Nail Fungus

An untreated fungal growth in the nails can be significantly problematic. A fungus can affect not only the nail itself, but can also cause damage to the entire nail area, including the nail bed and matrix. Nail tinea can cause the nails to become deformed. Not only do these nails tend to be cosmetically unacceptable, but they may be uncomfortable. Fingernail tinea can sometimes interfere with proper hand function. In the case of toenail tinea, people can have difficulty wearing their usual shoes. Nail tinea can act as a source of fungal infection for the skin. Tinea of the skin can act as an entry point for bacteria. Patients with diabetes or peripheral vascular disease require special consideration. Cellulitis of the lower legs is a serious bacterial skin and soft tissue infection that can cause significant morbidity in these patients.


A number of different types of organism may infect the nail

  • Moulds (dermatomycosis)
  • Yeasts
  • Dermatophyte fungi (dermatophytosis)

The most common dermatophyte to cause infection of the nails is Trichophytum rubrum. This organism causes 90% of toenail and 50% of fingernail dermatophyte infections.



Nail Fungus Signs

  • Yellow/white changes in one or more nails
  • Discoloured streaks on the nails
  • Scaling or thickening beneath a nail
  • Nail plate thickening
  • Lifting of the nail from its bed
  • The nail pits and flakes
  • Nail crumbling


Treating Nail Fungal Infections

A skin specialist can diagnose the type of nail fungi that you have. An appropriate treatment plan may then be developed. It is important to note that some fungal infections can be very challenging to eradicate.


Here are a few things to be mindful of when treating nail fungal infections:

  • Fingernail infections tend to be easier to eliminate than toenail infections.
  • Toenails take 12 months and fingernails take 6-9 months to grow out.
  • It is very important to consider sources of re-infection: these sources include communal showers, old shoes and socks, other family members.
  • Around 80% of mild infections can be remedied via a topical treatment.
  • Fungus grows well in warm and wet environments: people whose feet are constantly wet will find that it is more difficult to eradicate the tinea.
  • Infections involving a significant proportion of the nail plate respond best to oral therapies.
  • Laser treatments; this is a medication-free option. It is more expensive than traditional therapies. At least 2 t 5 treatments are often required.
  • Nail removal is an option in recalcitrant cases. This can be performed by either surgery, or chemical (urea) application. Antifungal agents are an important adjunct in these cases.
  • The cure rate for any treatment modality is generally 65-75%.

Toe nail fungus Onychomycosis

is a fungal infection affecting the nails. It is a chronic infection that affects as many as 3% of people at any one time. The nails are often thickened and have a yellowish discolouration. Toenails are more more commonly affected than fingernails and men are more likely to be affected than women. The infection can spread to the surrounding skin. Inversely, a skin tinea infection may spread to involve the nails. Tinea can be quite difficult to treat and it can readily recur.

Onychomycosis is a fungal infection affecting the nails. It is a chronic infection that affects as many as 3% of people at any one time. The nails are often thickened and have a yellowish discolouration. Toenails are more more commonly affected than fingernails and men are more likely to be affected than women. The infection can spread to the surrounding skin. Inversely, a skin tinea infection may spread to involve the nails. Tinea can be quite difficult to treat and it can readily recur.


Toe nail fungus Onychomycosis

There are a number of risk factors which increase the likelihood of developing onychomycosis. These include:

  • Compromised immune system – for example in diseases such as HIV, diabetes and people who are on immune suppressing medications (e.g. following an organ transplant)
  • Using communal showers – wearing shoes in communal showers at swimming pools and caravan parks can help to prevent the infection
  • Swimming
  • Co-morbid tinea pedis
  • Family members/housemates who have the infection
  • Trauma to the nail
  • Constant hand washing
  • Warm and humid conditions – these help the causative fungi to grow
  • Exercise – shoes and socks become hot and sweaty, which favours the growth of fungi. In addition, there can be minor trauma to the nails which can introduce the fungi into the nails; especially if the shoes worn are too tight


Diagnosis

Onychomycosis may be diagnosed based on the appearance of the nail in combination with laboratory tests. A scraping of the nail bed and nail clippings are often taken and then sent to the lab to be viewed under a microscope. The samples are then cultured on a special medium to identify the type of organism involved.



Treatment Options

  • Laser treatment
  • Medical treatments– oral and topical


If you have any questions or concerns about nail fungus Contact us today at 780-570-5855.