What is Nail Fungus?
Onychomycosis is an infection of the bed and plate underlying the surface of the nail caused by various types of fungi commonly found in the environment. Fungi are simple parasitic plant organisms, such as molds and mildew, that lack chlorophyll and therefore do not require sunlight for growth. A group of fungi called dermatophytes easily attack the nail, thriving on keratin, the nail's protein substance.
When the tiny organisms take hold, the nail may become thicker, yellowish-brown or 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 fingernails.
Other contributory factors may be a history of athlete's foot, improper cleansing, anxiety and excessive perspiration.
Because fungi are everywhere (including the skin) they can be present months before they find opportunities to strike, and before signs of infection appear. By following certain precautions, including proper hygiene and regular inspection of the feet and toes, chances of the problem occurring can be significantly reduced.
Clean, dry feet resist disease. A strict regimen of washing the feet with soap and water is the best way to prevent an infection. Shoes, socks, or hosiery should be changed daily. Toenails should be clipped straight across so that the nail does not extend beyond the tip of the toe.
It is very unlikely that a few exposures to an unclean environment will cause a fungal infection. Walking barefoot once or twice in a public shower will not generally spread the infection. Similarly, it is also unlikely that a single visit to a pedicurist will cause the infection. Lengthy exposure to a contaminated environment is often required in order to contract the fungal infection. Some individuals may be more susceptible to fungal infections than others.
Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks, especially for those with more active life styles. This can be helpfulin denying a hospitable environment for the fungi to grow in.
Artificial Nails and Polish
Moisture collecting underneath the surface of the toenail would ordinarily evaporate, passing through the porous structure of the nail. The presence of an artificial nail or polish impedes evaporation.
Depending on the nature and severity of your infection, treatment may vary. Most over-the-counter treatments are minimally effective at best, but almost none of them have produced a permanent treatment. The main reason for these poor results is that the fungal infection resides deep within the nail or nail bed, and the topical medications have great difficulty in penetrating to this depth. A fungus may work its way through the entire nail, penetrating both the nail plate and the nail bed.
Podiatric Medical Care
Your doctor can diagnose a fungal infection, culture the nail, and form a suitable treatment plan. Treatment may include topical or oral medication and debridement (removal of diseased nail matter and debris.)
Newer oral anti-fungal medications are the most effective treatment. The two most common oral medications are Lamisil and Sporonox. These medications are very similar in most respects, and are about 75% effective. The medication is taken for three months. A total of approximately nine months is required for new healthy nail growth. Current studies show that for a very small percentage of the population there are some unwanted side effects with an oral antifungal, however these are usually reversible when medication is terminated.
A topical medication is Penlac Lacquer. This prescription medication is generally less effective than the oral medications, and is best used with a limited fungal infection. Penlac is applied approximately three times per week for several months.
In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed. If there is no response to other treatment methods, permanent removal of a chronically painful nail may become necessary.