Nail Fungus?

Onychomycosis, or nail fungus, is a condition that occurs when a microscopic organism a fungus enters either a fingernail or toenail. Fungal infections occur in toenails more often than in fingernails. Nail fungus has cosmetic concerns as well as potential health concerns. For people who have diabetes or a weakened immune system, nail fungus can present serious risks. Research is ongoing about the deleterious effects on the immune system of constantly fighting a chronic infection.

Onychomycosis is a fungal infection of the toenail itself, while athlete's foot fungus affects the skin of the foot, rather than the toenail itself. These are caused by some of the same organisms.  Unfortunately, nail fungus is especially common in people with diabetes or circulation problems. Anyone can get nail fungus, but infections are more common in people over the age of 60.

Who gets nail fungus? Who is most susceptible?

Men and the elderly seem to be more prone to onychomycosis; however, it has been found to affect both genders of any age - even children. Also highly susceptible are individuals who have developed the infection previously. People who have, or are prone to, athlete's foot, those whose feet perspire heavily, and those affected by diabetes are also candidates, but they are by no means the only ones who can develop it. There isn't a "type" that develops onychomycosis. Nor is it a result of bad personal hygiene habits.

What causes nail fungus?

Usually, nail fungus occurs when fungus gets under the toenail through a small trauma (cut or break) in the nail bed or skin under the toenail or when you injure and stub a toe allowing the microorganism to cause an infection because the swelling won’t allow you to mount an immune response. Nail fungus is not caused by poor hygiene, it is caused by a microscopic organism. Nail fungus can be spread from person to person just like the flu or a cold. Research has shown that people who possess an autosomal dominant genetic trait are more susceptible to a fungal infection after an injury. Like a cold or a flu, weekly people cough on us, sneeze on us but most of the time our immune system will help us fight the infection. With a fungus the injury is frequently the initiating factor. People wonder where the fungus comes from and where they live. The fungus is very prevalent, it is in the dirt, the air, in all of our shoes, socks, carpets, sheets and towels. This is why people who have taken oral medication sometimes get the fungus infection back because they are always reinfecting and reinnoculating themselves. The fungal organisms live in moist, dark, warm environments and this is why the feet in shoes are a perfect place. Our feet perspire and each foot has more than 100,000 sweat glands.

What are the symptoms of nail fungus?

Thickened, yellowish or discolored toenails; toenails that become difficult to cut. The toenail may separate from the nail bed, and may begin to crumble. Without treatment, the condition may continue without pain, or may progress over time, resulting in nails that become so thick that they cannot be cut using conventional instruments, or in the formation of abscesses under the nail, causing pain when the patient puts on footwear or attempts activities that put pressure on the toes.

Do these symptoms always mean mycotic toenails?

Not every ugly toenail has fungus in it. In fact, it’s only about 50%. The rest are just ugly toenails. In medical terminology they are “dystrophic” nails. These other ugly nails may be caused by psoriasis, lichen planus, ‘yellow nail syndrome’, among others. The more nails involved the less likely it is to be nail fungus. No - other disorders can have similar symptoms. Therefore, it's best to see a qualified podiatric physician who can evaluate your symptoms and give you a reliable diagnosis, as well as discuss your treatment options.

How is nail fungus diagnosed?

Your doctor might be able to tell if you have a nail fungus infection by looking carefully at your nails. He or she might scrape some tissue from your nail and send it to a lab in order to determine for certain what kind of infection you have. Appropriate nail specimens can be sent for laboratory testing (KOH preparation, fungal culture, or nail biopsy).