Physician Journal : Is There a Fungus Among Us?
A very common problem evaluated in our office is that of fungal toenails. Women and men alike will relate toenails, which are “funny” or “ugly” looking. The nails are abnormal in appearance, but can also be painful with shoes and during activities. But, not all abnormal nails are due to fungus. So, let’s dive into this common problem and get to the bottom of it!
Fungal Nails…What do they look like? Nails infected by fungus can be white and/or yellow to brown in color. The nails can get thick, develop ridges, crumble and spilt easily. They can have debris underneath the nail and separate from the skin below.
What causes it? Yeast, mold and several types of fungi can cause fungal toenails, A.K.A Onychomycosis and Tinea Ungium. The most common culprit is a fungus called Tricophyton Rubrum. This is the same organism that causes athlete’s foot.
Where did I get it? Fungus is everywhere! But it really likes warm, moist places such as, pools, showers, locker rooms, beaches and your shoes! Nail polish and acrylic nails do not let the nail “breath” and can increase your risk for fungus. It can be spread from person to person and from skin (athlete’s foot) to nail.
Is it always fungus? Nope! There are many other causes for abnormal nails. Trauma to the nails can cause bruising, thickening and lifting. Certain diseases such as Psoriasis can lead to abnormal pitted nails. Nails also tend to become thicker and more brittle as we age.
How can we tell for sure it is fungus? Your physician can obtain a sample of the affected nail and tissue and submit it for testing. A KOH and fungal culture would be ordered to evaluate for yeast, fungi or mold. Many insurance companies will require a positive fungal test prior to authorizing medications.
How is it treated? Depending on the severity of the nail infection topical and oral medications exist. Many times fungal nail infections can be very difficult to treat. In mild cases the topical medicine Penlac can be applied daily for up to 12 months.The oral medications (Lamisil, Sporanox and Diflucan) are given, usually, on a daily basis for several months. With these medications, the patient’s liver function should be assesses prior to starting treatment and retested during the course of the medication. Numerous home remedies have been attempted such as, Vicks VapoRub, Tea Tree Oil and vinegar but with little success.
Can I prevent it from happening again? Allow your shoes to air out, not wearing the same pair daily. You can also apply antifungal powder to the shoes. Keep your feet clean and dry, drying well in-between the toes after bathing. Protect yourself at pools, showers, and locker rooms. Most importantly, treat athlete’s foot in a timely fashion!
Posted by Jennifer Kirchens, DPM @ 7:53 PM
August 12, 2008