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Fungal nails, medically known as onychomycosis or tinea unguium, occur when fungal organisms infect the nails, leading to thickening, discoloration, and potential damage. The condition typically affects toenails but can also involve fingernails. If left untreated, the fungal infection may spread to other nails and the surrounding skin.
Causes and Risk Factors of Fungal Nails
Fungal nails are caused by dermatophytes, yeasts, or molds that thrive in warm, moist environments. These organisms typically enter the nails through a portal of entry, due to trauma or cuts.
Risk factors for fungal nails include:
Nail Trauma: Injury to the nail can create an entry point for fungi.
Footwear: Tight, closed-toe shoes can cause microtrauma to the nails and create a warm, damp environment conducive to fungal growth.
Poor Foot Hygiene and Improper Nail Cutting: Lack of proper foot and nail care increases the risk of infection.
Underlying Conditions: Conditions such as diabetes, a weakened immune system, or circulatory issues increase susceptibility.
Age: Older adults are more prone due to slower nail growth and reduced immunity.
Prolonged Nail Polish Use: Nail polish traps moisture, creating an environment ideal for fungal growth.
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Signs and Symptoms of Fungal Nails
Signs and Symptoms of Fungal Nails
Discoloration: Yellow, white, or brown patches on the nail.
Thickened Nails: Nails become brittle, thick, and difficult to trim.
Deformity: Uneven nail surfaces may develop, and in some cases, the nail may grow into the skin, leading to an ingrown toenail.
Separation: The nail may lift or separate from the nail bed (onycholysis).
Crumbling: Advanced infections may cause nails to crumble or break.
Odor: In some cases, an unpleasant odor may be present.
Treatment and Management of Fungal Nails
Fungal nails can be challenging to treat, as the fungus often resides deep beneath the nail, making it difficult for topical treatments to penetrate effectively. Compliance is also a common issue. Early intervention is essential to prevent the infection from progressing deeper towards the nail base.
Proper Foot Hygiene: Keep feet clean and dry, change socks regularly, disinfect shoes, and avoid sharing nail tools.
Topical Antifungals: May be effective for mild or superficial infections.
Nail Debridement: Professional medical trimming and thinning of thickened nails by a podiatrist to improve the effectiveness of fungal nail treatments.
PACT Therapy (Photodynamic Light Therapy): A non-invasive option that targets and destroys fungal infections using laser technology.
Oral Antifungal Medications: For severe, chronic, or widespread infections. These are more effective but require monitoring for potential side effects.
Total Nail Avulsion: In cases of severe or unresponsive infections, complete nail removal may be performed to eliminate the source of infection and allow treatment of the nail bed.
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