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Fungal
infection of the toenail, a common foot health problem, is an infection underneath the surface of the nail, which can also penetrate the nail.
Fungal infection of the nail is known to podiatrists and other physicians as
onychomycosis. It is caused by various types of fungi commonly
found throughout the environment. If it is ignored, its spread could impair one's ability to work or even walk. That happens because it is frequently accompanied by thickening of the nails, which then cannot easily be trimmed and may cause pain while wearing shoes.
The nail may become yellowish-brown or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.
This disease can frequently be accompanied by a secondary bacterial and/or yeast infection in or about the nail.
The majority of individuals with this foot health problem don't seek treatment and often don't even recognize the problem. Studies estimate that fungal infections of the toenail affect three to five percent of the population; however, this statistic is
likely much higher due to the number of unidentified or unreported cases.
A fungal infection of the toenail can exist for years without causing pain; this is a likely reason reason that so many people ignore the infection and don't seek treatment. This condition is more prevalent among older adults.
This is an aggravating disease which can take months to control, and is not a minor problem. Cosmetologists frequently see this disease because many women use nail polish as an easy solution to cover the discolored nail instead of seeking treatment from a podiatric physician.
Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially susceptible to
exposure to this type of infection around damp areas where people are likely to be walking barefoot, such as swimming pools, locker rooms, and showers. 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.
Treatment
Treatment will vary, depending on the nature of the infection and the severity of each case. A daily routine of cleansing, over a period of many months, may temporarily suppress mild infections. White markings that appear on the surface of the nail can be filed off, followed by the application of an over-the-counter liquid antifungal agent.
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.
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
podiatrists.
Newer oral antifungals approved by the Food and Drug Administration may be the most effective treatment. They offer a shorter treatment timeframe (three to four months) and improved effectiveness, although lengthier treatments may still be required for some infections. 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 guidance 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.
Prevention
Fungi are everywhere, including the skin, and they can be present months before they find opportunities to strike and before signs of infection appear. Using proper hygiene and regular inspection of the feet and toes will help to decrease chances of the problem occurring or help you to identify it early to allow for early treatment from your podiatric physician. Follow these simple guidelines to prevent fungal toenail infections:
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Clean, dry feet resist disease; washing feet daily with soap and water, remembering to dry thoroughly, is the best way to prevent an infection.
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Wear shower shoes when possible, in public areas.
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Change shoes, socks, or hosiery daily.
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Clip toenails straight across so that the nail does not extend beyond the tip of the toe.
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Use a quality foot powder such as talcum, not cornstarch, in conjunction with shoes that fit well and are made of materials that breathe.
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Avoid wearing excessively tight hosiery, which promotes moisture around the foot. Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks, especially for those with more active life styles.
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Always use preventive measures when applying nail polishes.
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Disinfect home pedicure tools and don't apply polish to nails suspected of infection or on toenails where the toe is red, discolored, or swollen.
A Word About Artificial Nails and Nail Polish
Moisture that collects 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 nail polish impedes that evaporation, and the water trapped below can become stagnant and unhealthy, an ideal environment for fungi and similar organisms to grow.
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