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When the tiny organisms take
hold, the nail often becomes darker in color and foul
smelling. Debris may collect beneath the nail plate, white
marks frequently appear on the nail plate, and the
infection is capable of spreading to other toenails, the
skin, or even the fingernails. If ignored, the infection
can spread and possibly impair one's ability to work or
even walk. This happens because the resulting thicker
nails are difficult to trim and make walking painful when
wearing shoes. Onychomycosis can also be accompanied by a
secondary bacterial or yeast infection in or about the
nail plate.
Because it is difficult to avoid contact with microscopic
organisms like fungi, the toenails are especially
vulnerable around damp areas where people are likely to be
walking barefoot, such as swimming pools, locker rooms,
and showers, for example. Injury to the nail bed may make
it more susceptible to all types of infection, including
fungal infection. Those who suffer from chronic diseases,
such as diabetes, circulatory problems, or
immune-deficiency conditions, are especially prone to
fungal nails. Other contributing factors may be a history
of athlete's foot and excessive perspiration.
Prevention
- Proper hygiene and
regular inspection of the feet and toes are the first
lines of defense against fungal nails.
- Clean and dry feet
resist disease.
- Washing the feet with
soap and water, remembering to dry thoroughly, is the
best way to prevent an infection.
- Shower shoes should be
worn when possible in public areas.
- Shoes, socks, or
hosiery should be changed more than once daily.
- Toenails should be
clipped straight across so that the nail does not extend
beyond the tip of the toe.
- Wear shoes that fit
well and are made of materials that breathe.
- Avoid wearing
excessively tight hosiery, which promote moisture.
- Socks made of
synthetic fiber tend to "wick" away moisture faster than
cotton or wool socks.
- Disinfect instruments
used to cut nails.
- Disinfect home
pedicure tools.
- Don't apply polish to
nails suspected of infection—those that are red,
discolored, or swollen, for example.
Treatment of Fungal Nails
Treatments may vary, depending on the nature and
severity of the infection. A daily routine of cleansing
over a period of many months may temporarily suppress mild
infections. White markings that appear on the surface of
the nail can be filed off, followed by the application of
an over-the-counter liquid antifungal agent. However, even
the best over-the-counter treatments may not prevent a
fungal infection from coming back.
A podiatric physician can detect a fungal infection early,
culture the nail, determine the cause, and form a suitable
treatment plan, which may include prescribing topical or
oral medication, and debridement (removal of diseased nail
matter and debris) of an infected nail.
Newer oral antifungals, approved by the Food and Drug
Administration, may be the most effective treatment. They
offer a shorter treatment regimen of approximately three
months and improved effectiveness. Podiatrists may also
prescribe a topical treatment for onychomycosis, which can
be an effective treatment modality for fungal nails.
In some cases, surgical treatment may be required.
Temporary removal of the infected nail can be performed to
permit direct application of a topical antifungal.
Permanent removal of a chronically painful nail, which has
not responded to any other treatment, permits the fungal
infection to be cured, and prevents the return of a
deformed nail.
Trying to solve the infection without the qualified help
of a podiatric physician can lead to more problems. With
new technical advances in combination with simple
preventive measures, the treatment of this lightly
regarded health problems can often be successful.
Your podiatric
physician/surgeon has been trained specifically and
extensively in the diagnosis and treatment of all manners
of foot conditions. This training encompasses all of the
intricately related systems and structures of the foot and
lower leg including neurological, circulatory, skin, and
the musculoskeletal system, which includes bones, joints,
ligaments, tendons, muscles, and nerves. |
