Fungal Nail Infection

Have you ever noticed your nails turning yellow, thick, or crumbly? These signs might indicate a fungal nail infection, a common condition affecting millions worldwide. Fungal nail infections can be frustrating and persistent, causing discomfort and embarrassment for those who experience them. Knowing this condition in detail is crucial for effective diagnosis and treatment. This article delves into the world of fungal nail infections, exploring their types, symptoms, and causes. 

What is a Fungal Nail Infection?

Fungal nail infection, or onychomycosis or tinea unguium, occurs when fungi invade the nails. These organisms, normally present in the environment, enter through small nail cracks or cracks in the skin surrounding the nails. The infection affects both fingernails and toenails, but toenails are at higher risk due to the warm, moist environment inside shoes.

Types of Fungal Nail Infection

Fungal nail infections (fingernails or toenails) come in four main types, each with distinct characteristics. 

• Distal subungual infections, the most common type, affect fingernails and toenails. 
• White superficial infections primarily target toenails, causing well-defined white spots that eventually cover the entire nail. 
• Proximal subungual infections can affect both fingernails and toenails and manifest as yellow spots at the nail base, spreading upward.
• Candida infections, caused by yeasts, typically affect fingernails. 

Symptoms of Fungal Nail Infection

Fungal nail infections often start mild and worsen over time. 

• Initially, a white or yellow spot may be seen beneath the nail. 
• The entire nail can turn white, yellow, green, or black as the infection grows. T
• The affected nail may thicken, become difficult to trim, and might curl up or down or loosen from the nail bed. 
• The affected nail can also become brittle and crumble when touched. 
• The nail's shape may change, and an unpleasant odour might develop. 
• While these infections may not cause pain at first, untreated cases can make pressure on the affected area uncomfortable. 
• In severe cases, walking might become challenging. 

Causes of Fungal Nail Infection

Fungal nail infections occur when fungi overgrow in, under, or on the nail. These organisms grow rapidly in warm & moist environments, making toenails more susceptible than fingernails. The fungi responsible for these infections are often the same ones that cause athlete's foot, jock itch, and ringworm.

Several factors contribute to fungal nail infections:

• Fungi present in the environment enter through small cracks in the nail or surrounding skin.
• Touching someone with a fungal infection can spread it.
• Shoes create a warm & moist environment conducive to fungal growth.

Diagnosis of Fungal Nail Infection

Doctors examine nails and collect samples to diagnose fungal nail infections. They take nail clippings or scrape debris from under the nail and send them to a lab for identification. This process helps determine the cause of symptoms, as other conditions like psoriasis can mimic fungal infections. 

Diagnostic tools include potassium hydroxide (KOH) testing, fungal culture, and histopathology of nail clippings.

Newer techniques like dermoscopy, reflectance confocal microscopy, molecular assays, and artificial intelligence are also emerging. 

Treatment for Fungal Nail Infection

Doctors treat fungal nail infections with various methods, depending on the severity and type of infection.

• Oral antifungal drugs are often the first choice. These medications help a new, healthy nail grow, replacing the infected part over 6 to 12 weeks. 
• Medicated nail polish containing is another option, and it can be applied daily for up to a year. 
• Antifungal creams are also effective, especially when combined with nail-thinning techniques. 
• In severe cases, doctors may recommend temporary or permanent nail removal to apply medication directly to the infection site.

Risk Factors For Fungal Nail Infection

Several factors increase the risk of developing fungal nail infections. 

• Age as older individuals often have poor circulation, slower nail growth, and longer exposure to fungi. Obesity 
• Pre-existing conditions like tinea pedis (athlete's foot), diabetes and HIV, vascular issues (particularly venous insufficiency)
• Nail trauma and frequent exposure to moist environments 

Complications of Fungal Nail Infection

Fungal nail infections can lead to several complications if left untreated. These include the resurgence of the infection, permanent loss of the affected nail, and discolouration. The infection may spread to other body areas, potentially reaching the bloodstream. It can sometimes develop into cellulitis, a bacterial skin infection. 

When To See A Doctor

Individuals should consult a doctor if they suspect a fungal nail infection. These infections can be stubborn, and prescription fungal nail infection treatments often yield better results. It is essential to seek medical attention as soon as possible, especially for those with diabetes, as they face a higher risk of serious skin infections. 

Prevention

Preventing fungal nail infections involves several key steps. 

• Wearing flip-flops or shower sandals in public areas like gyms, pools, and locker 
• Keeping feet clean and dry, washing them daily with soap and water, especially between toes
• Wearing clean, moisture-wicking socks and well-fitting, breathable shoes 
• Regularly trimming nails straight across and keeping them short  
• Sanitising nail clippers and avoiding sharing personal items like towels and shoes 
• Treating athlete's foot promptly and moisturising dry skin 

Conclusion

Fungal nail infections can have a significant impact on a person's quality of life, causing both physical discomfort and emotional distress. Understanding the various types, symptoms, and causes of these infections is crucial to seeking timely medical advice and appropriate fingernail or toenail fungal infection treatment. Individuals can reduce their chances of getting these persistent infections by recognising the risk factors and taking preventive measures.

FAQ's

1. What is the leading cause of nail fungus?

Fungi cause nail infections. People often contract the infection through skin-to-skin contact, walking barefoot in public areas like pool decks or locker rooms, and sharing infected nail clippers or towels can spread the infection as well.

2. How to clear up nail fungus naturally?

Some natural remedies may help treat nail fungus:

• Tea tree oil: Apply directly to the affected nail twice daily.
• Oregano oil: Contains thymol, which has antifungal properties. Apply twice daily.
• Garlic: Place crushed garlic on the affected area for 30 minutes daily or take garlic capsules.
• Snakeroot extract: A traditional Mexican toenail or fingernail fungal infection treatment with potential antifungal properties

3. How long can nail fungus last?

Nail fungus can persist indefinitely if left untreated. Even with treatment, it may take several months for a new, healthy nail to grow. 

4. Is Vaseline good for nail fungus?

There's limited evidence supporting Vaseline for nail fungus treatment. However, a petroleum jelly-like product has shown better results than an antifungal cream when used for three months. 

5. Does nail fungus go away?

Nail fungus rarely resolves on its own. Most cases require treatment with prescription oral antifungals or topical medications. In severe cases, nail removal may be necessary. 

Dr. Shradha Mahalle

CARE Medical Team