It can be easy to get a nail infection, and if you’ve ever had one you know how stubborn they can be and how easily they can spread to other nails. Fungal nail infections, medically known as onychomycosis, are infections caused by fungi that can affect either the fingernails or the toenails and can develop in, under, or on the nail.
Fungi are tiny and can only be seen with microscopes. While fungi are everywhere and sometimes can live on your skin without trouble, an overabundance of fungus can lead to infection.
Symptoms
Often developing slowly over time, it can be awhile before the patient notices any severe symptoms. Fungal infections of the nail can vary on the type of fungi and where the infection begins, but overall the symptoms are the same for most cases. More often than not fungal nail infections develop on toenails, as socks can make your feet warm, moist, and the ideal environment for fungi to grow. The infection can spread to other nails and even onto the skin.
Common symptoms include:
- Distortion of the nail (lifting, curling, or loosening from the nail bed)
- Pain may not be present at first but will develop over time as the infection progresses untreated
- Debris build up underneath the nail
- Discoloration of part of the nail, typically yellow, brown, white, and/or green
- Thickening or thinning of the nail
- The nail may become brittle, crumble, or split
Risk factors
Nail fungus is common and can affect anyone at any age, though it is often rare for children under the age of six to develop fungal nail infections. Living in humid climates can increase a person’s risk of developing an infection. The following instances may increase your risk of developing fungal nail infections:
- Wearing tight footwear that can crowd toes and keep them warm and moist
- Frequent trauma to nails
- Frequent exposure to communal areas that are damp, wet, moist, humid, or warm such as spas, locker rooms, public restrooms, showers, and gyms.
- A history of diseases or medical conditions that can lead to weakened immune systems, poor circulation, athlete’s foot, or chronic illness.
Treatment
An examination of the nail, nearby skin and a sample of debris found under the nail can help a podiatrist determine if you have a fungal infection. Treatment for minor cases involves medication, whether topical creams or oral antifungals, that will need to be taken for months either daily or weekly. It is important to take your medication as prescribed to eliminate infection and prevent it from returning.
For more aggressive or severe cases, surgery may be required and can be done in the office without an overnight stay. Surgery is typically reserved for cases where large portions are infected, diseased, damaged, or causing extreme pain.
An injection in the toe or the finger will be done to numb the area and prevent the patient from feeling any pain. Special tools are used to remove either the entire nail or just the infected piece. If the patient suffers from recurrent infections, the nail matrix (the area from which the nail begins to grow) may need to be destroyed with a chemical solution. This ensures that the new nail will be healthy and grow properly.
After the diseased nail is removed, antifungal medicine is applied directly to the area. Once the surgery is completed, antibiotics will be administered and the finger or toe will be bandaged. The procedure usually takes an hour or less.
Following surgery, the area will remain numb for several hours. Patients may notice pain, throbbing, swelling, bleeding or discharge from the wound. Keep your arm or leg elevated to reduce pain and swelling. Change your bandages regularly, and follow your doctor’s instructions for how and when to do this. Medication may be prescribed to prevent further infection during your recovery. Expect at least a month for the nail bed to heal. Your doctor will inform you when you can resume normal activity. Fingernails can take six months to heal whereas toenails may take 18 months or longer.
Prevention
After treatment, it is important to use preventative measures to avoid the infection from returning. Some good preventative measures include:
- Wash your hands and feet often with soap and water. Be sure to dry them thoroughly.
- Trim your fingernails or toenails straight across and avoid having them longer than the skin. Wear socks that absorb moisture. If you struggle with having sweaty feet, change your socks often. Allow your shoes to dry out for a minimum of 24 hours before wearing them again.
- Antifungal powder or spray can help to keep your shoes clean.
- Check your nails constantly for any changes in color or texture.
If you have any questions regarding fungal nail infections or if you suspect you may be suffering from an infection, please contact Dennis Grandy, DPM today.