Fungal nail infections

Fungal nail infection (onychomycosis) is an infection that causes the nails to thicken and discolour. It is an unsightly and uncomfortable infection that targets the space between the nail plates and the sensitive flesh beneath. The nails of persons with onychomycosis are initially a cosmetic concern. Without treatment, the nails can become so thick that they press against the shoe and cause discomfort.

The big toe is the most susceptible to this condition, however other toes can become infected. The toenail protects the tender nail bed below and once a fungal nail infection occurs it is guarded by the same shield. Fungal nail is caused by the same fungus that causes athlete’s foot. The fungal organisms (dermatophytes), like the warm, moist, enclosed conditions of socks and shoes. Cutting your nails too short, damage to the nail caused by a bang on the foot, or tight shoes that constrict or rub the toes, can allow the fungus to get under the nail.

The primary fungi that cause onychomycosis are tricophyton rubrum or tricophyton mentagrophytes which feed on keratinised (nail) tissue. The infections they cause are normally confined to the nails, but occasionally spread to the surrounding skin.

The infection usually starts at the tip or side of the nails and spreads towards the base of the nail. In the early stages the nail may change colour to off-white, yellow and in some cases green. The nail becomes thicker and crumbly and can eventually crumble away completely. Toenail infections are more difficult to clear totally than skin infections. This is because the nails grow slowly and receive very little blood supply. Because nails grow slowly, it typically takes up to a year for the nail to regain a healthy, clear, thin appearance. Onychomycosis is an ongoing fungal infection and patients with the condition should consult a registered Chiropodist.
Fungal nail infections can recur, often because the original infection did not completely clear or because athlete’s foot has caused reinfection. Because of the thickening your Chiropodist will reduce (thin) the nail as far as possible and apply a topical treatment. Oral medications are also available on prescription only, however these may have contra-indications and patients may be required to have a blood test prior to and sometimes during this course of treatment.
Patients with diabetes commonly develop onychomycosis because blood circulation is poor in the extremities, and the body’s ability to fight infections is compromised.