Nail Fungus

1 What is Nail Fungus?

Nail fungus a common condition that starts with the formation of a white or yellow spot under the tips of the nails. It affects both the finger nails and the toe nails. This is also a fungal infection that can go deeper and make the nails to lose their original color. They may also become thicker and crumble often at the edges of the nails. 

It may also affect a number of the nails but usually not all may be affected. This may not be a problem if the condition is mild and not giving you a problem. Therefore, treatment may not be required. However, pain may come with time as the fungus grows deeper and the nails starts to thicken. 

Management of this problem may require self-care steps and taking of medication may be the other alternative. Successful treatment may not be easy sometimes since the nail fungus always comes back. Nail fungus is also referred to as onychomycosis and tinea unguium. When the fungus extends the infection to between the regions between the toes and the skin of the feet, this is referred to as the athlete’s foot often referred to as tinea pedis.

2 Symptoms

Nail fungus is characterized by the following symptoms:

  • The nails are thick and brittle.
  • They also crumble or ragged.
  • They also may look distorted in their shape.
  • They appear dull or darkened and do not shine as a result of the accumulation of debris behind the nail. 

It sometime comes with pain in your toes or fingertips. A foul smell/ odor may also be felt.

It is recommended that you see a doctor in case the self-help steps do not work out.

In addition, it is also recommended that one needs to visit a doctor when one has diabetes and believe that they are developing nail fungus.

3 Causes

The nail fungus is caused by a dermatophyte fungus. Involvement of yeast and molds in nail fungus infection has also been demonstrated. A fungus is a microscopic organism that does not require sunlight so that it services. 

While some fungi are beneficial, others are pathogenic and may cause serious infections. They often live in warm and moist environments. They can invade your skin through open wounds. However, they are so small that they cannot be seen even when going through your nail and nail bed. 

If your hands and fingers are often exposed to worm and moisture, they can often be a big problem. Studies have suggested that nail fungus causes more damage to the toes nails than fingernails. This is because the toenails are often enclosed in shoes which are warm, dark and have moisture. This environment allows the fungi to thrive. Moreover, the toes do not have sufficient blood flow than the fingers. Therefore, they fail to be detected by the immune system and hence no resistance is generated by the body.

4 Making a Diagnosis

Because other infections can affect the nail and mimic symptoms of nail fungus, the only way to confirm a diagnosis is to see a doctor. 

The doctor may offer you proper counsel on the right direction for medication which include referring you to an appropriate dermatologist or podiatrist who is the specialist for foot conditions. Set up an appointment with the doctor and feel free to suggest and discuss all matters concerning your lifestyles. Stress or recent challenges.

Medications being used or have been used before such as vitamins and supplements. Also make a list of possible questions on symptoms, conditions, tests, course of action to take, alternative primary approach, other health conditions being experienced. Ask any other question not related to the diseases but is affecting your health.

The doctor will be required to examine your nails. He may collect some debris from the nails. They can then be forwarded to the laboratory for identification of the type of fungus. Diagnosis will then be made a distinction made from psoriasis which shares the symptoms with the nail fungus. 

Examination for yeast and bacteria from the nails can also be assessed by special culture techniques. This will help in the determination of the best form of treatment for your nail infection.

5 Treatment

Several treatment methods exist for nail fungus.

After trying to use the self-care strategies and over the counter drugs with no success; combination therapy can be applied involving both a prescription drugs and other methods. Take not that the possibility for disease reoccurance is possible. 

Some possible drugs for treatment include: 

  • Oral antifungal drugs: You may be prescribed with oral antifungal drugs. Efficacy studies suggest that terbinafine (Lamisil) and itraconazole (Sporanox) are the best in the market currently. This treatments help in the regeneration of the new nail free from the infection. The drug is taken for between 6 to 12 weeks. However, you can only be sure of the effectiveness one the entire nail has grown. Hence, this treatment can go for as long as 4 months and even longer. 
  • Age has been implicated in the success rates for this treatment, it’s effectiveness of treatment is lower in adults over the age of 65. This treatment can be combined with topical applications. Use of these drugs however comes with development of skin rash and hepatotoxicity. 
  • Frequent blood tests may be required to check on the tolerance to the drugs. Moreover, for patients with liver disease or congestive heart disease and even those taking drugs with possible interaction; they are discouraged from taking these drugs. 
  • Medicated nail polish may also be prescribed by your doctor. An example of the nail polish includes ciclopirox (Penlac). The drug is painted on the surrounding skins once daily. This is wiped off after 7 days and cleaned with alcohol for application of fresh paint. This polish can be applied for about a year. 
  • Antifungal cream may also be prescribed. The cream is rubbed onto the infected nails after soaking. It is advised to thin the nails first before applying the cream for the drug to be effective. Thinning allows for the penetration of the cream beneath the hard surface to the fungus beneath it. Thinning of the nails can be done by use of a nonprescription lotion containing urea. It can also be debrided by use of a file or any other tool. 
  • The nails may also be removed surgically. However, in case of severe pain, it may be suggested that the entire nail to be removed. It is expected that a new nail will develop but will take time, it take a whole year to grow completely. Surgery may also be used in combination with drugs such as ciclopirox in the management of the nail bed. 
  • Laser and light-based therapies: This is not used frequently. But when used alone or in combination with other medications, it has been suggested that it is more effective in the improvement. Use of carbon dioxide has been tested in the use of Laser Therapy and in combination with an antifungal cream has been shown to be effective. However, Laser and light-based therapies may not be available in most of the places for treatment of this condition. Similarly, they may not be covered by insurance.

6 Prevention

Simple self-help habits can be used to prevent the development of the nail fungus. They include:

  • Washing hands and feet regularly.
  • Keeping the nails short, clean and dry always.
  • Wash your hands and feet with soap and clean water and dry them thoroughly.
  • Ensure that the spaces between the toes are also cleaned. 
  • Nails also require to be trimmed straight.
  • Thick regions can also be filled down.
  • Wear socks so that your feet becomes dry since it absorbs the sweat. Good socks are those made from wool, nylon, and polypropylene.
  • Change socks as frequently as possible if you have sweaty feet’s. 
  • Always considers shoes that have less humidity.
  • You can be taking off your shoes to aerate your toes and footwear.
  • Old shoes may also be discarded if possible since they can harbor the fungi and promote reinfection of the toes.
  • Antifungal or disinfectants can be used for the treatment of the toes. 
  • The spray can also be used for spraying your feet and inside of the shoes.
  • When working with water, always wear rubber gloves to reduce the overexposure to water.
  • Afterwards, the gloves need to be dried inside out. Do not injure the skin around the nails since this will give access the fungi to the nails.
  • Always wear shoes or sandals when walking or working around the moist places.

7 Alternative and Homeopathic Remedies

Several alternative remedies exist for nail fungus.

Using snake root extract has been successful for some people. This product is extracted from a plant which is in the sunflower family. 

According to clinical trial research findings, it was established to be as effective as ciclopirox. In this study, it was used every third day for the period of one month, twice a week within the second month and then once per week for the third month. 

Another plant, tree oil applied twice every day was found to be an effective treatment for the nail fungus, however, more studies and clinical trials are needed to confirm their efficacy.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to take care of nail fungus at home.

It has always been presumed that one can take care of the fungal nails infection at home. However, over the counter antifungal nail creams and ointments are advisable. However, other products are also available in the market. 

In case of development of white marking on the toe or finger nails, it is advisable to be scratching them off. The nails can then be soaked in water, dried and either cream or lotion applied. In case one has both the athlete’s foot and nail fungus, medicated powders are recommended for use. However, sprays can also be used and ensure that your feet are clean and dry. 

Vicks VapoRub can also be used since many people have acknowledged its effectiveness. These findings are also supported by research findings of a study involving 18 patient’s. In this study, 56% of the patients were observed to have improved symptoms and signs. The product needs to be applied in small amounts daily using a cotton swab. 

It is also advisable to trim the nails and thin when possible. This allows the reduction of the pain through the reduction of the pressure on the nails by the thick layer of the nail. The nails can be softened before thinning or filling the thick nail. 

Urea can also be applied on the affected nails, and cover them appropriately with a bandage. The urea can be removed with soap and water. This needs to be done until the nails soften. Protect the skin around the nails using a petroleum jelly. However, if you have a condition that causes low blood flow in your feet, do not trim the nails. Instead, see a health provider.

9 Risks and Complications

There are several factors that would increase your risk of developing nail fungus. They include:

  • Old age,
  • reduced blood flow,
  • more exposure time of exposure to the fungi,
  • slow growing nail,
  • heavy perspirations especially among the males,
  • family history of nail fungal infection,
  • working frequently in humid and moist environment. This can be prevented by wearing socks and shoes that hinder ventilation.

Moreover, living with someone that has nail fungus exposes one to the danger of nail infection. 

Walking barefoot in the moist conditions such as water pools, gyms and showers. The risk is even higher when one has athletes foot or has minor injury on the skin, nails or skin condition including psoriasis. Diseases such as diabetes and heart problems confer a weak immune system. 

Children with Down syndrome are also exposed to the risk. Severe nail fungus is painful and may lead to permanent damage of the nails. It may also promote other serious infections that may infect other parts beyond the feet especially when having a lower immune system as a result of diabetes and other chronic diseases. 

Diabetes causes a reduction in the blood supply to the feet. This also exposes you to greater risk of bacterial infection such as cellulitis. Any minor injury to the feet with a nail infection may lead to serious complications. It is advisable to see a medical doctor.

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