Fungal nail infection, or onychomycosis, is by far the most common nail disease. Fingernails or toenails may be affected, though toenail fungus is the more common form.
Causes of Fungal Nail Infection
The fungi that cause fungal nail disease are usually the same as those that cause athlete’s foot. These dermatophytes (‘skin plants’) colonize parts of the body that contain the protein keratin – namely, the skin, hair and nails.
Less often, the nails become infected with yeasts, including Candida. Such infections are more common in hot, humid climates. They are also more likely in nails that are already weakened, such as by a previous injury, and in older people, whose nails may be less able to defend against infection.
Risk factors for fingernail disease include prolonged immersion of the hands in water during household tasks or at work. Toenail disease is a risk in people who walk barefoot in public areas, or wear socks made from synthetic materials. Excessive sweating can also increase the risk of nail fungus, and infections are more common in people with diabetes or problems with their circulation.
Symptoms of Fungal Nail Disease
Infected nails become thickened, yellowish in colour and crumbly. The infection usually starts at the tip and progresses downwards until the whole nail is affected. Occasionally, the fungus appears as a white streak. In severe cases, the nail may separate from its bed or fall off altogether.
Anyone who suspects he may have a fungal nail infection should see his doctor. He or she will take a small sample of nail for testing to confirm the diagnosis.
How to Treat Nail Fungus
Once an infection begins, it is unlikely to disappear without treatment. Fungal disease can be slow to cure, however, as the fungus is often embedded deep within the nail. There are two main types of treatment: topical remedies that are applied to the surface of the nail, and medications taken by mouth.
Topical treatments for nail fungus work best in the early stages of a mild infection. A doctor may prescribe ciclopirox, an antifungal nail polish that is painted onto the nails and surrounding skin, or terbinafine antifungal cream. Over-the-counter fungus treatments are also available, though their effectiveness varies.
Oral medications prescribed by the doctor are generally more effective than topical remedies, especially in advanced infections. The antifungal drugs itraconazole and terbinafine are taken as tablets or capsules.
As with many common ailments, home or ‘natural’ remedies for nail fungus are advocated by some, ranging from apple cider vinegar and tea tree oil to Vicks VapoRub and Listerine Mouthwash. However, none of these treatments has been verified scientifically.
Preventing Fungal Nail Infections
People who have had nail fungus in the past are likely to suffer recurrent infections. To help minimize the risk, observe the following simple measures.
- Avoid walking barefoot, especially in public areas such as changing rooms and showers.
- Wear clean socks – preferably cotton – every day.
- Whenever practicable, remove shoes to give the feet a breather.
- Avoid sharing socks or shoes.
- Keep feet clean and dry, taking particular care between the toes.
- People who have had fingernail fungus should wear protective gloves for washing the dishes and other wet household tasks. After use, turn the gloves inside-out to dry.
- Avoid wearing nail polish and artificial nails; these can trap moisture against the nail, creating the ideal conditions for fungi to grow.
- Always ensure that manicure and pedicure tools are clean before use.
Fungal Nail Disease is a Common Problem
Many people with nail fungus are embarrassed by the appearance of their nails and may avoid seeking help as a consequence. The problem is common, however, and will not ‘go away’ by itself. Medications to cure these infections are available, though patience is required as treatment can take some time.
References
British Skin Foundation. Fungal Nail Infections. Accessed 16-07-09
Mayo Clinic. Nail Fungus. Accessed 16-07-09
Disclaimer
The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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