Onychomadesis is a cutaneous condition, or condition affecting the skin, caused by fungi that involves the total shedding of toenails or fingernails. For this reason, it is sometimes referred to as fungal nail infection, or tinea unguium. Onychomadesis is described as a periodically idiopathic ailment, meaning that it appears unexpectedly from time to time.

Nails that exhibit onychomadesis usually have a dull look, with white or yellow streaks found on their sides. They also become brittle and weak as they begin to crumble away and loosen from the nail bed. The specific fungi that causes onychomadesis is from the genusTrichophyton. Perhaps the most common member for this infection is Trichophyton rubrum, which also causes athlete’s foot, ringworm and jock itch. Another example is Trichophyton tonsurans, which is perhaps best known for causing the hair-scalp infection called tinea capitis.

Some fungi are actually useful for the human body, such as the production of antibiotics to kill or reduce harmful bacteria instrumental in causing infectious diseases. Others, however, are capable of creating infections themselves. One of their biggest targets is the nails, where they can subsist on dead tissue.

Since fungi thrive in warm and moist sites, people with persistently moist skin, who sweat a lot or who frequently wear closed-in shoes have a heightened risk of developing onychomadesis. Other possible causes include skin or nail injuries, manicures and pedicures with tools previously used on infected clients, fingernail or toenail abrasions from nail filing, and the use of public amenities such as gyms and swimming pools.

In many cases, onychomadesis is an indication of more serious ailments. These could include diabetes or an immune system that is not working properly. It can also be triggered by a nail disease; or peripheral vascular disease, which is characterized by malfunction of small blood vessels. Onychomadesis is more commonly detected in adults, and toenails are more frequently affected than fingernails. Some medical researchers believe that older women in particular are more susceptible to the condition, as it is believed that reduced levels of estrogen increases the body’s infection risk.

Physicians usually determine the presence of onychomadesis by scraping the nail and establishing the type of fungus causing the infection. Usually, anti-fungal medications such as terbinafine hydrochloride, whose brand name is Lamisil; and griseofulvin and fluconazole, whose brand name is Diflucan, are prescribed. A two-to-three-month treatment period is recommended for toenails, and a shorter treatment time for fingernails. The prognosis has limited success, as some patients may still experience recurrence after completion of treatment.