Fungal toenails, a condition also called ‘onychomycosis,’ is a fairly common disease that destroys that affected nail (or at least disfigures it). It can be triggered by numerous types of fungi such as dermatophytes (including trichophyton interdigitale and trichophyton rubrum), yeasts, and molds. These fungi multiply in the moist, dark, and cramped environment in the shoes and eat keratin – which is the protein that makes the hard structure of the nails – as they grow. The big and the little toe are more prone to developing toenail fungi because they are the toe nails most exposed to friction caused by the sides of footwear.
Signs & Symptoms
Yellow toenails and thick toenails that also become overgrown are probably infected by fungi. Some debris with unpleasant smell usually also builds up under the infected nails, particularly at tip and at the sides. Fungal toenails may eventually crumble and sometimes fall off as the infection worsens. Some yellow toenails and thick toenails become very thick, cramping the feet inside the shoes.
In cases of white superficial onychomycosis, the infected toenail instead turns white (not brown or yellow). Its surface softens, dries up and then becomes powdery.
Causes & Risk Factors
Around 2 percent to 18 percent of people in the world (and an estimated 3 to 5 percent of Americans) have fungal toenails or onychomycosis. Children are not very susceptible – in fact, only one out of 200 children and young adults (below 18) are affected. People seem to become more prone as they get older. It is estimated that nearly 50 percent of people undergo the condition at least once before they arrive at age 70.
Fungal toenails or onychomycosis is mostly caused by tight shoes or hosiery that do not breathe. Another cause is toenail polish applied in layers. Toenail fungi can also be contacted on the moist flooring of public locker rooms and showers and locker rooms. People suffering from chronic illnesses like HIV, diabetes, or circulatory problems seem to be more prone.
Tests & Diagnosis
The doctor will likely conduct an interview to determine what might have caused the toenail fungus. Factors such as high-risk jobs, tight-fitting footwear, socks, or stockings, poor hygiene, participation in sports, toenail polish usage, and chronic illnesses should be declared. The doctor will likely inquire of the patient’s family has a history of psoriasis, which may look very akin to fungal infection. Some doctors may take toenail samples for examination.
Treatment Options
Contrary to popular belief, fungal toenails hardly ever heal on their own. If not managed, they can slowly worsen and fungi may spread to other toenails. The infected part of the nail may grow off, but the new growth will likely be affected by fungi, too.
The doctor may take away as much of the fungal toenails as required. It can be trimmed, filed down, or dissolved with bifonazole and urea paste. Medicated polish (usually containing Loceryl or Loprox may be prescribed – the patient may apply it himself, usually two times a week until the fungal toenail is completely cured. This medication only works on milder infections, though. Oral antifungal medication is usually required if the onychomycosis is worse. Sporanox and Lamisil are popular. These medications do have some side effects, though, so be sure to follow the doctor’s prescription and dosage requirements.
Surgical removal is typically only done when the infected toenail already impedes walking and other functional activities.
