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Fungal nail disease (Tinea unguium): Treatment, symptoms, advice and help

About fungal nail disease (tinea unguium)

Fungal nail disease is one of the most common problems involving the nails. Tinea unguium is a term used for infection of nails of the fingers and the toes which is caused by the dermatophyte fungus. Nails are keratinised coverings over the tip of the fingers and the toes which are responsible for protection of the soft tissues underneath them.

Fungal nail disease (tinea unguium): Incidence, age and sex

Fungal infection of the nails is a common occurrence worldwide and can affect an individual of any age group. However, it is more frequently seen in older adults with same prevalence in both men and women. The toe nails are more frequently involved than the finger nails.

Signs and symptoms of fungal nail disease (tinea unguium): Diagnosis

The most common clinical feature of tinea unguium is discolouration of the affected nail which usually becomes yellow. The affected nail usually thickens and becomes disfigured in appearance. In long-standing instances, the dermatophytes can invade the skin folds at the side of nails which may progress to separation of nail from the nail bed. Very rarely, the affected nail may get secondarily infected with bacteria - resulting in increased localised pain and redness along with swelling of surrounding skin.

Tinea unguium can be diagnosed by detailed physical examination of the nails. Sometimes a small sample of the nail may be required for lab examination and culture. The offending dermatophyte can be cultured from the nail sample and thereby help in establishing the diagnosis.

Causes and prevention of fungal nail disease (tinea unguium)

Fungal nail disease is most commonly encountered in regions of warm and humid climate because fungi which are plant-like organisms which usually thrive in such climatic conditions. Tinea unguium is caused by fungus group called dermatophytes, examples of which are Trichophyton rubrum, Trichophyton interdigitale and Trichophyton tonsurans. Moreover, daily chores which cause prolonged exposure of hands or feet in water pose increased risk for fungal nail infections. Such nail disease is mostly associated with another condition called athlete’s foot. Individuals with diabetes - which leads to reduced blood circulation in lower limbs - show higher frequency of toe nail infections as compared to normal individuals.

Fungal nail infections can be effectively prevented by following certain measures which include proper wiping of the toes and the fingers after bath. It is advisable to wear cotton socks and change them frequently if there is a tendency for excessive sweating. It is better to take off shoes for small periods of time during the day. Wearing tight-fitting footwear. The nails should be kept trimmed and the side skin edges should not be cut. Diabetics are advised to consult a foot specialist if they encounter any problem in their feet.

Fungal nail disease (Tinea unguium): Complications

Tinea unguium has a high recurrence rate. It is a long-standing infection which may take weeks and months to heal. Such infection causes physical disfigurement of nails resulting in psychosocial problems in the affected individual. Occasionally, affected nails may get secondarily infected with bacteria resulting in severe and painful condition.

Fungal nail disease (Tinea unguium): Treatment

Fungal nail disease can be treated with topical anti-fungal powder or ointments. Such topical treatment modality can be effective only when the nail infection is mild. However, nail infection if severe, will need additional oral anti-fungal medications like Terbinafine and Itraconazole which need to be given for 3 to 6 months for effective cure. The individual may suffer from adverse effects of anti-fungal medications and thus require regular tests especially that of the liver. Antibiotic medications are prescribed if the nails get secondarily infected with bacteria. Strict following of preventive measures may help in averting relapse of the fungal nail disease.