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If you have noticed your toenails changing in colour or appearance, consider that they may be infected with fungus and should be treated readily to ensure that the infection does not spread to nearby toes, or to the feet of family and friends. Fungus can be highly contagious.

Prevalence of toenail fungus

A toenail fungal infection, also called “onychomycosis” or “tinea unguium” in the medical world, occurs in approximately 10% of the general population. However, it is more common in older adults; the prevalence is 20% in those older than 60 years and 50% in those older than 70 years. However, with some conditions it can occur more often. For example, the risk of developing fungal toenails is up to 2.8 times higher in persons with diabetes compared with the general population. Simply put, some medical conditions decrease your ability to fight infection or cause your toenails to become more brittle, making you more susceptible and increasing the likelihood that a fungal agent can prosper.
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Onychomycosis: Current Trends in Diagnosis and Treatment. DRS. WESTERBERG and VOYACK. Cooper Medical School of Rowan University, Camden, New Jersey. Am Fam Physician. 2013 Dec 1;88(11):762-770.

Causes

A fungal infection of the skin and nails occurs from colonization by one of three types of organisms – dermatophytes, yeast or non-dermatophytes. Dermatophytes are the family of fungi capable of using the dead layers of the skin and nails, or “keratin,” as nutrition. Yeast is a normal skin contaminant that, like the non-dermatophytes, flourishes when the body’s defenses are weak.

Mechanism of infection

While there may be many types of fungus, they all infect the toenail in a similar way. Fungus grows best in warm, moist places and can spread from person to person – e.g. by sharing shoes or nail clippers, or walking barefoot in a public area. Infection can also spread from skin to nails or nails to local skin. Additionally, pedicure-goers become contaminated if the spa that they’re attending does not follow proper sterilization procedures. The toenail is exposed to fungus – either by way of a dirty instrument (such as a nail clipper at a salon that was not properly sterilized), or by way of a dirty footbath, or shared shoes/socks/slippers with someone who is already infected. In all cases, the fungus gets under the toenail and flourishes, changing the nails’ appearance.

Toenail appearance

Fungal toenails may appear thickened and/or discoloured. Typically, fungal toenails will have white, yellow or brown spots and may be brittle. Underneath the nail, at the very tip of the toe, some patients may notice a crumbly white substance. Keep in mind that toenails can change colour and texture following trauma, such as stubbing your toe, or in some cases, as a result of a medical condition. So, any toenail changes require a trip to a Chiropodist or Footcare Nurse to identify the possible cause(s), and create an appropriate treatment plan.

Treatment

Fungal toenail infection treatment can take up to a year or more if complicated by lack of penetration of medication and constant reinfection. Your Chiropodist will be able to assist you by prescribing or recommending the correct antifungal for your condition. However, even if your family doctor is managing this infection, routine medical footcare is vital to ensuring that the medicine can penetrate the thick nail and work better. It is recommended that you visit with your BioPed Chiropodist or Footcare Nurse every 6-8 weeks to manually clear away fungal residue, which can cause reinfection. BioPed Chiropodists and Footcare Nurses have fungal toenail training and sterile equipment for safe skin and toenail care.

For more information, contact your local clinic today.