image: Mahmoud Ghannoum
Credit: Case Western Reserve University
CLEVELAND—Athletes are 2.5 times more likely than the general public to develop nail fungus, according to a study in the Journal of the American Academy of Dermatology. A condition that can disrupt training, change performance and end careers. However, until now, no thorough study has examined how nail fungus affects various sports.
Today, Case Western Reserve University and University Hospitals announced the launch of the first large-scale collaborative study focused on onychomycosis, a chronic fungal infection of the nails, among athletes.
While fans focus on visible injuries, nail fungus quietly undermines athletic performance in ways most people never consider.
“When athletes are dealing with pain, nail damage or recurring infections, it can alter gait, reduce training consistency and ultimately affect competitive outcomes,” said James Voos, chairman of Orthopedic Surgery and the Jack and Mary Herrick Distinguished Chair at University Hospitals. “This condition isn’t just about appearance; it’s about protecting athletes’ ability to perform at their best.”
The warm, moist environments created by intense training, restrictive footwear and shared facilities create perfect breeding grounds for fungal infections.
“There is very little data showing how common nail fungal infections are across different sports, despite the high risk among athletes,” said the study’s lead researcher Mahmoud Ghannoum, director of the Center for Medical Mycology at Case Western Reserve. “Our goal with this research is to better understand the epidemiology and general insights that will inform improved prevention, diagnosis and treatment strategies.”
The six-month study also includes UH Drusinsky Sports Medicine Institute—the healthcare partner of the Cleveland Ballet, Cleveland Browns and Cleveland Monsters—and Ortho Dermatologics, a division of Bausch Health.
These partners will help identify and recruit 100 to 200 collegiate and professional athletes, allowing researchers to gather data across multiple sports. They will also raise awareness, facilitate survey distribution and assist with athlete screening and optional nail sampling for follow-up studies.
“This research represents a critical step toward keeping athletes healthy, competitive and at the top of their game,” Ghannoum said. “Every athlete deserves to compete without preventable conditions holding them back.”
The study begins this month, with initial results expected by June. Athletes will be surveyed through an electronic questionnaire that asks about nail appearance, discomfort during training or competition, impact on performance and previous treatments. The anonymous survey captures how toenail fungal infections affect daily activities, confidence and athletic function.
Future study phases will focus on advanced diagnostic tools and enhanced treatment protocols with applications extending beyond professional athletics. The research could particularly benefit military personnel and other groups facing similar risks from repetitive foot trauma, shared equipment and challenging physical environments
Case Western Reserve and the City of Cleveland are uniquely positioned for this research because it brings together a high-volume sports medicine environment, a leading medical mycology center and direct access to professional, collegiate and youth athletic organizations. This combination allows researchers to study onychomycosis in athletes at a scale and level of clinical detail that is rarely available elsewhere.
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About Case Western Reserve University
As one of the fastest-growing research universities in the United States, Case Western Reserve University is a force in career-defining education and life-changing research. Across our campus, more than 12,000 students from around the world converge to seek knowledge, find solutions and accelerate their impact. They learn from and collaborate with faculty members renowned for expertise in medicine, engineering, science, law, management, dental medicine, nursing, social work, and the arts. And with our location in Cleveland, Ohio—a hub of cultural, business and healthcare activity—our students gain unparalleled access to academic, research, clinical and entrepreneurial opportunities that prepare them to join our network of more than 125,000 alumni worldwide. Visit case.edu to see why Case Western Reserve University is built for those driven to be a force in the world.
About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of more than 20 hospitals (including five joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University, Taiwan National University College of Medicine and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.
Method of Research
Survey
Subject of Research
People