Medical Centric

FUNGAL NAIL INFECTION

Uncategorized / By

FUNGAL NAIL INFECTION

Fungal nail infection is an infection caused by fungal invasion of the nail structure.

  • Fungal nail infections are the most common disease of the nail, making up about 50% of nail abnormalities
  • Damage to the nail structure can affect the growth, shape, size of the nail
  • Fungal nail infections can affect both the fingernails and the toenails, but the toenails are more susceptible to an infection because the toe has less blood flow than the fingers, making it harder for the body to pick up on and prevent infection. The toenails are also more commonly affected because fungus thrives in dark, warm places.
  • Fungal nail infections can develop in people of any age but it is more prevalent in older adults. As the nails age, it can become brittle, dry, and crack, allowing fungi to enter.
  • In severe cases, fungal nail infection can cause permanent damage to the nails and may lead to other serious infections that spread beyond the feet, this is usually common in people with a suppressed immune system due to medication, diabetes or other conditions

CAUSES

Fungal nail infections are caused by various fungi.

The most common cases are caused by a group of fungi called dermatophytes (making up around 85-90% of all cases), such as Trichophyton mentagrophytes, Trichophyton violaceum and Trichophyton rubrum (the most common dermatophytes that cause fungal nail infection). Dermatophytes are highly resistant and can survive for long periods in dark and warm environments.

Some yeasts and molds also cause these infections; they include:

Molds – Aspergillus, neoscytalidium, Scopulariopsis, and Acremonium species.

Yeasts – candida species which is responsible for 5-10% of fungal nail infection. This affects fingernails more than toenails.

Risk factors of the condition include:

  • Wearing shoes that make the feet hot and sweaty
  • Walking barefoot in damp communal areas, such as swimming pools, gym showers, and locker rooms which are places where fungus spreads easily
  • Having a history of athlete’s foot
  • Being older
  • Having a suppressed immune system, or diminished blood circulation
  • Heavy perspiration
  • Having a minor nail injury or a skin condition such as psoriasis

SYMPTOMS

Nails that are infected with fungus typically are:

  • Whitish to yellowish-brown in color
  • Thickened
  • Dull
  • Distorted in shape
  • Brittle, crumbly or ragged
  • Smelling slightly foul

You should see a doctor if the infection is severe and self-care treatment hasn’t worked, and if the infection has spread to other nails.

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will examine the nails.

The doctor may also take some nail clippings or scrape debris from underneath the nail and send the sample to a lab to identify the causal pathogen. This may help to determine the best course of treatment.

Care must be taken when making a diagnosis because several infections such as psoriasis, trauma, nail bed tumor, eczema, yellow nail syndrome, contact dermatitis can result in similar symptoms.

TREATMENT

Treating fungal nail infections can be difficult.  Treatment depends on the severity of the condition, and the type of fungus causing it. It can take months to see improvements. Even with the improvement, repeat infections are common.

Treatment options include:

  • Oral antifungal drugs
  • Medicated nail cream
  • Medicated nail polish
  • Surgery to remove the nail temporarily while the antifungal drug is applied directly under the nail or permanent nail removal if the infection is severe and extremely painful