Onychomycosis

What is onychomycosis?

Onychomycosis or nail fungus is a common fungal infection of the toenails or fingernails. It causes nails to thicken, discolour and become brittle at the edges.

If the condition is mild, treatment may not be needed, however, if the nails become too thick and cause pain and discomfort, medical intervention will be required. Nail fungus is more common among adults, particularly the elderly and is associated with diabetes and a suppressed immune system. It is also more common in toenails but can occur in fingernails.

What are the symptoms of onychomycosis?

The initial symptoms are characterised by nails becoming yellowish or whitish, distorted in shape, fragile, brittle or slightly foul smelling. Those with diabetes, reduced circulation to the feet and older people are at a greater risk of developing a bacterial infection (cellulitis) in the surrounding skin from a fungal nail infection, so onychomycosis can lead to further complications.

What are the causes of onychomycosis?

The most common cause of onychomycosis is a fungus called dermatophyte. These fungi or dermatophytes usually come from walking barefoot on the ground or from another person, especially in warm and humid environments.

For this reason, onychomycosis is often contracted in swimming pools, changing rooms and showers of sports facilities, since it is easier to get a fungal infection from a wet floor. Athlete's foot is a fungal foot infection often picked up from swimming pool floors, which can lead to nail fungus.

Can onychomycosis be prevented?

The following tips can help prevent nail fungus and athlete’s foot:

• Wear footwear in pool areas and gym changing areas.
• Wash your hands and feet regularly and use dry your feet properly after a shower.
• Trim your nails straight across and file down the edges, and disinfect your nail clippers after every use
• Stop using artificial nails and nail polishes
• Choose comfortable shoes and change socks throughout the day
• Use antifungal creams or disinfectant

What is the treatment for onychomycosis?

Topical antifungal creams can be applied to the infected skin and nails. Some can be applied like nail polish. The downfall of topical treatments is that it generally doesn’t cure the fungal infection and additional oral medication is required. Oral medication can have adverse side effects like nausea and won’t be prescribed to those with heart failure or liver conditions.

In severe cases, if the nails become too thick, they can be surgically or chemically removed. Nails are removed chemically using a urea compound. Surgically removing the nails isn’t an effective treatment on its own and should be combined with prescribed oral medication.

Laser treatment is one of the newest treatments for nail infections. The laser can penetrate the nail tissue and kill the fungal infection, but laser may need to be carried out more than once and has a lower cure rate at present.