NAIL FUNGUS
Toenail fungus is a common condition that disfigures and sometimes destroys the nail. There are several different fungi that can infect the nail. These fungi thrive in the warm, dark, moist environments; such as a shoe. As the fungus grows, it feeds on the nail plate, destroying and disfiguring it. In most cases, the infecting toenail fungus belongs to a group of fungi called dermatophytes, which also cause athletes foot.
The incidence of nail fungus increases with age. It is relatively rare in children, affecting only about one out of every 200 people younger than 18. The number increases to approximately 50% of people over age 70. For some people, toenail fungus is a cosmetically embarrassing problem that they cover up by wearing closed-toe shoes or layers of toenail polish.
Nail polish, tight fitting hosiery and tight fitting shoes increase the likelihood of toenail fungus. Toenail fungus may spread from foot to foot on the floors of showers and locker rooms. The condition also tends to affect persons with chronic illnesses, such as HIV or diabetes, as well as individuals with circulatory problems that decrease blood flow to the toes. Although, many people have no clear predisposing factors.
The big toe and the little toe are the most likely to develop a toenail fungus. This may be due to the the big toe and little toe constantly being exposed to the friction from the sides of shoes.
Symptoms
Typically, when a toenail develops a fungal infection, it turns yellow or brown and becomes thickened. Debris may also accumulate under the nail, especially at the sides and tip. The nail may become crumble so thick that they are hard to cut. They may even become so thick that the toe feels uncomfortable or painful especially when wearing shoes.
Diagnosis
For the most part, the diagnosis is clinical. But if your doctor is going to prescribe an oral anti-fungal medication he or she may want to take a sample of the nail for laboratory diagnosis. The sample may be viewed under a microscope to see if fungus is apparent or it may be cultured to see if a fungus grows.
Duration
Toenail fungus rarely goes away on its own. It is usually a chronic condition that progresses to involve more of the nail and other toes. Even if the affected nail falls off spontaneously or is knocked off, the nail that grows back is usually affected by the fungus.
Prevention
You can help to prevent toenail fungus by:
 | Wearing comfortable shoes and socks that "breathe" (prevents excess moisture) |
| Wearing clean socks every day |
| Wearing sandals in community showers or locker rooms |
| Keeping toenails trimmed |
| Washing your feet every day and using a good-quality foot powder |
Treatment
There are several approaches to therapy. Depending on the individual and the circumstances involved, treatment may begin with your doctor removing as much of the infected nail as possible. This can be done by trimming the nail with clippers and filing it down.
Also, if the infection is mild and very localized, your doctor may prescribe a medicated nail polish such as Penlac. You should apply this clear polish every day (remove weekly with rubbing alcohol) This treatment is limited in its effectiveness because of the thickness of some nails.
If the infection involves a wider area of your nail, or several nails, your doctor may prescribe an oral antifungal medication, such as Lamisil. For toenails, Lamisil is taken daily for 12 weeks. Because of the possible side effects of the oral antifungal medication, a blood test is performed before starting the medicine to check for possible liver problems. Even after treatment with oral antifungal medication, only 36 percent to 50 percent have completely clear, normal-looking nails. After treatment of toenail fungus with oral medication approximately 10% of patients experience relapse or re-infection within one year.
In very severe cases of toenail fungus resistant to therapy, surgical removal of the nail may be necessary. But, as stated earlier, the new nail may also be infected with a fungus.
If you are experiencing any of these signs or symptoms, call today for an appointment.