Fungal nail infection (onychomycosis)

Fungal nail infection (onychomycosis) is the infection of one or more nails due to the presence of particular fungi. The infection usually causes a small white, yellow-brown or green spot to appear on a particular area of the nail, but if left untreated, it tends to spread to affect a larger portion of the nail. The affected nail will become thicker and may crumble or fall off, causing pain and discomfort. At this point, the fungus may also spread to affect other nails.

Description

Toenails are more frequently affected by fungi than fingernails because socks and shoes provide the warm, moist environment that fungi need to grow and spread. In addition, it is easier for fungus to take root in nails that are already damaged and, compared to the fingernails, the toenails are much more susceptible to damage from sport, external trauma or from wearing tight shoes.

Causes

Fungal nail infections are generally caused by several fungi, including candida albicans, trichophyton and epidermophyton. Molds and yeasts (such as aspergillus) can also cause or enhance damage. A major risk factor for catching a fungal nail infection is walking barefoot in communal hot and humid environments, such as gym locker rooms and swimming pools.

Symptoms

Symptoms of a fungal nail infection include:

• increased brittleness and friability of the affected nail
• deformation of the nail
• dull lamina with different colors on the inside
• an inflammation of the tissues near the nail

Infected nails may also lift and detach from the nail bed (onycholysis), cause pain or emit bad odor.

Diagnosis

In order for a fungal nail infection to be correctly diagnosed, a dermatologist will need to see the affected nail(s). Usually, a nail fragment will be taken and analyzed under a microscope where the typical elements of fungi will be seen (hyphae and spores).

Treatment

Depending on the severity of the infection, there are several options available to treat fungal nail infections: Antifungal ointments can be applied to the affected area, and may also be used in conjunction with oral therapy; 2S Cream with colloidal sulfur and salicylic acid can be applied. For moderate or superficial infections, antifungal nail polishes can be applied to the infected nail.
An emerging, yet innovative treatment is photodynamic therapy, where the nail is treated with acid before an intense light irradiates it, thus eliminating the infection. To ensure antifungal products penetrate the nail, file the nail every fifteen days.

Prevention

To prevent the development of nail fungus and reduce the risk of recurrent infections, practice good hand and foot hygiene:

• keep the feet as dry and clean as possible and avoid very hot, humid places, especially if they are frequented by several people
• keep nails short, dry and clean
• wear socks that allow feet to breathe and change them often, especially if feet tend to sweat excessively: alternate closed shoes with open shoes whenever possible
• wear rubber gloves to protect hands from overexposure to water
• to reduce the risk of germs spreading, do not cut the skin around the nails
• do not walk barefoot in locker rooms and showers in gyms and swimming pools
• when you go to the pool, remember to wear flip-flops
• do not hide fungal nail infections under a coat of nail polish, as this will trap moisture and worsen the infection
• wash your hands thoroughly after touching an infected nail