Nail Fungus

Fungal infections can affect your nails, making them look unhealthy. A fungal infection often starts as a small, discolored spot (white, yellow, or brownish) under the tip of a fingernail or toenail. As the infection spreads, the nail can become thicker, rough, and possibly crumble or separate from the nail bed. This can happen to one or more nails.

Sometimes, a mild fungal nail infection isn't noticeable or bothersome, and no treatment is needed. However, if the infection is painful or the nails are significantly thickened, there are things you can do to try to improve the situation. These might include self-care techniques and medications. Even if treatment works, fungal nail infections can sometimes return.

A fungal nail infection is also known as onychomycosis. A similar fungal infection that affects the skin between the toes and the soles of the feet is called athlete's foot (or tinea pedis). It's important to note that athlete's foot and nail fungus are related and sometimes one can lead to the other.

Nail fungus is a common problem that affects the nails, usually on the toes. It causes changes in the appearance and texture of the nails.

Here are some common signs of nail fungus:

• Thick nails: The nail may become noticeably thicker than usual.
• Changes in color: The nail might turn yellow, white, or another unusual color. It could also have patches of different colors.
• Weakened nails: The nail might become brittle, easily broken, or have a ragged appearance. It might also crumble.
• Warped nails: The nail's shape might become misshapen or deformed.
• Separation from the nail bed: The nail might lift or separate from the skin beneath it.
• Unpleasant odor: A foul smell coming from the affected nail is another possible symptom.

While nail fungus can affect fingernails, it's more often found in toenails. This is because the toes are typically enclosed in shoes and have less air circulation, which can create a moist environment ideal for the fungus to grow.

If you think you have nail fungus, and home remedies aren't working, it's a good idea to see a doctor. Also, see a doctor if:

• You have diabetes: People with diabetes may be more prone to nail fungus and should seek medical attention early.
• You notice bleeding around the nails: Bleeding is not normal and could indicate a more serious problem, so it's important to get checked out.
• There's swelling or pain around the nails: Pain or swelling could indicate infection and requires medical attention.
• You have difficulty walking: If nail fungus is causing pain or discomfort that affects your ability to walk, see a doctor.

It's important to remember that these are just some of the possible symptoms. If you have concerns about your nails, consulting a healthcare professional is always the best course of action to get a proper diagnosis and treatment plan.

If simple home remedies aren't working and your toenail (or fingernail) is getting noticeably more discolored, thicker, or oddly shaped, it's a good idea to see a doctor. You should also schedule an appointment if:

• You have diabetes and think you might have nail fungus. Diabetes can affect how your body heals, making nail infections more likely. It's important to get this checked out early.

• You see bleeding around your nails. Bleeding near your nails could be a sign of a more serious issue, such as an injury or an underlying health problem.

• You have swelling or pain around your nails. Swelling and pain can indicate an infection or other problem that needs medical attention.

• You're having trouble walking. Pain or problems with your feet, including those related to your nails, can make walking difficult. This could be a sign of a more serious issue, and you should see a doctor to find out what's causing it.

Getting a pedicure can be a relaxing treat, but it's important to be mindful of potential health risks. Before you get your toes pampered, make sure the spa is properly licensed. This helps ensure they're following safety procedures.

A doctor specializing in nails, Dr. Rachel Miest, says bacteria and fungi are common concerns. To reduce the risk, ask if the spa thoroughly cleans all tools and equipment between clients. Even with careful cleaning, germs are everywhere.

To further minimize risk, don't shave your feet right before a pedicure and avoid having your cuticles cut. Cuticles act like a protective seal, so it's best to leave them alone or gently push them back, not aggressively cut or trim them.

Your nails can reveal important information about your overall health. Normal nails might have lines or ridges, but there are other changes that could signal underlying problems.

Dr. Miest explains that changes in your nails can be indicators of various health conditions. These include:

• Pitting: Small pits in the nails can be a sign of psoriasis.
• Clubbing: Swollen, rounded fingernails might indicate low oxygen levels, potentially linked to lung problems.
• Spooning: Nails that curve inward, like spoons, could suggest iron deficiency anemia or liver disease.
• Beau's line: A horizontal groove across the nail indicates a past injury or infection.
• Nail separation: If your nail separates from the nail bed, it could be due to an injury, infection, or a medication.
• Yellowing: Yellow nails might be a sign of chronic bronchitis.

Nail infections are often caused by fungi, including dermatophytes (a common type), yeasts, bacteria, and molds. A bacterial infection might cause green or black discoloration. Nail fungus can spread from the feet (athlete's foot) to the nails, and vice versa. You can also get nail fungus from places where fungi grow easily, like damp gym floors or inside sweaty, moist shoes. This is why it's crucial to practice good hygiene and keep your feet and nails clean and dry.

Nail fungus, a common problem, can affect anyone. Several things can make you more likely to get it.

One factor is age. As you get older, your risk of developing nail fungus tends to increase. This is because your body's natural defenses might weaken over time.

Sweaty shoes are another significant risk. If your shoes don't allow your feet to breathe properly, they trap moisture and heat, creating a perfect environment for fungus to grow. This is especially true if you're on your feet a lot.

If you've had athlete's foot before, you're more susceptible to nail fungus. This is because the same type of fungus that causes athlete's foot can also infect your nails.

Walking barefoot in damp public places like swimming pools, gyms, and locker rooms can also increase your risk. These areas often have high humidity and may contain fungal spores that can easily transfer to your feet and nails.

A minor cut or scrape on your foot or nail can create a pathway for the fungus to enter your skin and nails. Even small injuries can allow infection to occur.

Certain skin conditions, like psoriasis, can sometimes affect the nails and make them more vulnerable to fungus. Psoriasis can cause changes to the nail's structure that make it easier for fungus to take hold.

Finally, health conditions like diabetes, poor blood circulation, or a weakened immune system can also increase your risk. These conditions can impact your body's ability to fight off infections, making you more prone to nail fungus. If you have any of these conditions, it's important to be extra cautious about foot hygiene.

Nail fungus, when severe, can be quite uncomfortable and potentially harm your nails permanently. If you have a weakened immune system—for example, from taking certain medications, having diabetes, or other health issues—the infection could spread beyond your feet and cause other, more serious problems.

Preventing nail fungus and athlete's foot involves several simple steps. These conditions can sometimes lead to nail fungus. Here's how to stay healthy:

Nail Care:

• Keep your nails clean and dry: Regularly wash your hands and feet. This is crucial. If you touch an infected nail, wash your hands immediately. Thoroughly dry your hands and feet, and apply an antifungal foot powder. Moisturizing your nails can also help. A nail hardener might help strengthen your nails and cuticles, making them less susceptible to damage that could allow fungus to enter.

• Trim your nails properly: Cut your nails straight across. Smooth any rough edges with a nail file, and file down any thickened areas. Crucially, disinfect your nail clippers after each use to prevent spreading infection. Long nails offer more places for fungus to hide and grow.

Foot Care:

• Keep your feet dry: Wear absorbent socks, and change them throughout the day. This helps keep your feet dry, which is important in preventing fungus.

• Choose breathable shoes: Opt for shoes made of materials that allow your feet to breathe. This helps prevent moisture buildup, a major risk factor for fungal infections.

• Maintain shoe hygiene: Discard old shoes if possible. If not, treat them with disinfectants or antifungal powders. This helps keep fungus from taking hold in your shoes.

• Protect your feet in public areas: Wear footwear in pool areas, locker rooms, and public showers. These areas can have high levels of moisture and fungus.

Salon and Home Care:

• Safe salon practices: If getting a manicure or pedicure, choose a salon that uses sterilized tools for each customer. If doing pedicures at home, be sure to disinfect your tools thoroughly after each use.

• Avoid nail enhancements: Skip nail polish and artificial nails. These can trap moisture and provide a breeding ground for fungus.

Athlete's Foot Treatment:

• Treat athlete's foot immediately: If you have athlete's foot, use an antifungal product to treat it. Early treatment is essential to prevent the spread to your nails.

By following these simple steps, you can significantly reduce your risk of developing nail fungus or athlete's foot, and help prevent reinfections.

Your doctor will check your nails. They might take a small sample of your nail or the material under it. This sample goes to a lab to find out what's causing the problem.

Sometimes, other skin conditions, like psoriasis, can look a lot like a nail fungus. Tiny living things like yeast and bacteria can also infect your nails. Knowing exactly what's causing the infection helps doctors choose the best treatment plan.

Treating toenail fungus isn't always necessary. Sometimes, simple home care and over-the-counter products can help clear up the infection. However, if your toenail fungus doesn't improve, it's important to see a healthcare provider.

The best treatment depends on how severe the fungus is and what type it is. It can take several months to see results, and even if the nail looks better, you might get the infection again.

Different treatments are available, and your doctor will recommend the best one for you.

Oral Antifungal Medications:

These are often the first choice of treatment. One common example is itraconazole (Sporanox). These medications work by helping a new, healthy nail grow to replace the infected one. The new nail will gradually replace the infected part, and the process can take 4 months or longer.

You usually take these pills daily for 6 to 12 weeks. Crucially, you won't see the full results of the treatment until the entire infected nail is replaced by a healthy one. Treatment success rates for these medications might be lower in adults over 65.

Oral antifungal medications can have side effects, such as skin rashes or liver problems, and they can sometimes interact with other medicines you're taking. Your doctor might need to monitor your liver function with blood tests during treatment. They might not recommend these drugs if you have liver disease, heart problems, or are taking certain other medications.

Medicated Nail Polish:

Your doctor might prescribe a special antifungal nail polish, such as ciclopirox (Penlac). You apply this polish daily to the infected nail and surrounding skin. After a few days (about a week), you remove any excess polish with alcohol and start again. This treatment may need to be continued for nearly a year.

Medicated Nail Creams:

Your healthcare provider may prescribe antifungal creams, like efinaconazole (Jublia) or tavaborole (Kerydin). These creams are applied to the infected nail after soaking it. Sometimes, it helps to make the nail thinner before applying the cream so the medication can reach the fungus underneath. You can do this at home with a lotion containing urea, or your doctor can use a file or other tool to gently thin the nail (a process called debriding).

Nail creams can cause side effects like skin rashes.

Other Treatment Options:

In some cases, your doctor might suggest temporarily removing the affected toenail so the medication can be applied directly to the infected area underneath.

A more extreme option is surgery to permanently remove the infected nail and its root, but this is typically only used as a last resort.

It's crucial to discuss all treatment options and potential side effects with your healthcare provider to determine the best course of action for your specific situation.