Fungal Nails

What is a fungal nail?

Fungal infection of toenails is a common foot health problem. In many cases, the change in color of the nail is the start of an aggravating disease that ultimately could take months to control. Fungal infection of the nails is known to podiatrists and other physicians as onychomycosis. It is an infection underneath the surface of the nail, which can also penetrate the nail. It is frequently accompanied by thickening of the nails, which then cannot easily be trimmed and may cause pain while wearing shoes. This disease can frequently be accompanied by a secondary bacterial and/or yeast infection in or about the nail plate.

Onychomycosis is an infection of the bed and plate underlying the surface of the nail, and is caused by various types of fungi, which are commonly found throughout the environment. A group of fungi called dermophytes easily attack the nail, thriving off keratin, the nail's protein substance.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where people are likely to be walking barefoot - swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of athlete's foot and excessive perspiration.

Prevention

By following precautions, including proper hygiene and regular inspection of the feet and toes, chances of the problem occurring can be sharply reduced.

Shower shoes should be worn when possible, in public areas. Shoes, socks, or hosiery should be changed daily. Toenails should be clipped straight across so that the nail does not extend beyond the tip of the toe. Use a quality foot powder in conjunction with shoes that fit well and are made of materials that breathe.

Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks, especially for those with more active life styles.

Artificial Nails and Polish

Moisture collecting underneath the surface of the toenail would ordinarily evaporate, passing through the porous structure of the nail. The presence of an artificial nail or a polish impedes that, and the water trapped below can become stagnant and unhealthy, ideal for fungi and similar organisms to thrive.

Always use preventive measures when applying polishes. Disinfect home pedicure tools and don't apply polish to nails suspected of infection: those toes that are red, discolored, or swollen, for example.

Treatment

Depending on the nature of the infection and the severity of each case, treatment may vary. A daily application of an over-the-counter liquid antifungal agent may be warranted.

However, even the best-over-the-counter treatments may not prevent a fungal infection from coming back. A fungus may work its way through the entire nail, penetrating both the nail plate and the nail bed. If an infection is not overcome, or continues to reappear, further medical attention is strongly recommended.

Professional treatment

A podiatric physician can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail. Indeed, debridement is one of the most common foot care procedures performed by DPMs.

Newer oral antifungals approved by the Food and Drug Administration may be the most effective treatment. Current studies show that, for a small percentage of the population, there are some unwanted side effects with any oral antifungal.

In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured, and prevents the return of a deformed nail.

Trying to solve the infection without the qualified help of a podiatric physician can lead to more problems. With new technological advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful.

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