At a glance:
- Nail fungus (Onychomycosis) is a common condition.
- Fungal infection of the nail becomes more common as you get older, and is more common in men.
- Common symptoms include a change in colour and lifting of the nail.
- May occur in toenails and fingernails.
- More common with some chronic diseases.
What is nail fungus?
Nail fungus is a common condition affecting roughly 21% of the population (USA). It is typified by a change in colour of the nail, lifting of the nail plate and occasional thickening of the nail or a smell. Nail fungus is caused by contact with fungal spores or an imbalance in your skin's natural flora. It can affect any of your nails, but is more common in your toe nails.
The fungal cells eat the protein that makes the skin and nail. Anyone can get a fungal infection, but as you get older they become more common. The nail fungus can occur when foot wear is too tight, nail trauma has occurred, a fungal skin infection has been untreated, poor foot hygiene, poor blood supply, toe deformity like claw toes, and exercise habits.
The fungal cells eat the protein that makes the skin and nail. Anyone can get a fungal infection, but as you get older they become more common. The nail fungus can occur when foot wear is too tight, nail trauma has occurred, a fungal skin infection has been untreated, poor foot hygiene, poor blood supply, toe deformity like claw toes, and exercise habits.
Symptoms of a fungal infection.
Major signs that a fungal infection has started in a nail is a change in colour. Lifting of the nail from the nail bed is also common. It may start from the end of the nail or occasionally with trauma around the sides or the base. Pain is uncommon, but may be present.
As nail fungus progresses, the nail may thicken. It may change shape, or the surface may distort. Other signs or symptoms of a fungal nail infection may be smell, debris under or around nails, crumbling nails when cutting, red irritated peeling skin around nails, itching, or a nail falling off/weak attachment to the skin.
What causes a nail fungal infection?
Nail fungus is caused by types of common fungal spores that live off the protein in the nail. There are many ways to come in contact with these fungal spores, such as cross contamination from cutting utensils, nail trauma, shared surfaces, uncontrolled tinea infections and tight toe boxes on shoes.
Fungal nail infections are often considered a cosmetic problem, but if left untreated can lead to other conditions such as cellulitis or paronychia.
People with peripheral vascular disease, type two diabetes and Psoriasis are more likely to have a fungal nail infection, or other changes to the nail that appear similar to a fungal infection.
How to diagnose a fungal infection.
A lot of fungal nail infections are self diagnosed. If you are unsure your GP can be a good first point of contact . They will often take a clipping that is then grown in a laboratory, and the type of fungus may be isolated (negative results, even with obvious fungal symptoms are common). Podiatrists will often diagnose through a clinical history, appearance of the nail and nail texture.
Treatment for nail fungus.
- Topicals - many over the counter pharmacy-only nail polish/lacquer products, each with their own instructions for use. These topicals are a great first choice option, though there may be some limitations to efficacy if the nail fungus has reached a more advanced stage of infection. Use as directed.
- Orals - oral medications typically have a very high success rate. Some people are unable to take these medications due to existing medical conditions and polypharmacy (the regular use of at least five medications). Oral fungal medications may have side effects and are only available from your GP or dermatologist.
- Laser - there are two main types of laser therapy with their own rates of success: thermal or hot laser therapy and cold laser or lunula laser therapy. Which type of therapy may be recommended to you will depend on your podiatrist and the type of fungal infection you have.
- Home remedies - while there are a number of home remedies that may be found online, most only have unsubstantiated anecdotal evidence pointing towards any real effectiveness.
There are few complications associated with corns and calluses, but people living with diabetes or other conditions that may affect peripheral blood flow and sensation should monitor the condition of corns and calluses and should never try to remove them at home (cutting or medicated corn removal pads) due to the risk of developing an ulcer.