Nail fungus

Nail infection or Onychomycosis is the infection of nail by microscopic fungus.  It is the most common disease affecting nails and make up to 50% of all nail abnormalities. Both fingernails and toenails are susceptible to infection. Nail fungus usually appears as discoloration or thickening of the nail with crumbling edges. The condition is more common in toenails. 

Risk factors

Factors that can increase the risk of developing nail fungus includes:

  • Old age – Due to reduced blood flow and years of exposure to fungi.
  • Heavy sweating
  •  History of athlete’s foot(fungal infection)
  • Walking barefoot in damp public areas, such as swimming pools, gyms and shower rooms
  • Minor skin or nail injury or psoriasis(skin disease)
  • Diabetes or blood circulation issues 
  • Weak immune system

Symptoms

You may have a nail fungus if one or more of your nails are:

  • Thickened
  • Whitish to yellow-brown discoloration
  • Brittle and crumbly/ragged
  • Distorted in shape
  • Dark in color caused by debris under the nail
  • Foul smelling

Diagnosis

The physician will examine your nails and may take nail clippings or scrape debris from under the nails to send the sample to a lab to identify the type of fungus causing the infection.

Microorganisms such as yeast and bacteria can also infect the nails. Knowing the cause of infection helps in determining the best course of treatment.

Other conditions like psoriasis can mimic a fungal infection of the nail. 

Treatment

Fungal nail infections can be difficult to treat. Treatment depends on the severity of your condition and the type of fungus causing it. It can take months for any results and reinfections are common.

Your physician may prescribe antifungal drugs which are to be taken orally or apply to the nail. In some situations both oral oral and topical antifungal medicines are advised.

Oral antifungal drugs. These are often the first choice drugs because they clear the infection more quickly than topical (applied on skin surface) drugs. It is typically advised for six to 12 weeks but results won’t be visible until the nail grows back completely. It may take four months or longer to completely eliminate the infection. These medications are not recommended for people with liver disease or congestive heart failure or those taking certain medications.

In few cases medicated nail paints and creams are advised to apply over the nail.

Prevention

The following habits can help prevent nail fungus or reinfection:

  • Wash your hands and feet regularly. Wash your hands after touching an infected nail. 
  • Trim nails regularly by smoothening the edges with a file and file down thickened areas. Disinfect nail clippers after each use.
  • Wear sweat-absorbing socks or change your socks everyday.
  • Choose shoes made of materials that allow air circulation
  • Discard old shoes or treat them with disinfectants or antifungal powders.
  • Avoid walking barefoot in public areas like near pool areas or locker rooms.
  • Avoid applying nail polish and artificial nails.

Consult your dermatologist if you have any of the symptoms as above as nail fungal infection may take a few months of treatment to resolve.

-Dr Prerna Gaur

Acknowledgement

https://www.nhs.uk/conditions/fungal-nail-infection/

https://www.cdc.gov/fungal/nail-infections.html

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