rate of side effects in children. Terbinafine is more effective in children than adults with a cure rate of 93%.
Laser Treatment
We currently provide laser treatment for children.
Shoe Treatment
To add to the effectiveness of any of these methods, it’s important to treat your kids shoes with a shoe sanitizer to destroy fungus in their shoes. In addition, trade off shoes daily to allow them to fully dry out and ensure your child wears a clean pair of non-cotton socks each day.
Prevention of Toenail Fungus
It’s best to prevent the infection in the first place. Here are the main ways to prevent nail fungus in your children.
- Keep children away from infected adults
- Make sure infected adults don’t share nail tools
- Store nail tools in a place kids can’t access
- Kids should use their own towels, combs, and soap
- Wear flip flops when they go to a pool or locker room
- Avoid pedicures in nail salons
- Wear socks that wick away moisture (avoid cotton)
- Wear shoes that allow the feet to breathe
- Remove wet shoes as soon as possible and allow to completely dry out before wearing
- Avoid tight shoes; pressure on the nails from the shoes can cause the nail to lift away from the nailbed creating entry for the fungus.
Visit our main fungal toenail page, to learn more about our comprehensive laser treatment program.
Sources:
Global Nail Fungus Organization (Safe treatments for nail fungus infections for infants and kids)
Anti-fungal therapy for onychomycosis in children, Clinics in Dermatology, Vol 33, Issue 3, Pgs 333-39
