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Nail Fungus: An Overview
Nail fungus is an infection that could occur in either the toenails or fingernails. Technically it is referred to as tinea unguium or onychomychosis.
These infections are caused by a fungus which belongs to the group called dermatophytes(as for example Trichophyton rubrum and Trichophyton interdigitale). Our nails are tough in structure. Nevertheless these funguses have the capacity to eat up the keratin in the skin of the nail bed and in the nails. That’s how the infection continues. Apart from fungus, yeasts (candida albicans) and moulds can also cause nail fungus. Nail fungus appears more in toenails than in fingernails.
Who are susceptible to nail fungus?
- Some people are more likely to get nail fungus than others, especially people suffering from diabetes. This is because high blood sugar could cause a weakened immune response to infections like nail fungus.
- The same is the case of AIDS patients who also have with markedly sluggish immune responses.
- People with athlete’s foot should get it treated appropriately. Otherwise the toenails could get infected as well.
- Another interesting point is men are more likely to get toenail fungus than women possibly due to a genetic factor.
Appearance of the nail fungus
Initially the fungus infection will appear either as a white or yellow spot just beneath the tip of either the fingernail or toenail. When the fungus eats up the nail keratin and penetrates the nail further, the nails develop some characteristics. These characteristics could be thickening of the nails with the edges tending to crumble, become brittle and ragged. Discoloration of the nails could be seen as well.
There could be distortion in the shape of the nail with the nails tending to become lusterless and dull. The infected portion of the nail could detach itself from the nail bed and pain could radiate to the toes or fingertips as the case may be.
Sometimes it could give out a slightly foul odor.
When does nail fungus generally appear?
Nail fungus could occur when your toenails and or fingernails are exposed to warm and moist conditions on an extended basis. For example, wearing of shoes provides warm, moist and dark conditions that are conducive for growth of fungi. That apart, wearing a shoe for long periods in these conditions could lessen blood circulation to the toes making it difficult for the body’s natural immune system to work effectively.
Differentiate nail fungus from other nail disorders
Nail fungus is the commonest disease of the nail. But it should not be confused with other nail disorders.
- For example, it should not be confused with athlete’s foot. Athlete’s foot occurs in the skin of the foot and sometimes it is possible that nail fungus and athlete’s foot could occur concurrently.
- Nail fungus should not be mistaken for bacterial infections caused by Pseudomonas aeruginosa which could make the nail black or green in color. Only a doctor can confirm whether you indeed have nail fungus infection.
- In the elderly the nail could thicken and scale beneath the nail. This is not caused due to fungus but is due to peripheral vascular disorders.
- Nail fungus should not be confused with psoriasis of the nail and other conditions like onycholysis wherein the nail plate separates from the underlying structure.
Why is it difficult to treat nail fungus?
The reason why nail fungus is difficult to treat is because it could reoccur despite being rid of the problem earlier. Another reason is it takes up to a year for a new toe nail to grow. This makes both treatment and cure difficult.
Why are fungal infections such as nail fungus common?
Dermatophytes or the organisms that cause nail fungus infections are abundantly found in the floor of commercial areas as for example public bathing places like by the side of swimming pool etc. Research studies have shown that there could be about 100 fungal fragments/m2 plus minute pieces of keratin in these areas. In those areas with staircases the figure could be greater than 700 fungal fragments/m2 of floor space. Any one of these fragments could cause infection. This probably explains why there are more fungal infections like nail fungus infection.