Fungal Nail Infection – Onychomycosis
Fungal Nail Infection – Onychomycosis – is the most difficult of the superficial fungal infections to treat. The active infection is often in the skin beneath the nail (nail bed), rather than just in the nail itself. The nail grows differently and is damaged as a result of the infection. Fungal nails can be unsightly, and patients are often embarrassed with the way they look.
How do I know if I have Fungal Nails?
Fungal nails can be diagnosed through careful examination and confirmation in clinic using a dermatophyte test strip – this takes 5 minutes, is over 97% accurate and tests for the dermatophytes (a group of microscopic fungi adapted to living on the keratin of skin) which are responsible for fungal nail infection.
The first signs of fungal nail infections are often changes in the texture, quality and colour of your nails. Typical first signs are a yellow or rusty/brown discolouration. They may become thick, crumbly and brittle. Nails may also become distorted, misshapen and lift from the nail bed, losing their healthy shine.
Trauma can also cause nail colour change. Injured nails often thicken and have a yellowish hue. This change in colour is due to the thickening of the nail tissue due to the injury, not a fungal infection. Mistakenly treating a nail discoloured due to trauma will not harm you but it is best to test for dermatophytes before any treatment commences.
What causes fungal nails?
Fungal infections occur when dermatophytes (a group of microscopic fungi adapted to living on the keratin of skin) enter the nail, usually through trauma or micro trauma from footwear. This group of fungi can reside on the sole of your feet before spreading between your toes and then eventually into your nails. Fungi typically thrive in warm, damp and dark environments – what better place than a warm sweaty foot inside a shoe!
Why is it hard to treat?
Getting anti-fungal treatment to the source of the infection, including the nail bed, in sufficient concentration, is very difficult. Most topical agents (paints, ointments, creams & sprays) are unable to penetrate the nail to reach the active infection in this area. The slow growing nature of nails also means any treatment is necessary over a long period.
Treatment
There are many topical treatments available, including sprays, paints creams and lacquers. Most people try these options with little success and then give up trying to treat the problem. Lack of success with these treatments is usually because the treatment used is not getting to the source of the infection, which is often the nail bed.
Prescription-only anti-fungal drugs are available, but these are never a first line treatment. Careful consideration is needed as they are not suitable for everyone to use. A GP assessment will be necessary to investigate suitability for this oral medication.
