Fungal Nail Infection / Onychomycosis
Fungal nail infection, medically known as onychomycosis, is a common condition that affects the toenails and, less frequently, the fingernails. It is caused by various types of fungi, primarily dermatophytes, which thrive in warm, moist environments. In Australia’s warm and usually humid climate, fungal infections can be persistent and difficult to treat without professional care.
What is Onychomycosis?
Onychomycosis is a fungal infection that occurs when fungi, including dermatophytes, yeasts, or moulds, penetrate/invade the nail bed or nail plate through small cuts or separations between the nail and the nail bed. It often begins as a white or yellow spot under the tip of the toenail and can gradually cause the nail to discolour, thicken, or crumble. The infection can affect one or multiple nails and may spread if left untreated.
Causes of Fungal Nails
Fungal nail infections can develop from various sources, including:
Underlying fungal infections of the skin including athletes foot or tinea pedis
Walking barefoot in communal areas like gyms, locker rooms, swimming pools, or public showers
Cross-contamination with items that have been in contact with other fungal nails including nail polish
Wearing tight-fitting, enclosed shoes or socks that restrict ventilation and creates a warm, moist environment
Nail trauma, injury or damage, which can damage the nail and provide an entry point for fungi
Having athlete’s foot (tinea pedis)
Having a weakened immune system or chronic health conditions such as diabetes, HIV/AIDS, or autoimmune disorders
Aging, as nails tend to become thicker and more brittle with age, making them more susceptible to fungal infections
Symptoms of Fungal Nail Infection:
The symptoms of fungal nail infection can vary depending on the severity of the infection and the type of fungus involved. Common signs may include:
Thickened, discolored, or brittle nails
Yellow, white, or brown discoloration of the nails
Crumbly or ragged nail texture
Distorted nail shape or lifting of the nail from the nail bed
Foul odor emanating from the affected nails
Itching, irritation, pain or discomfort in the affected nails or surrounding skin
Diagnosis of Fungal Nails:
Diagnosing fungal nail infection typically involves a physical examination and laboratory testing. A healthcare professional may examine the affected nails and take a nail clipping or scraping to be analyzed under a microscope or sent to a laboratory for fungal culture. This helps confirm the presence of fungi and identify the specific type of fungus causing the infection.
Podiatry Treatment Options for Fungal Nails:
Treatment for onychomycosis can be challenging, as the infection resides deep within the nail. The treatment approach for fungal nail infection may vary depending on the severity of the infection and the patient's overall health. However, podiatrists offer a range of effective options which may include:
Topical Antifungal Medications: Over-the-counter or prescription-strength topical medications, often in the form of antifungal nail lacquers, creams, or ointments may be applied directly to the affected nails to kill the fungus. These are most effective in mild to moderate cases and require consistent daily use for several months.
Oral Antifungal Medications: For more severe or stubborn infections, your podiatrist or GP may recommend a course of prescription oral antifungal medication. These drugs work systemically to target and eradicate the fungus from within, but they may require blood tests to monitor liver function during treatment.
Nail Debridement and Laser Therapy: Podiatrists may also use debridement (thinning and cleaning of the nail) to improve the effectiveness of topical treatments. Laser treatment involves using focused laser energy to target and destroy fungal cells with light energy in the affected nails without harming the surrounding tissue, offering a non-invasive and pain-free option.
Surgical intervention: In some cases, surgical removal of the affected nail (partial or complete) may be necessary, particularly if the infection is severe or causing significant pain or discomfort.
Prevention of Fungal Nails:
Preventing fungal nail infections involves practicing good foot hygiene and taking steps to reduce the risk of fungal exposure. Tips for preventing fungal nails include:
Keeping the feet clean, dry, and well-ventilated
Avoiding walking barefoot in public areas
Wearing clean socks and shoes that allow for adequate ventilation
Trimming the nails straight across and keeping them at a moderate length
Avoiding sharing personal items such as towels, nail clippers, or shoes with others
Treating fungal infections of the skin
Conclusion:
Fungal nail infection is a common condition that can affect individuals of all ages, but it is particularly prevalent among older adults and individuals with certain medical conditions. By understanding the causes, symptoms, and treatment options for fungal nails, individuals can take proactive steps to prevent infection, seek timely treatment, and effectively manage the condition. If you suspect you have a fungal nail infection, it's important to consult with a healthcare professional for accurate diagnosis and personalized treatment recommendations. Early diagnosis, intervention and treatment are key to managing fungal nail infections effectively, preventing the spread of infection and promote healthy nail growth. If you suspect you have onychomycosis, book an appointment with our podiatrists to explore the best treatment options and prevent the infection from spreading.
