Onychomycosis or “Fungal Nail” 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. Fungi are simple parasitic plant organisms, such as molds and mildew, that lack chlorophyll, and therefore, do not require sunlight for growth. A group of fungi called dermatophytes easily attack the nail, thriving off keratin, the nail’s protein substance.
An Under-reported Health Problem
Fungal infection of toenails is a common foot health problem. A majority of victims don’t seek treatment, and often don’t even recognize the existence of a problem. Studies estimate that it affects 3% to 13% of the population. However, because so many cases go unreported, the incidence is much higher than that.
One reason so many people ignore the infection is that it can be present for years without ever causing pain. Its prevalence rises sharply among older adults. Because older adults may be experiencing much more serious medical problems, it is understandable that fungal nails can be passed over as a minor problem.
Whatever the case, the disease, characterized by a change in a toenail’s colour, is often ugly and embarrassing. Nail polish is an easy solution for many women, rendering the problem “out of sight, out of mind”.
In many cases, however, the change in colour is the start of an aggravating disease that ultimately could take months to control. Fungal nail infections are known to Chiropodists/ Podiatrists as Oynchomycosis. This infection then leads to 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 around the nail plate.
What Is Fungal Nail?
When the tiny organisms take hold, the nail may become thicker, yellowish brown 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.
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 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 infections. 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 and Treatment
Because fungi are everywhere, including the skin, they can be present months before they find opportunities to strike, and appear. By following precautions, chances of the problem occurring can be reduced, or even avoided.
- Clean, dry feet resist disease. Wash your feet with soap and water, remembering to dry thoroughly.
- Shower shoes should be worn in public areas when possible.
- Shoes, socks, or hosiery should be changed daily.
- Use a quality foot powder with talcum (not cornstarch) or use an anti-fungal agent.
- Wear shoes that fit well and are made of materials that breathe.
- Throw away old shoes.
- Alternate by wearing different pairs of shoes.
- Nail Polish – moisture collecting underneath the surface of the toenail would ordinarily evaporate, passing through the porous structure of the nail. The presence of 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.
A Chiropodist/ Podiatrist 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 the preferred procedure.
Newer oral antifungals approved by Health Canada may be an effective treatment. They offer a shorter treatment time (3 to 4 months) however current studies show there are many unwanted side effects with any oral antifungal.
In some cases, surgical treatment may be required. Temporary removal of the infected nail can be preformed 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 Chiropodist/ Podiatrist can lead to more problems. With new technological advances in combination with simple preventive measures, the treatment of this health problem can often be successful.