Fungal nail infections (onychomycosis) are common conditions that may affect up to 50% of the population and are more likely to occur in the shoe wearing population. Although general harmless, they can produce an unsightly nail and if left untreated may affect the nail health and structure long term.
Fungal nail infections are most commonly caused by dermatophytes and non dermatophyte (moulds and yeasts) organisms. Dermatophyte infections are fungal infections that require the protein Keratin which is part of the structure of your nail for growth.
With athletes foot infection (tinea pedis), the fungal infection in the skin can eventually spread into the nail. In most cases trauma to the nail may increase the chances of a nail infection. Fungal nail infections and athlete’s foot occur more frequently in persons who wear enclosed footwear and in hot or sweaty conditions. In particular if you wear shoes made of artificial fabrics/materials such as running trainers may increase your risk of developing fungal nail and/or athletes foot conditions.
Other risk factors contributing toward the development of fungal nail infections include, diabetes, peripheral vascular disease (reduced circulation to the extremities of the body), old age, smoking, trauma to the nail, psoriasis, compromised immune system and in some cases it may just occur as there is increased familial risk of developing the condition.
It may cause yellowish, brittle, discoloured nails that could be prone to thickening. Sometimes parts of the infected nail may break off. They tend not to have an odour unless you grind the nail down.
Fungal nail infections are determined generally upon appearance first. They usually present in the classic manner of a degrading discoloured and brittle nail however, lab tests in the form of taking a clipping sample and sending it to pathology for tests may conclude the presence of fungal infection. It is not always easy to grow a fungal organism under laboratory conditions so appearance, signs and symptoms are usually the first call in diagnosis of fungal nails.
Have your Podiatrist or Chiropodist pair down the nail with a professional nail drill and to smooth the local skin if required. Regular treatment of the skin all over the foot with anti-fungal creams available from your Podiatrist/Chiropodist, pharmacist or GP. Treatment of the nail with a medicated nail lacquer such as Amorolfine/Terbinafine. In some cases your GP may prescribe oral anti fungal medication in tablet form where you take them on average for three to six months.
Other treatment methods such as laser are showing some positive evidence for assisting in resolving fungal nails. On occasions there is option for the nail to be removed under local anaesthesia and to be allowed to attempt nail re growth without phenolisation (destruction of the nail matrix). If this removal is to occur it is still recommended the person have topical or sometimes oral anti fungal treatment to assist in the best outcome to clear the overall. In such circumstances your medical practitioner or GP should always be consulted. Your GP is likely to request blood tests before starting a course of any oral anti fungal tablets along with regular tests around every three months until the infection appears cleared.
It is important to keep a good foot hygiene regime. Remember to dry your feet after swimming/bathing. Do not share other people’s shoes or towels. If you are going to wear shoes, then select those of natural materials that are breathable. Spending time out of footwear should your health and lifestyle allow may also have benefits in prevention or helping to resolve the condition coupled with treatments, best hygiene practices and or medications.
For further advice on all things fungal nail contact your Podiatrist / Chiropodist or Medical Practitioner.