The Prevalence of Onychomycosis in the Global Population: A Literature Study

J Eur Acad Dermatol Venereol. 2014 Nov;28(11):1480-91. doi: 10.1111/jdv.12323. Epub 2013 Nov 28.


Background: Onychomycosis is a common disorder, and high prevalence figures are commonly cited in the literature.

Objectives: Evaluate the prevalence of onychomycosis based on published studies.

Methods: Relevant studies were identified in Medline by using specific search criteria.

Results: Eleven population-based and 21 hospital-based studies were identified. The mean prevalence in Europe and North America was 4.3% [95% Confidence Interval (CI): 1.9-6.8] in the population-based studies, but it was 8.9% (95% CI: 4.3-13.6) for the hospital-based studies. Both population-based and hospital-based studies showed that onychomycosis is more common in toenails and is seen more frequently in males. The main causative agent was a dermatophyte in 65.0% (95% CI: 51.9-78.1) of the cases. Trichophyton rubrum was the single most common fungus and was cultured on average in 44.9% of the cases (95% CI: 33.8-56.0). Moulds were found on average in 13.3% (95% CI: 4.6-22.1) and yeasts in 21.1% (95% CI: 11.0-31.3).

Limitations: We may not have been able to locate all studies.

Conclusions: Onychomycosis is a common disorder, but it may not be as common as cited in the literature, because hospital-based studies might overestimate the prevalence of onychomycosis. It is more frequent in males, and toenails are more commonly affected. Dermatophytes, particularly T. rubrum, are the main causative agents.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Africa / epidemiology
  • Aged
  • Aged, 80 and over
  • Asia / epidemiology
  • Child
  • Europe / epidemiology
  • Female
  • Foot Dermatoses / epidemiology*
  • Foot Dermatoses / microbiology
  • Global Health*
  • Hand Dermatoses / epidemiology*
  • Hand Dermatoses / microbiology
  • Humans
  • Male
  • Middle Aged
  • North America / epidemiology
  • Onychomycosis / epidemiology*
  • Onychomycosis / microbiology
  • Prevalence
  • South America / epidemiology
  • Tinea / complications
  • Trichophyton
  • Young Adult

Supplementary concepts

  • Trichophyton infection