Summary about Disease
Fungal nail infection (onychomycosis) is a common infection that begins as a white or yellow spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, it can cause your nail to discolor, thicken and crumble at the edge. It can affect one or several nails.
Symptoms
Thickened nail
Discoloration (yellowish-brown or white)
Brittle, crumbly or ragged
Distorted in shape
Darkening under the nail
Separation of the nail from the nail bed
Pain or discomfort (sometimes)
Foul odor (sometimes)
Causes
Fungal nail infections are typically caused by:
Dermatophytes: The most common type of fungus.
Yeasts: Such as Candida.
Molds: Less common causes. These fungi thrive in warm, moist environments and can enter the nail through small cuts or separations between the nail and nail bed. Risk factors include:
Older age
Heavy sweating
History of athlete's foot
Walking barefoot in damp public places, such as swimming pools, showers, and gyms
Minor skin or nail injury, or nail surgery
Diabetes
Problems with circulation
Weakened immune system
Medicine Used
Oral Antifungal Medications: These are often the first choice because they clear the infection more quickly than topical drugs. Examples include terbinafine (Lamisil) and itraconazole (Sporanox). These medications can have side effects and require monitoring by a doctor.
Antifungal Nail Lacquers (Topical): Medications like ciclopirox (Penlac) can be painted on the affected nails. These are less effective than oral medications and are used for milder infections.
Antifungal Creams: Some topical creams are also available, often used in conjunction with oral medications or after nail thinning.
Laser Therapy: Some clinics offer laser treatment, but its effectiveness varies.
Nail Removal: In severe cases, the nail may need to be removed surgically or chemically.
Is Communicable
Yes, fungal nail infections are communicable. They can spread through:
Direct contact with an infected nail.
Touching surfaces contaminated with the fungus (e.g., shower floors, public pools).
Sharing personal items like nail clippers, towels, or shoes.
Spreading from other fungal infections, such as athlete's foot.
Precautions
Keep nails short, clean, and dry.
Wear breathable socks and shoes.
Change socks regularly, especially if they get damp.
Wear footwear in public showers, locker rooms, and swimming pools.
Avoid sharing nail clippers, files, or other personal items.
Disinfect manicure and pedicure tools.
Treat athlete's foot promptly.
Consider antifungal powders or sprays for shoes.
Wash and dry hands and feet thoroughly, especially between toes.
How long does an outbreak last?
The duration of a fungal nail infection can vary significantly:
Mild Infections: May take several months to clear, even with treatment.
Severe Infections: Can take a year or longer to resolve completely.
Recurrence: Re-infection is common, so continued preventative measures are essential.
Oral medications typically need to be taken for 6-12 weeks for toenails and 6 weeks for fingernails. Topical treatments may need to be applied for several months.
How is it diagnosed?
Visual Examination: A doctor will examine the affected nail(s).
Nail Clippings/Scrapings: A sample of the nail is taken and sent to a lab for testing. This helps to identify the specific type of fungus causing the infection.
Microscopic Examination: The sample is examined under a microscope to look for fungal elements.
Fungal Culture: The sample is placed in a culture medium to allow the fungus to grow, which helps in identifying the specific type.
Timeline of Symptoms
The progression of symptoms is usually slow and gradual:
Early Stages: Small white or yellow spot appears under the nail tip.
Weeks/Months: Discoloration spreads, and the nail starts to thicken.
Months/Years: Nail becomes brittle, crumbly, and distorted. Separation from the nail bed may occur. Pain or discomfort may develop.
Untreated: The infection can spread to other nails or the surrounding skin, and may become more difficult to treat.
Important Considerations
Fungal nail infections can be difficult to treat, and recurrence is common.
Treatment success depends on factors such as the severity of the infection, the type of fungus, and the individual's overall health.
It's essential to complete the full course of treatment, even if the nail appears to be improving.
People with diabetes or weakened immune systems should seek prompt treatment for fungal nail infections.
Monitor liver function when taking oral antifungals, as they can sometimes affect the liver.
Consult a doctor or podiatrist for proper diagnosis and treatment options.