An infection of nail fungus is also called the onychomycosis and it usually occurs when fungi infect one or more nails. This condition is easily recognizable because it usually begins as a white or yellow spot under the tip of nail or nail. As the nail fungus spreads deeper into nail, it may cause the whole nail to loose its normal color, thicken and develop crumbling edges. Beside this esthetic damage, this condition can be extremely painful. Infections of nail fungus account for about half of all nail disorders. Fungal infections usually develop on nails when they are continually exposed to warm, moist environments, such as sweaty shoes or shower floors. Although many people believe that nail fungus is the same thing as athlete's foot it is not so. Athlete%26rsquo;s foot primarily affects the skin of the feet. Although these infections aren%26rsquo;t a life-threatening disorder, the treatment can turn out to be a big problem. Even after a complete recovery, infections often recur again and again. Incidence
These infections are far more common on the toenails than the fingernails. It is estimated that they affects about 12% of all Americans. When it comes to age distribution, it occurs in approximately 25% of people at age 40, and 40% of older people. These infections tend to run in families but not everyone is susceptible.
Cause of nail fungal infection
Fungi are microscopic organisms that don't need sunlight to survive.
That%26rsquo;s why they live in moist and dark places. Several researches have proven that great majority of nail fungal infections are caused by a group of fungi called dermatophytes. Yeasts and molds can also be responsible for nail fungal infections.
They invade skin through tiny invisible cuts or through a small separation between your nail and nail bed. This infection is far more common in toenails than in fingernails because toenails are often confined in a dark, warm, moist environment inside the shoes.
Signs and symptoms of nail fungal infection
These infections are very easy to detect and diagnose. A patient may have a nail fungal infection if one or more of his or hers nails are:
%26bull; Thickened
%26bull; Brittle, crumbly or ragged
%26bull; Distorted in shape
%26bull; Flat or dull, having lost luster and shine
%26bull; Yellow, green, brown or black in color
%26bull; With debris building up under nail
Risk factors for developing nail fungal infection
%26bull; Age
It is proven that nail fungus is more common among older adults because nails grow more slowly and thicken with aging, making them more susceptible to infection.
%26bull; Sex
Nail fungus also tends to affect men more than women.
%26bull; Perspiring heavily
%26bull; Working in a humid or moist environment
%26bull; Wearing socks and shoes that lack of ventilation
%26bull; A minor skin or nail injury, a damaged nail or another infection
%26bull; Diabetes, circulation problems or a weakened immune system
%26bull; Other fungal skin infection
%26bull; After washing hands frequently, or have them in water a lot
%26bull; A nail that has recently been damaged is also more likely to become infected
%26bull; Nail infections are more common in people who live in hot or humid climates
%26bull; Smoking also increases the risk of developing a nail infection
Possible complications
Beside the fact that these nail fungal infections can be very painful, they may cause permanent damage to the nails. These infections may also lead to other serious infections that can spread beyond patient%26rsquo;s feet. They can pose a serious health risk for people with diabetes and for those with weakened immune systems. In such cases even a minor injury to the feet can lead to a more serious complication, such as an open sore that's difficult to heal.
Diagnosis of nail fungal infections
Examination of nails
The first step in beating nail fungus is getting a diagnosis. Your doctor will likely examine your nails first.
Sample testing and analysis
To test for fungi, your doctor may scrape some debris from under your nail for analysis. The debris can be examined under a microscope or cultured in a lab to identify what is causing the infection. Other microorganisms, including yeast and bacteria, also can infect nails.
Treatment of nail fungus infections
The treatment of fungal nail infections is expensive and long-term and it requires taking medicine for several months, sometimes even years. Unfortunately, topical preparations do not effectively treat fungal nail infections.
Oral Antifungal Medications
There are 3 effective oral antifungal medications - 2 that are FDA approved for fungal nail infections and one that is not FDA approved specifically for nail infections. All 3 medications have significant side effects and interact with many medications. Patients should know that these medications are incorporated into the nail and that%26rsquo;s why-they continue to work even after the medication is discontinued. It is important to remember that none of the oral antifungal medications can be taken during pregnancy.
%26bull; Terbinafine (Lamisil%26reg;, Apo-Terbinafine%26reg;)
This is an FDA approved medication for fungal nail infections treatment. Several researches have proven that it is 70% to 90% effective when used as prescribed. The dosage used is 250 mg once a day for 6 weeks for fingernail infections and 12 weeks for toenail infections.
%26bull; Itraconazole (Sporanox%26reg;)
Second FDA approved medicine for fungal nail infections is called Itraconazole. Studies have shown that it is 70% to 80% effective. This drug interacts with many medications and should always be taken with some kind of food. It can be taken daily or as pulse therapy with one but very large dose. The daily dose is 200 mg once a day for 6 weeks for fingernail infections and 12 weeks for toenail infections. The pulse dosing is 200 mg twice a day for one week per month repeated for 2 or 3 months.
%26bull; Fluconazole (Diflucan%26reg;)
This medication is not approved by the FDA to treat fungal nail infections. However, it is an effective oral antifungal medication. The advantage of fluconazole is that it stays in the body for a long time and only needs to be taken weekly.
Other treatment options
Doctor may also suggest these treatments:
%26bull; Antifungal lacquer
If patient has a mild to moderate infection of nail fungus, sometimes the doctor may prefer to prescribe some simple antifungal nail polish instead of any medication. FDA has approved a topical antifungal lacquer called ciclopirox (Penlac). This lacquer should be applied onto infected nails and surrounding skin once a day. Single treatment lasts for seven days after which the patient should wipe the piled-on layers clean with alcohol and begin fresh applications. Daily use of Penlac for up to one year or longer has been shown to help clear nail fungal infections.
%26bull; Topical medications
The doctor may also recommend some other topical antifungal medications, such as econazole-nitrate (Spectazole%26reg;). Topical medications usually don't provide a cure but may be used in conjunction with oral medications.
%26bull; Nail removal
If other treatments have failed, the infected nail can be removed by a small operation done under local anaesthetic. This is combined with treatment with antifungal medication.
%26bull; Not treating
If the infection is mild or causing no symptoms it can be left untreated. Some people may prefer not to take medication as, although rare, there is a small chance of serious side-effects from antifungal medication.
Some treatment tips
All the fungi that are killed with treatment remain in the nail until the nail grows out. When a fresh, healthy nail grows out from the base of the nail, it is a secure sign that the treatment is working. When this healthy nail reaches the end of the finger or toe, the nail will often look normal again. Most people already know that fingernails grow faster than toenails, so it may appear they are quicker to get back to normal.
Prevention tips
To help prevent nail fungus and reduce recurrent infections, practice good hand and foot hygiene by following these steps:
%26bull; Patient should keep nails short, dry and clean.
%26bull; Only appropriate socks should be wear. Synthetic socks that wick away moisture may keep feet dryer than cotton or wool socks
%26bull; Some antifungal spray or powder should be used on a daily basis.
%26bull; Patient should wear rubber gloves and give up nail polish and artificial nails. Although it may be tempting to hide nail fungal infections under a coat of pretty pink polish, this can trap unwanted moisture and worsen the infection.
%26bull; Hands should be washed after touching an infected nail.
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