About fungal toenails (Onychomycosis)
Toenail fungus is a condition that disfigures and sometimes destroys the nail. It is also called onychomycosis. Toenail fungus can be caused by several different types of fungi. Fungi are microscopic organisms related to mold and mildew. These fungi thrive in the dark, moist and stuffy environment inside shoes. As they grow, fungi feed on keratin. Keratin is the protein that makes up the hard surface of the toenails.
- Factors that increase the risk of developing toenail fungus include:
- Wearing tight-fitting shoes or tight hosiery
- Practicing poor foot hygiene
- Wearing layers of toenail polish, which doesn’t allow the nail to breathe
- Being a military personnel, athlete or miner.
- Having a chronic illnesses, such as diabetes or HIV Having a circulatory problem that decreases blood flow to the toes
- Being infected through direct contact such as pedicure salons that may not sterilize contaminated instruments between clients.
However, many people with toenail fungus have no clear risk factors. Toenails on the big toe and little toe are the most likely to develop a toenail fungus. This may be partly because the big toe and little toe are constantly exposed to friction from the sides of shoes.
When a toenail develops a fungal infection, it typically turns yellow or brown. It becomes thick and overgrown. Foul-smelling debris also may accumulate under the nail. As the infection continues, the nail may crumble gradually and fall off. Or, it may become so thick that the affected toe feels uncomfortable or painful inside shoes. A less common variety of toenail fungus is called white superficial onychomycosis. The nail turns white rather than yellow or brown. The surface becomes soft, dry and powdery.
You will describe your foot symptoms to the podiatrist. He or she will ask about any factors that may increase your risk of toenail fungus. These include: A high-risk occupation; Sports participation; Tight-fitting shoes or hosiery; Poor foot hygiene; Use of heavy toenail polish; A history of illness that may decrease your resistance to infection or interfere with blood flow to your toes. These include: Poor circulation; Diabetes HIV; A skin disease called psoriasis sometimes can cause nail problems that look similar to a fungal infection. As a result, the podiatrist may ask whether you or a family member has psoriasis. It is possible for psoriasis and a fungal infection to affect the same toenail. The podiatrist will examine your affected toenail or toenails. Often the diagnosis can be made based on the appearance of toenails. The podiatrist may take small samples of the affected nails. These samples will be sent to a laboratory where they are tested for fungi and other infectious agents. Expected Duration Toenail fungus rarely heals on its own. It is usually a chronic (long-lasting) condition. It can gradually worsen to involve more and more of the nail. Even if the affected nail comes off, the new nail may be infected with fungus.
To help to prevent toenail fungus:
- Wear comfortable shoes and hosiery that allow your feet some breathing space.
- Wear shoes, sandals or flip-flops in community showers or locker rooms.
- Wash your feet every day.
- Dry them thoroughly, and use a good-quality foot powder.
- Wear clean socks or stockings every day.
- Keep your toenails trimmed.
- Disinfect pedicure tools before you use them
Treatment may begin with the podiatrist removing as much of the infected nail as possible. This is painless and helps to gain better results.
There are many options in treating fungal toenails. Treatment choice depends on the degree of infection, the type of infection, duration, previous treatment outcomes, age, lifestyle and cost. Treatment options are topical medicated products being solutions or lacquers; laser treatment ; oral medication; non-medicated products such tea tree oil. A podiatrist can assess and recommend which treatment is most suitable for you, thus saving you time and money trying to resolve it yourself.
What other conditions can be mistaken for fungal nails?
Here are some other conditions you may have instead of fungal nails:
1. Lines and ridges: These are common and may be considered normal.
2. Aging nails: As you age, the nails become brittle, develop ridges and separation of the nail layers at the end of the nail.
3. Whitish or yellowish nails due to onycholysis. This means separation of the nail from the nail bed.
4. Red or black nails due to a hematoma, or blood under the nail, usually occur from trauma (like whacking yourself on the thumb with a hammer).
5. Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed, thereby producing a green pigment.
6. Pitted nails may be associated with psoriasis or other skin problems that affect the nail matrix, the area under the skin just behind the nail. This is the area from which the nail grows.
7. Swelling and redness of the skin around the nail is called paronychia. This is an infection of the skin at the bottom of the nail (cuticle). If the infection is acute (has a rapid onset), it is usually caused by bacteria.
8. Chronic nail trauma, such as repeatedly starting and stopping, kicking, and other athletic endeavors, can cause damage to the nails that can look a lot like fungal nails. This sort of repetitive trauma can also occur with certain types of employment or wearing tight-fitting shoes.
When to see a podiatrist?
If you suspect a fungal toenail infection, you must see a podiatrist. Often people attempt to treat it on their own with expensive chemist products for months and not see the results. In order to treat nail fungus effectively, the nail requires professional trimming and filing so any topical product used absorbs effectively and gets to the source of the problem.