Fungal Nails
Fungal Nail Infection
Fungal nail infections are a common nail conditions affecting one in five people during their lifetime. These infections often lead to thick, deformed, and discoloured nails, and can be a source of physical discomfort, anxiety and embarrassment. As the infection progresses, nails change from a healthy pink to a yellow/green colour, becoming thick, flaky, and detached from the nail bed. The gradual onset requires intervention to halt the relentless progression.
Causes
Fungi, are parasitic plant-like organisms that thrive in warm, dark, and moist environments—making feet, especially in socks and shoes, an attractive breeding ground. Dermatophytes, a specific type of fungi, are a common cause of nail infections. They often infect the skin of the feet first, causing the condition athlete’s foot, which commonly spreads into the toenails to cause fungal nail infections. The infection can affect the underlying nail bed and may spread to multiple nails, with the big and little toenails being the most commonly affected.
If left untreated, a fungal toenail infection can worsen to the point of causing pain while wearing shoes
Treatment
Topical Medication
Oral Treatments
Surgery
Topical Medication
Applying a nail paint containing amorolfine is a common treatment. The treatment is more effective if the nails are thin. Your podiatrist can thin the nails using high concentration Urea containing creams (40%), or alternatively by using a surgical drill.
Oral Treatments
Terbinafine and itraconazole are the principal drugs used. They interfere with the growth of the fungi which eventually leads to the elimination of the toenail infection.
Surgery
An extreme option with potential re-infection risks post-surgery. Two options are available. The first involves removing the nail and then applying antifungal medication to the nail bed and matrix of the toenail. The nail will regrow, but antifungal medication will have to be applied to reduce the chances of reinfection. The second option is to permanently remove the nail altogether.
Before & After Images
Fungal Nail Infection*
Fungal Nail Infection*
Prevention is Key
While there’s no foolproof way to avoid fungal nail infections, maintaining good hygiene significantly reduces the risk. Basic steps include:
- Thoroughly wash feet daily, paying attention to the spaces between toes.
- Ensure feet are completely dry especially before putting on socks.
- Choose breathable socks and footwear made from natural fibres like leather and cotton.
- Discard old, worn-out footwear that may harbour infections.
- Avoid going barefoot in public areas, especially damp communal places.
- Wear flip-flops in places where others go barefoot.
- Treat athlete’s foot promptly with antifungal sprays and powders, treating both feet and footwear.
- Keep nails short and use a separate clipper for infected nails.
- Avoid nail trauma that can predispose the nail to infection.
- Refrain from sharing towels, shoes, and socks.
- Wash socks at a higher temperature
- If excessive sweating (hyperhidrosis) is an issue, explore treatment options after understanding potential side effects.