Nail fungus is known by doctors as Onychomycosis which is also known as “Ringworm of the nail”. Nail fungus is a fungal infection of the nails or toenails where the actual infection is on the bed of the nail and of the plate under the surface of the nail. This is the most common of all nail abnormalities. This affects about half of Americans when they reach the age of 70. 90% of the elderly may be affected by this type of infection and men are more commonly affected than women.

Causes:

The infection is caused by three types of fungi:

  • Dermatophytes
  • Yeasts
  • Nondermatophyte Molds

Fungi are parasitic plant organisms that do not need sunlight in order to grow. This fungus may be picked up in damp areas like public gyms, shower stalls, locker rooms or swimming pools. This kind of infection can be passed on among family members. The condition can also spread from one toe to another or even to other parts of the body.

Symptoms:

  • Swelling of the nail
  • Yellow to Yellowish brown nail
  • Thickening or crumbling of the nail
  • Foul smelling debris may occur
  • Streaks down the side of the nail
  • Complete loss of the nail can happen

Risk Factors:

  • Diabetes Mellitus
  • Aging is the most common factor
  • Psoriasis
  • Perspiring heavily
  • Moist environment
  • Weaving socks and shoes that hinder ventilation
  • Long-term steroid use
  • A weakened immune system due to cancer, AIDS, or immunosuppressant medications following an organ or bone marrow transplant
  • Vascular disease
  • Barefoot in damp public places
  • Having Athlete's Foot
  • Minor skin or nail injury
  • Circulation problems
  • Damaged nail

Treatment:

  • Oral medication – Systematic antifungal medications:
  1. Clotrimazole
  2. Itrafconazole
  3. Terbinafine
  4. Fluconazole

This medication when taken orally for 12 weeks can bring better cure rates. Patients who are taking oral antifungal medications should have a complete blood count (CBC) and liver enzyme workup every 4-6 weeks. One side effect upon taking this medication is an upset stomach. Treatment should be continued until microscopic exam or culture shows the fungal infection is gone.

  • Topical medication – This is just for controlling the infection not completely curing it. Lotrimin cream should be thoroughly rubbed into the nail daily to control the infection. This medication is available over the counter.
  • Antifungal Lacquer – This is prescribed for those with less severe cases. Penlac (ciclopirox) is an anti-fungal nail polish would be prescribed.
  • Surgery – In very sever cases, surgery to remove the complete nail will be performed by the doctor.
  • Photodynamic Therapy – This treatment is known to be effective. This is a laser treatment which uses intense heat generated by light to get rid of the nail after acid-treatment.

Prevention:

  • Wash your feet regularly and dry them thoroughly when they get wet.
  • Avoid putting on nail polish as it can seal in fungus and allows it to grow.
  • Keep toenails trimmed and clean.
  • Make sure to disinfect pedicure tools before using it.
  • Wearing shower shoes whenever walking or showering in public places.
  • Wear appropriate socks.
  • Wear rubber gloves.