Have you ever noticed that one of your fingernails or toenails suddenly turns yellow, becomes thicker than before, and breaks easily? Or does it look like the nail is separating from the skin underneath? Many people think that this is normal, perhaps something that happens as you get older. But in reality, it is very likely that this is a fungal nail infection (Mycotic Nail) . Let's talk about this in detail, simply.
What is this nail fungus infection?
Simply put, this is an infection that occurs when a fungus invades your fingernails or toenails. Medically, we also call it Onychomycosis . When this infection occurs, the fungus begins to eat away at the nail. This causes the nail to separate from the nail bed. Over time, the nail thickens, changes color (may be yellow, brown, or white), and becomes brittle and easily broken.
Wait a minute, what are our nails made of?
It's good to know this too. Our nails are made of a strong protein called keratin . This is the same protein that is found in our hair and the top layer of our skin. When new cells are first formed in the nail, the old cells are pushed forward. As they are pushed forward, they thicken, and the nail we see is formed. Nails give strength to our fingertips, protect them from infections, and help with delicate tasks like picking up small objects.
Are there types of these infections?
Yes, these fungal infections can be divided into several main types based on how they occur. You don't need to know all of these types, but it's good to have a little idea of them when you talk to your doctor.
- Tip-starting type: This is the most common type. The fungus enters the tip or side of the nail and spreads throughout the nail. The nail may turn yellow, brown, or white.
- The type that starts at the base of the nail: This is a little less common. The infection starts at the base of the nail, that is, the part of the nail that is connected to the skin.
- The type that starts on the surface of the nail: Here, the fungus affects only the top layers of the nail and then spreads downwards. In this case, the nail often turns white.
- Yeast infections: Sometimes these infections can be caused by yeasts like Candida . These are more common on fingernails than toenails. Sometimes this can be a sign of a weak immune system in your body.
In the final stages of all of these types, the nail can become completely thickened, deformed, and unsightly.
Who is most likely to develop this condition? (Risk factors)
Anyone can get this fungal infection. However, some people are more likely to develop it, meaning they are at higher risk. If you have one or more of the conditions below, you should be a little more careful.
| Risk factor | Simple explanation |
|---|---|
| Diabetes | People with diabetes are more susceptible to infections because their blood circulation and immune system are weak. |
| A weak immune system | Fungal infections are easily spread to people with weakened immune systems. |
| Athlete's foot | This is also a fungal infection. Fungus on the skin can also spread to the nails. |
| Poor blood circulation | People with poor blood circulation to their hands, and especially their legs, are more likely to develop infections and heal less quickly. |
| Injuries to a nail | Even a small crack in a nail can allow fungus to enter. |
| Skin diseases (e.g. Psoriasis) | Skin diseases change the nature of the nails, making it easier for fungi to enter. |
In addition, some of your habits may also increase this risk:
- Smoking.
- Using public places like bathrooms and swimming pools.
- Constantly wearing poorly ventilated, sweaty shoes.
Sometimes it can be hereditary, meaning if someone in your family has the condition, you have a small chance of developing it too.
What are the symptoms of this?
Check to see if your nails have one or more of these changes. These are the main symptoms:
- Color change: The nail turns white, yellow, or brown.
- Thickening: The nail becomes thicker and taller than normal.
- Shape change: Distortion of the shape of the nail.
- Brittleness: The nail breaks or crumbles easily.
- Cracking: The surface of the nail takes on a striated appearance.
- Nail bed detachment: The nail separating from the skin underneath.
- Pain: Sometimes there is pain, especially when shoes are tight.
- A bad odor: When the infection is severe, the nail may emit a bad odor.
Is this contagious? Can complications occur?
Yes, fungal infections are contagious. They can be spread from one person to another. They can also spread from one nail to another on your own body. Therefore, avoid walking barefoot in public bathrooms, swimming pools, and gym locker rooms. Do not use other people's towels, socks, or shoes.
In terms of complications, it is usually not a big problem for a healthy person. However, it can be dangerous for the elderly and especially for those with diabetes . If left untreated, the infection can spread to the skin and cause serious skin infections like cellulitis and foot ulcers. So don't take it lightly.
How does the doctor diagnose and treat this?
If you have these symptoms, the best thing to do is see a doctor.
Diagnosis
Most of the time, your doctor will examine your nail and tell you if it's a fungal infection. But to be sure, or to find out exactly what type of fungus is causing the infection, he or she may do the following:
- Nail scraping: A very small piece of your nail is scraped off and examined under a microscope.
- Fungal Culture: A piece of the nail is sent to a lab to see if the fungus grows on it. This can take a few days or a few weeks.
Treatment
A mistake many people make is cutting off the infected part of the nail and thinking that it's the only way to get rid of the fungus. But that doesn't get rid of the fungus. This requires proper treatment.
The most important thing is that this takes some time to treat. You need to be patient.
There are several treatment methods:
- Oral Antifungal Medications: This is the most effective and commonly used method. Your doctor will prescribe a medication such as Terbinafine or Itraconazole . You will need to take this medication for about 6 weeks for a fingernail and 12 weeks (3 months) for a toenail.
- Topical Medications: These come in the form of creams, lotions, or nail polish. However, using these alone is often difficult to completely cure the infection. Because the medication needs to penetrate the nail and reach the fungus, you may be told to use these along with oral medications.
- Debridement: If the infection is severe and doesn't respond to medication, your doctor may need to surgically remove the nail. It can then take up to a year for a new nail to grow back.
How can I prevent it from recurring?
After treatment and recovery, there is a 10% - 50% chance of it recurring. Therefore, it is very important to do these things to prevent it from recurring.
- Keep your feet clean and dry: Wash your feet with soap every day, especially between the toes, and dry them thoroughly.
- Trim your nails: Cut your nails straight across and make the corners soft.
- Wear the right shoes: Wear shoes with well-ventilated, sweat-wicking socks. Wear sandals when possible.
- Be careful in public places: Do not walk barefoot in places like public bathrooms and swimming pools.
- Don't share nail clippers with others: keep your own personal nail clipper kit.
- Be careful about nail salons: If you go to a nail salon, make sure they sterilize the equipment after each customer.
Take-Home Message
- If your nail changes color, thickness, or shape, don't assume it's normal. It could be a fungal infection.
- These infections do not heal on their own. If left untreated, the condition will worsen.
- For proper diagnosis and treatment, definitely see a doctor. Do not try to treat yourself by buying medicine from the pharmacy.
- Oral medication is usually the most effective treatment. It can take several months, so be patient and complete the treatment.
- Since this is a contagious disease, take care of cleanliness to prevent spreading it to your family and others.
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