Nail Fungal Infections: A Guide to Prevention and Treatment

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How Nail Fungal Infections Occur

Nail fungus (onychomycosis) is a common problem, affecting an estimated 40 million Americans. Most susceptible are men, individuals over forty, athletes, women who use acrylic nails, and those with a family history of infections or conditions which affect circulation, such as diabetes. Some individuals may also have inherited tendencies which make them more susceptible to developing nail fungus. The culprits are called dermatophytes, and they’re found virtually everywhere in the environment. These are the same organisms that cause athlete’s foot – a common skin infection of the feet.

Symptoms of a fungal nail infection typically begin with nail discoloration. Fungal dermatophytes convert healthy nail into keratin debris, upon which they live and feed. As keratin debris collects beneath the nail(s), they become thickened and may cause mild to severe discomfort, depending on the degree of infection. In advanced cases, nails become crumbly and may lift completely off the nail bed. As nail fungus advances it can become a social as well as a cosmetic problem. People with nail fungus will often shy away from pool or beach activities to avoid the embarrassment of ugly nails. For women in particular, fingernail fungus creates an even more serious social embarrassment. Hiding the problem behind false nails can make matters worse, as moisture becomes trapped between the acrylic surface, cement and the normal nail.

Changes You Can Make in Your Daily Routine to Help Prevent A Nail Fungus Infection:

·Avoid going barefoot in public places, especially health clubs, swimming pools and spas

·Dry toenails thoroughly after bathing or showering: Fungus thrives on moisture and warmth

·Don’t wear shoes that fit too tightly and don’t wear the same shoes every day; Throw away old shoes that may harbor fungus

·Regularly treat the insides of shoes with antifungal spray (an athlete?s foot spray will work well)

·Don’t let athlete’s foot infections go untreated, which can spread to the nails where it is much more difficult to get rid of

·Avoid injuring nails; dermatophytes look for opportunities to invade through damaged cuticle margins. Wear protective shoes when playing sports or doing construction projects and gloves when gardening or doing other chores that may lead to nail injury or irritation

·When having nails manicured, bring your own nail care tools to avoid picking up infections from others. Use caution with acrylic or sculptured nails to avoid breaking the skin barrier which protects against fungal invasion. Use separate tools for healthy and infected nails

Treatment Options

Nail fungus infections have been notoriously difficult to treat, and it takes time for new, healthy nail to emerge. It is important to be patient and stay with the course of treatment you have chosen, to let it run its full course. Toenails can take between twelve to eighteen months to grow out, while fingernails normally grow out in about five and a half months. Also remember that damaged nails are more susceptible to reinfection, so try to avoid further injuring nails during the treatment period. The older you are, the slower your nails grow.

Prescription oral antifungals, such as Terbinafine (Lamisil), Itraconazole (Sporanox) and Griseofulvin (Fulvacin, Grinactin). Though the rate of effectiveness is reported to be high, be aware that the use of systemic antifungals carries with it the risk of potentially serious side effects, including liver damage. Elderly individuals and those with conditions such as diabetics or compromised immune systems are not good candidates for this course of treatment. Cost ranges from $350. – $700. Further information on these antifungals may be obtained at www.us.janssen.com (Sporanox); www.pharma.us.novartis.com (Lamisil) and www.doctorfungus.org hedrugs/Griseofulvin.htm.

Penlac Nail Lacquer (ciclopirox 8%) is a topically applied lacquer available through a prescribing physician. Though without the side effects associated with systemic antifungals, clinical trials of Penlac indicate its effectiveness is much lower. Further information may be obtained at www.dermik.com/prod/penlac/penlac.html.

NonyX Nail Gel is an all natural, non-prescription topical gel, which takes an exfoliating approach to the problem. NonyX Gel penetrates the nail and removes keratin debris – the food supply of fungus. NonyX is a less expensive alternative, and the manufacturer’s website indicates a podiatrist-conducted study achieved good results. Further information may be obtained at www.xenna.com.

A final note: It is important not to let a fungal nail infection go untreated, because nail fungus will not resolve on its own and the condition will only become worse if ignored. See your podiatrist or physician who may wish to perform lab tests to be certain that you have nail fungus instead of another nail or skin condition, such as psoriasis.

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Author: Piyawut Sutthiruk

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