Fungal Toenails, or mycotic, nail infections are very common. Although they can occur on the fingernails, they are more commonly found on the toenails because fungus grows more readily in warm, dark, moist areas like enclosed shoes. Infected nails appear discolored, thick and brittle and may at times be painful. Fungal nail infections most frequently appear in adults.
Risk factors for developing fungal infections of the toenails include:
- Having athlete’s foot
- Sharing socks, shoes or other personal belongings
- Walking barefoot at public pools, gyms or shower rooms
- Having a tendency to sweat excessively
- Getting manicures or pedicures
- Having deformed or diseased nails
- Wearing closed footwear
- Having a damaged immune system
It is impossible to avoid contact with fungal organisms since they are found almost everywhere. Keeping the feet clean and dry, wearing clean socks and well-fitted shoes and taking care of any injuries promptly can all lessen the risk of developing a fungal nail infection.
Nails infected by fungus appear abnormal in shape and texture. They may be brittle or crumbly and there may be debris trapped under them. Mycotic nails are lusterless, thick and discolored, usually appearing yellow or brown. They may separate from the nail bed, loosening or lifting from their normal position.
Although observation is usually sufficient to provide a diagnosis of fungal nail infection, confirmation can be made by obtaining a laboratory culture of nail scrapings. Results of such a culture may take a few weeks to be reported.
Fungal nail infections are notoriously resistant to treatment. Most over-the-counter ointments are likely to be ineffective in combating the fungus, although prescription ointments may promote healing and keep the infection from spreading. There are a number of oral medications that can be administered to treat fungal nail infections, but these must be taken for 3 months. The oral medications can also have serious side effects, including possible liver damage, so patients taking them must undergo regular testing.
Laser treatments are sometimes successful in treating fungal nail infections and have no damaging side effects. Unfortunately, even with treatment, fungal nail infections have a tendency to recur, so patients are advised to be conscientious in their efforts to avoid the development of a chronic problem.
Robert Spencer, DPM
Nitza Rodriguez, DPM
Han Nguyen, DPM
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