Nail fungal infections, also called as onychomycosis (onycho means nail and mycosis means fungal growth) are due to overgrowth of fungus in your nails. Common fungi that can cause this nail infection are called as dermatophytes. Nail fungal infections is very common and may involve both the nails of hands and foot. But most commonly is seen in foot nails because of humidity while wearing shoes and socks. Toe nail is most susceptible to this infection. It can lead to nail deformity and it is difficult to treat.
Risk factors for Nail Fungal Infection
Following are the major risk factors that can favor this fungal infection.
- Excessive heat
- Low immunity like in AIDS
- Diabetic person
- Trauma to nail
- Poor hygiene
- excessive shoes wearing
- Old age
Sign and Symptoms of Fungal nail Infection
Your nails look pale, yellow or black but yellowish discoloration is most common presentation. Nails may be thick, rough and brittle. Nail may be deformed like humped or broken, there may be local discharge. Nail may be separated from its bed. Dull looking nail with streaks, laxity in nail bed is common. Systemic symptoms and sign may also be presented in some patients. Nail may be tough, with or without pain and may be associated with foul smelling.
Usually your doctor will diagnose it just by direct examination, and may perform fungal scraping to see the fungus under microscope and confirm the case.
Prevention and Treatment
Prevention is better than cure so following points must be kept in mind if you really want to avoid fungal infections.
- Always maintain good hygiene
- Take care of your foot and nails
- Degrade long nails proper nail cutting with sterilized cutter.
- Don’t go bear footed in dirty places
- Proper care of foot and nail wounds
- Temperature regulation
- Care in old age
- Take proper control of your diabetes if you have it, because diabetes predisposes to infection.
Treatment of nail fungal infection is long term usually requiring 3 months or more. Most commonly used drugs are those of azoles family and some other antifungal agents like Itraconazole, fluconazole and terbinafine. Other drug like griseofulvin is also used with success. These drugs are for oral use only. NSAIDs used as symptomatic treatment as it slow down deformity process and reduce pain and discharge. During treatment, history of patient about drug allergy and other hepatic diseases is very important. Because these drugs have side effects like hepatotoxicity and renal problem and some have bad effect on heart pump action.
There is also topical treatment for this disease. Antifungal nail polish and topical creams can be used, these have low efficacy due to less absorption. But these can be used for mild to moderate infection.
Nail can be surgically removed with excision of nail while preserving nail bed. And in some severe conditions onychectomy removal of nail with nail bed is performed.