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Fungal nail infections (onychomycosis): Treatment, symptoms, advice and help

About fungal nail infections (onychomycosis)

Fungal nail infections are the most common problems involving the nails. Onychomycosis is a term used for infection of the nails of the fingers and the toes which is caused by fungi belonging to the group yeast (also called candida), mould or dermatophytes. Nails are keratinised coverings over the tip of fingers and toes which are responsible for protection of soft tissues underneath them.

Fungal nail infections (onychomycosis): 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 adults with the same prevalence in both men and women.

Signs and symptoms of fungal nail infections (onychomycosis): Diagnosis

The most common clinical feature of onychomycosis is discolouration of the affected nail which may become yellow, grey or black depending upon the type of fungus involved. The affected nail usually thickens and becomes disfigured in appearance. In long-standing instances the infected nail may become brittle and may separate from 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.

Onychomycosis 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, if the diagnosis is in doubt.

Causes and prevention of fungal nail infections (onychomycosis)

Fungal nail infections are most commonly encountered in regions of hot and humid climate because fungi which are plant like organisms usually thrive in such climatic conditions. The fungi namely candida, mould and dermatophytes are responsible for these nail infections. Moreover, daily chores which cause prolonged exposure of the hands or the feet in water pose increased risk for fungal nail infections. 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 toes and fingers after bath especially the interphalangeal space and keeping them dry throughout the day. It is advisable to wear cotton socks and change them frequently if there is a tendency for excessive sweating. Avoid wearing footwear continuously for long periods of time. Avoid wearing tight-fitting footwear. The nails should be kept trimmed and the side skin edges should not be cut.

Fungal nail infections (onychomycosis): Complications

Fungal nail infections have a high recurrence rate. Moreover, this is a long-standing infection which may take weeks and months to heal. Such infection causes physical disfigurement of the 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 infections (onychomycosis): Treatment

Fungal nail infection can be treated with topical antifungal powder or ointments. Such topical treatment modality can be effective only when the nail infection is mild. However nail infection if severe, it will need additional oral anti-fungal medications like Griseofulvin or Ketoconazole. These medications need to be given for about 6 to 12 months for curing the nail infection. But with the onset of newer drugs like Terbinafine, Fluconazole and Itraconazole, the duration of treatment is reduced. Antibiotic medications are prescribed if the nails get secondarily infected with bacteria. It is important for the individual to follow preventive measures after the treatment is over and the infection cured. This will help in preventing repeated episodes of fungal nail infection.