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Walk On Podiatry

Fungal Nails or Toe Nail FungusFungal nail infections are the most common disease that effect toenails and is the main cause of about half of all nail abnormalities. Onychomycosis is the medical term used to describe this nail appearance. 

A fungal nail infection can effect either toe nails or finger nails, but is most common in toe nails and is prevalent in approximately 6-8% of adults. The appearance of this infection differs depending on the type of fungal nail infection present.

There are 3 different types of onychomycoses that affects the nails of the feet:

  • Distal subungal onychomycosis – this is the most common form of fungal nail infection which invades the nail bed and the underside of the nail plate. 
  • Superficial white onychomycosis – this is caused by a fungal invasion of the superficial or top layers of the nail and forms islands with a white chalky appearance.
  • Proximal subungal onychomycosis – this occurs at the newly formed nail plate at the cuticle of the nail through the skin fold. It is the least common in healthy individuals and is more commonly found in patients that have a compromised immune system.

What causes it? 

Fungal nail infections are caused by pathogens including dermatophytes, Candida and also nodermatphytic moulds. The most common dermatopyte to cause fungal nail infections is Trichophyton rubrum. 

What does it feel like?  

The most common sign of fungal nail infections is thickening and discolouration of the nail plate. The nail will often appear yellow, black/brown, white or green. As this infections progresses the nail may become brittle allowing pieces to come away or break off. If left untreated the skin surrounding the nail can become inflamed and painful. The thickened nail can place a high amount pressure on the surrounding skin. Aside from appearance there are very little symptoms to fungal nail infections. 

What can you do to manage it? 

Treating fungal nail infections can be difficult and challenging as the infection is within the nail and is difficult to reach. Toe nails naturally grow slower than finger nails so full removal of the infection is also slow and may take up to and over a year. Most treatments readily available are over the counter at pharmacies and chemists. These nail lacquer treatments vary in price and also effectiveness. Currently one of the better products is Loceryl. This is the only treatment that is fungal-cidal which kills the fungus, many of the others are fungal-static, which halts it from advancing but the fungus remains alive.

Oral medication is also available to treat fungal infections, to acquire this medication you must have a positive nail sample tested by pathology. It is best to talk to your doctor on whether or not this medication is suitable for you. Evidence suggests that a combination of both topical and systemic, oral, treatment in most beneficial. 

What should you avoid doing? 

One of the important things to avoid doing is wearing nail polish. Nails are natural porous, this means that air and water can pass through them. Once you have applied the polish it stops this and creates a warm humid environment and this is the perfect environment to allow the fungus to flourish. 

Management: 

Your podiatrist will help to manage your fungal nail infection by helping to reduce the thickness of your nails if needed. They can advise you on the best treatment option whether topical lacquers or oral medication. Nail samples can be collected to be supplied to your local GP. If you think you may have a fungal nail, contact Walk On Podiatry for more information on management.