Have you ever noticed that your toenail, or that of someone you know, has become discolored, thickened, and perhaps even broken? Most often, this is due to a fungal infection of the toenail. We call this ``Toenail Fungus``. It is quite common, but if we are properly informed, it is easier for us to be careful of it and to get treatment if it occurs. So, shall we talk about this in more detail today?
What is Toenail Fungus?
Simply put, `(Toenail Fungus)` is a fungal infection that develops on your toenails. Sometimes, rarely, this fungal infection can also develop on your fingernails. Do you know how this happens? This condition occurs when microorganisms called fungi get between your nail and the skin underneath the nail (also called the nail bed). Most of the time, this happens through a small crack or cut on a toe.
Is this the same as `(Tinea Unguium)`?
Yes, you must have heard the word `(Tinea Unguium)`. That is what this nail fungus infection is all about. Especially when this infection is caused by a type of fungus called `(Dermatophyte)`, we call it `(Tinea Unguium)`. `(Dermatophyte)` is a type of mold. A protein called `(Keratin)` is essential for this type of mold to grow. `(Keratin)` is the main substance that helps our nails stay strong. 90% of toenail fungus infections are caused by this `(Dermatophyte)` fungus. `(Tinea Unguium)` is also called `(Onychomycosis)`. Although there are many names, the condition is the same.
Who is most likely to get this nail fungus infection?
Actually, anyone can develop this condition, but it is more common in older people, especially those over 60 .
If you have the following conditions, you are at slightly higher risk of developing a nail fungus infection:
- Athlete's foot (also known as Tinea Pedis).
- `(Diabetes)` (Diabetes).
- Hyperhidrosis (excessive sweating).
- A nail injury.
- Reduced blood circulation due to a disease such as `(Peripheral Vascular Disease)`.
- Psoriasis (a skin disease like scabies).
- Weakened immune system (for example, due to an autoimmune disorder or HIV infection).
How common is this condition?
Toenail fungus is very common , especially as we age. According to medical experts, on average, one in 10 people have ``Onychomycosis''. However, among people over the age of 70, this number increases to one in two (that's 50%). So, if you have it, know that you are not alone.
What does the nail look like when it has Tinea Unguium?
When you have Tinea Unguium, the appearance of your toenails can change in more than one way. Your nail:
- The color can vary. It can be white, yellow, or brown.
- In some places, it may look like chalk powder or clouds .
- It may appear thickened and perhaps have changed shape .
- The nail may separate from the nail bed (meaning there may be a gap between the nail and the skin underneath).
- It can be scratched or broken in one or more places.
Is this painful?
Usually not. Although toenail fungus is unsightly, it is usually not painful. However, if the nail becomes very thick or changes shape, it can cause discomfort and a feeling of pressure when wearing shoes.
What causes Tinea Unguium?
As we have already discussed, the main cause of Tinea Unguium is a type of fungus called `(Dermatophyte)`. `(Dermatophyte)` is a microscopic fungal organism (too small to be seen by our eyes). These live on a protein called `(Keratin)` found in our fingernails and toenails. `(Keratin)` is what keeps our nails strong.
Although 90% of toenail fungal infections are caused by dermatophytes, other types of fungi can also infect your nails.
Is Tinea Unguium contagious?
Yes, many types of nail fungus, including Tinea Unguium, are highly contagious. You can catch the fungus from someone else by touching them directly. Or, you can get it from touching a surface that has the fungus, such as a floor or towel.
How is nail fungus usually transmitted?
Nail fungus likes warm, moist, dark places. You can get nail fungus from things like:
- Walking around swimming pools barefoot.
- Using public locker rooms or bathrooms.
- Walking barefoot in public places.
Imagine, after a workout at the gym, you come home with your shoes still wet. Those are the times when fungi thrive.
Can nail fungus spread to other parts of the body?
Yes, it can. But most of the time, toenail fungus doesn't spread beyond the toe.
Some types of `(Dermatophyte)` fungi can easily spread to your skin. (Because your skin and scalp also contain `(Keratin)`. When `(Dermatophyte)` fungi affect the skin, we call the condition `(Ringworm)`.
Toenail fungus can spread to these areas:
- To the nails of the other legs.
- The skin between the toes (this is called `(Athlete's foot)`).
- To the groin area (this is called `(Jock itch)`).
- To the skull (the skin on top of the head).
So, when you put on socks, you should put them on first and then put on other clothes. That way, you can reduce the chance of the fungus spreading to other places on your clothes.
How do you know for sure if you have nail fungus? (Diagnosis)
Your doctor will first assess your symptoms and carefully examine the affected nail. He or she may be able to tell if you have nail fungus just by looking at your finger. However, they may also do some tests to confirm that you have a fungal infection.
What tests are being done for this?
Most likely, your doctor will take a small sample from under your nail and analyze it further. The cells can be examined under a microscope to confirm whether you have nail fungus. If the initial test is not clear, a small scraping of the nail can be sent to a laboratory to see if the fungus grows (culture). This will help the doctor determine exactly what type of fungus it is.
How do you treat nail fungus?
To be honest, toenail fungus is a bit difficult to treat, and it takes time. You may need to take treatment for several months (or even longer) to get rid of the fungus. Even then, the nail fungus is more likely to come back.
A dermatologist or podiatrist can explain your treatment options to you. If you have a minor infection and it's not causing you any major problems, your doctor may recommend no treatment at all.
Here are the treatment options for `(Tinea Unguium)`:
Oral Antifungal Medication
To treat the fungus, you can use oral antifungal medications prescribed by a doctor. For example, there are medications such as `(Terbinafine / Lamisil®)`, `(Itraconazole / Sporanox®)` or `(Fluconazole / Diflucan®)`. You will need to take these medications every day for several months (or longer). Your doctor may also do blood tests to check for possible side effects of these medications. These medications can affect your liver, and they can interact with other medications you are taking. Therefore, oral antifungal medications are not suitable for everyone.
Topical Medication
You can apply a topical medication directly to the nail every day. This medication will treat the fungus over time. However, these topical medications are most effective when used in conjunction with oral medications.
Laser Treatments
Your doctor can treat the fungus by directing high-tech `(Laser)` rays and special light beams at the nail. `(Laser)` treatments are approved by the `(FDA - US Food and Drug Administration)` in the United States to "temporarily clear up" nail fungus . However, it is not a cure. `(Laser)` treatments have a low cure rate compared to oral medications and topical medications. Therefore, doctors do not usually use `(Laser)` as a first-line treatment for nail fungus.
What is the most effective treatment for nail fungus?
The most effective nail fungus treatment for you will depend largely on your symptoms and condition. Your doctor will consider several factors before recommending a treatment plan. He or she will tailor a treatment plan that is right for you.
Generally speaking, oral antifungal medications are the most effective. Treatment can be even more successful when combined with topical antifungal medications.
How can you prevent nail fungus?
There's no way to be 100% sure that you won't get nail fungus. However, there are a few steps you can take to help prevent it:
- Avoid walking barefoot in public places like public bathrooms, locker rooms, and swimming pools. This is where many people get fungal infections. Wearing a pair of slippers in public places like these can be very helpful.
- If someone in your family has athlete's foot or nail fungus, try using a separate bathroom or wearing slippers in the bathroom. This can help prevent you from spreading it to yourself.
- Cuts made by mistake or by cutting too quickly while trimming your nails can become entry points for fungi. Therefore, clean your nail clippers thoroughly before using them.
- Don't tear or break your nails at will.
- If you have diabetes, follow all foot care recommendations given by your doctor.
- Keep your feet dry. After bathing, pat your feet dry.
- Soak your nails in warm water for a while before cutting them. Or, cut your nails after you've finished bathing.
- Cut your nails straight across (do not round the corners).
- Wear shoes that fit properly. They should neither be tight around your toes nor too loose.
What to expect if you have nail fungus?
Although toenail fungus is common, it is usually harmless. The symptoms mostly affect the appearance of your nails.
Nail fungus can spread to the skin between your toes or to other parts of your body. When getting dressed, put on socks first to reduce the chance of spreading the infection.
Treating nail fungus takes time and is not always successful. Even if it is successful, the nail fungus can come back. So, talk to your doctor about the pros and cons of treating nail fungus and decide what is best for you.
Practicing good hygiene and foot care can help reduce the chance of nail fungus coming back. If you have diabetes, checking your feet regularly can help you catch foot problems before they become serious.
Is it okay to apply nail polish when you have nail fungus?
You may be tempted to cover up a discolored nail with nail polish. However, if you are using an antifungal medication, you should not apply nail polish. Your doctor may tell you not to apply nail polish at all.
Nail polish traps moisture from your nail bed (the skin under your nail). Fungus thrives in moist environments, so applying nail polish can make a fungal infection worse. However, your nail will continue to grow whether you apply nail polish or not.
When should I see a doctor?
Rarely, nail fungus can cause a skin infection called ``Cellulitis.`` If not treated promptly, ``Cellulitis`` can be a serious threat to your health.
If you have any of these conditions, you should seek treatment advice from a trusted doctor:
- Blood circulation problems.
- `(Diabetes)` (Diabetes).
- Redness, pain, or pus near the nail.
- A weakened immune system.
What questions should I ask my doctor?
If you have nail fungus, it may be helpful to ask your doctor these questions:
- What kind of infection do I have?
- Would you recommend that I get this treated? Why/why not?
- How long will I have to receive treatment?
- What can I do to stop this from happening again?
- Are there any serious complications or side effects of the treatment that I should be aware of?
Finally, things to remember (Take-Home Message)
So, in conclusion, a fungal infection of the toenails (Tinea Unguium) is something that many people get, but it is usually not very harmful. However, it can be unsightly and can be a source of anxiety. If you have any questions about this, don't hesitate to talk to a doctor. Especially if you see a dermatologist or a podiatrist, they will help you choose the right treatment for you. Remember, the sooner you start treatment, the better the results. Also, keeping your feet clean and dry is the best way to protect yourself from this.
` Nail fungus, foot fungus, tinea anguimus, onychomycosis, fungal infections, nail health, foot care
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