The Impact of Onychomycosis on Quality of Life: A Systematic Review of the Available Literature

Skin Appendage Disord. 2018 Oct;4(4):208-216. doi: 10.1159/000485632. Epub 2018 Feb 13.


Purpose: Onychomycosis is a nail disorder that is increasing in prevalence worldwide. The psychological and social limitations caused by onychomycosis can potentially undermine the work and social lives of those experiencing these negative effects. This review aimed to evaluate the randomized controlled trials (RCTs) available in the current literature on the impact onychomycosis has on quality of life (QoL).

Methods: A systematic review was performed using the databases PubMed, PsycINFO, Scopus,, and Cochrane Library on July 18, 2017. Only RCTs with clinical effects described in English were included for review.

Results: Ten RCTs reported QoL outcomes for patients suffering from onychomycosis. Treatment satisfaction was statistically significant from baseline to end of treatment in 100.0% (4/4) measures which reported on satisfaction with treatment; mental health was also significant in 100.0% (3/3), symptoms index rating in 100.0% (2/2), symptom frequency in 75.0% (3/4), overall problems in 75.0% (3/4), functional activities in 75.0% (6/8), appearance problems in 66.7% (2/3), symptom distress in 57.1% (4/7), and stigma in 40.0% (2/5). The OnyCOE-tTM and the NailQoL were the most used common outcome measures to describe QoL.

Conclusion: The study sanctions that onychomycosis physically and psychologically distresses patients' lives. Further research should include validated outcome measures to more effectively treat onychomycosis.

Keywords: Onychomycosis; Quality of life.

Publication types

  • Review