Fungal Nail

What is a fungal nail infection?

Fungal nail infections are common infections of the finger or toenails. These problems develop when fungal spores lodge between the nail and the nail bed. Here the fungus begins to feed off the keratin within the healthy nail, infecting it.

The same fungus that causes athlete’s foot also causes this fungal nail infection. Athletes foot is a condition that mostly affects the area between the toes which can then spread to the toenail.

Another type of fungus that can cause infected nails are yeasts. When nails are damaged, this type of fungus can penetrate and infect them more easily.

How do you get fungal nail infections?

The fungus can rapidly grow and spread easily in the right environment. Direct skin contact with any warm moist environment can be a likely place to pick up a fungal infection. You may pick up a fungal infection from:

• Wet/damp shoes
• Unclean showers
• Swimming pools/ spas
• Public restrooms, locker rooms or changing areas
• Poor foot hygiene
• Wearing wet/ damp socks
• The transfer from an athletes foot infection

What do fungal nail infections look like?

Nail fungus tends to start at the top of the nail, gradually moving down the sides of the nail. If left untreated, it will reach the base of the nail known as the nail matrix.

Nail infections often show thickening or distorting of the nail. Often a yellow or brown colour will develop over time moving down the nail as the infection moves.

The nail will become weak, often causing the nail to split and break. There may also be redness and swelling around the infected area.

If the fungus moves from the affected nail to the skin, a skin infection can develop and spread the infection further into other nails.

Many of these effects come from the fungal cells. However, your immune system can also cause reactions. Swelling, redness and pain can be caused by your immune system’s reaction to the presence of these fungi.

Fungal nail treatment

Fungal nail infection treatments can come in many forms. This includes antifungal creams, tablets and nail lacquers. How much of the nail surface is affected largely determines which treatment is best.

Fungal nail tablets

Tablet treatments for nail infections are usually reserved for infections that reach the bottom of the nail. These infections are often harder to treat with other medicines. They may also be used to treat some fungal skin infections, or cases where the infection spreads from the nail to the skin.

Oral antifungal medicines are taken for 6 weeks to 12 months depending on the severity of the infection.

Tablets such as terbinafine use the same active ingredient as Lamisil and Lamisil Once.

The most common side effects of medicated treatments may include skin reactions, stomach issues and muscle and joint pain. Allergic reactions can be a serious side effect, and should be treated by a medical professional.

Fungal nail lacquer

The most common treatment for fungal nail infections is the application of antifungal nail lacquer. These medicines are applied to the nail for between 6 and 12 months.

Before using this medicine, it is best to file down any thickened layers of the nail caused by the infection.

Side effects of these medicines may include;

• brittle nails
• nail discolouration
• minor swelling to the hands or feet
• skin irritation

Laser treatment

A relatively new option for treating nail fungus is laser treatment. Laser devices emit pulses of heat that penetrate to the nail bed where the fungus is present. This treatment is usually required to be repeated a number of times to eliminate the nail fungus.

The cost of treatment can be quite high as it is not covered under the NHS. You should speak to your doctor to assess the severity before using laser treatments.

Fungal nail removal

As a last resort in severe infections, a doctor or podiatrist can remove the infected nail(s). This can remove a large majority of the fungal infection or eliminate it entirely. Your healthy nail will then being to grow back over the next 6-12 months.

How to prevent fungal nail infections from coming back

There are a number of ways you can try to greatly reduce your chances of another nail infection.

These include:

• Practising good foot hygiene. Always ensure you wash your feet properly, including in between the toes. Ensure you dry them properly afterwards.
• Buying fitting shoes. Shoes that are the right size allow your feet to get fresh air, yet are not big enough to be uncomfortable. Doing this will reduce the moisture in your shoes.
• Cut your nails regularly with clean nail clippers. Cutting and cleaning your nails regularly prevents dirt and fungus from building up under nails. If left to build up, they can begin a nail infection.
• Not walking in public areas barefoot. Public areas, especially warm and moist places like swimming pools, change rooms, and bathrooms, often have fungus spores on the floor.
• Avoiding sharing shoes, socks and towels with others. The fungus can be shared through all these, so they are best avoided whenever possible.
• Throwing away socks and shoes potentially containing toenail fungus OR treating these items with topical antifungal powders thoroughly.
• Changing your soiled socks regularly. If your socks become wet or damp, change them as soon as possible to avoid creating a warm moist environment.