What Is Toenail Fungus?
Toenail fungus is a condition that can cause the toenails to become thick, brittle, and discolored. It is caused by a type of yeast or mold that can invade the toenails and cause an infection. Toenail fungus is more common in people who have diabetes, psoriasis, or a weakened immune system.
Causes of Nail Fungus
There are many potential causes of nail fungus, including exposure to damp or wet conditions, trauma to the nail, and a weakened immune system. Fungal infections can also be passed from person to person.
What Are The Different Types Of Toenail Fungus?
1. Superficial Onychomycosis
Superficial onychomycosis is a fungal infection of the nail that causes the nails to become discolored, thickened, and brittle. The most common symptom of superficial onychomycosis is a white or yellow spot underneath the tip of the nail.
2. White Superficial Onychomycosis
White Superficial Onychomycosis (WSO) is a less common type of toenail fungus than Distal Subungual Onychomycosis (DSO). It is caused by a specific type of fungus known as mentagrophytes. Symptoms include small, white, speckled “islands” appearing on the nail plate, roughness, softness and crumbling. In contrast to DSO which usually causes moderate to severe inflammation in patients with the condition, WSO does not cause such inflammation and the nail only becomes soft, crumbly and rough. WSO can be contracted from other sources such as contact with infected soil or nails of someone else who has it.
3. Proximal Subungual Onychomycosis
Proximal subungual onychomycosis (PSO) is a form of toenail fungus which is more common in people with AIDS or AIDS-related complex. It differs from other types of toenail fungus in that it grows from the proximal nail fold, involving all layers of the nail. In contrast, distal subungual onychomycosis and white superficial onychomycosis are caused by fungal invasion of superficial layers of the nail plate; endonyx onychomycosis occurs without subungual hyperkeratosis or onycholysis; and candidal onychomycosis occurs due to Candida invasion as a result of frequent hand immersion in water.
4. Distal Subungual Onychomycosis
Distal subungual onychomycosis is a type of fungal infection of the nails that is typically caused by Trichophyton rubrum. It begins at the hyponychium and spreads proximally, resulting in onycholysis (detachment of the nail plate from the nail bed) and thickening of the subungual region. The space beneath the nails can serve as a reservoir for superinfecting organisms, giving nails a yellowish brown appearance. Treatment will depend on the severity and extent of infection, but generally includes topical or oral antifungals.
5. Candidal Onychomycosis
Candidal Onychomycosis is a fungal infection of the fingernails commonly caused by three types of fungi: Trichophyton, Epidermophyton, and Microsporum. This infection usually occurs in individuals who frequently immerse their hands in water. To confirm the diagnosis, a laboratory test should be conducted instead of relying on keratin granulations which are reactions to nail polishes that can cause the nails to have a chalky white appearance.
6. Total Dystrophic Onychomycosis
Total Dystrophic Onychomycosis is a subtype of end-stage nail disease caused by any of the four main patterns of onychomycosis. It is distinct from other types of toenail fungus in its clinical presentation, which includes subungual hyperkeratosis, yellow-brown discoloration and onycholysis. Additionally, Total Dystrophic Onychomycosis may be more likely to occur if the patient has a history of tinea pedis, particularly moccasin type. Diagnosing this condition requires examination for predisposing factors such as diabetes, older age, hyperhidrosis and more. Treating Total Dystrophic Onychomycosis involves managing risk factors associated with it and using antifungal medications or laser therapy.
7. Endonyx Onychomycosis
Endonyx Onychomycosis is a type of toenail fungus that affects the skin and nails, as opposed to other types of onychomycosis which typically only affect the nail. It can be difficult to diagnose due to its wide variety of symptoms, so a full clinical exam must be performed in order to rule out other potential diseases. Total dystrophic onychomycosis is a serious nail infection that can lead to the death of the nail and is an example of one type among seven different types of onychomycosis.
8. Nail Psoriasis
Nail psoriasis is a condition that causes the nails to become thick, yellow, and flaky. It can also cause the nails to separate from the nail bed. Nail psoriasis is often painful and can make it difficult to wear shoes or participate in activities.
9. Nail Trauma Fungus
A nail trauma fungus is a type of fungal infection that affects only the top layer of the nail. The infection is caused by a fungus, and can be treated with over-the-counter medication. Surgery is the only sure way to get relief from symptoms. Treatment depends on the severity of the symptoms. Prevention focuses on avoiding injury in the first place.
10. Nail Mould Infection
Nail mould infection is a type of toenail fungus that is different from other types of toenail fungus. It is caused by different types of fungi than toenail fungus, and can be found in tropical and temperate climates. People with diabetes and weakened immune systems are at greater risk for this type of infection, which can lead to serious complications including bone infection. Poor hygiene habits also increase the risk of nail mould infection. Treatment options include antifungal medications, topical creams or ointments, laser treatments, or removal of affected nails.
What Are The Symptoms Of Fungal Nail Infection?
1. Discolored Or Thickened Toenails
People suffering from toenail fungus may experience discoloration or thickening of their toenails, nail loss, brittleness, and an unpleasant smell or discharge. Other symptoms include pain when touching the affected area, dryness of the skin around the nail bed, and changes in shape or texture of the nails. If left untreated, toenail fungus can lead to other health problems such as infections in the surrounding tissue.
2. Brittle Or Crumbly Nails
Individuals with toenail fungus may experience thickened, colored, brittle, misshapen, and separated from the nail bed nails. Toenail fungus is commonly seen more in toenails than fingernails. Symptoms of toenail fungus can include white, yellow, brown or black patches on the nail; darkening underneath the nail; thickening of the nail; distortion of the nail shape and cracks; breaks and flaking; as well as separation of the nail from skin beneath it.
3. Distorted Toenail Shape
The shape of the toenail can be an indicator that a person has toenail fungus, as it is one of the most common symptoms associated with onychomycosis. The nail may appear thicker or brittle, curved or misshapen, and may even separate from the skin underneath. In addition to this physical sign of infection, individuals may also notice an unpleasant odour or experience discomfort and pain when wearing closed-toe shoes. Back pain can also be a symptom in some cases.
4. Toenails With White Spots Or Streaks
One of the symptoms of toenail fungus is white spots on the nails, which become more concentrated as the nail grows. The nail may also become rough and soft, prone to crumbling. As the toenail grows, these spots will move outward and eventually detach from the nail bed, resulting in the destruction of the affected areas.
5. Toenails With Yellow Or Brown Discoloration
People suffering from toenail fungus may experience thickening and brittleness of the nail, or even have it fall off completely. Other symptoms can include an odd spot on the nail that is not normal, as well as no visible signs or symptoms at all. In some cases, the nail may be the first place to show signs of fungal infection. It is recommended that people get their nails checked out by a doctor if they notice any irregularities in order to determine if there are any underlying conditions involved.
6. Foul Odor
A foul odor is a symptom of toenail fungus because the fungus attacks the keratin in your nails. This can cause an unpleasant smell when wearing shoes, as well as changes in color such as whitening, blacking, or yellowing.
7. Pain Or Discomfort
Pain or discomfort can be a symptom of toenail fungus due to the fact that it can cause nail separation, which can result in pain and other symptoms.
8. Itching Or Burning Sensation
The symptoms of toenail fungus can include skin lesions, itchiness, dryness, scaling, changes to the nails and pain. People should seek medical advice if they notice any of these signs or other changes to their skin or nails.
9. Flaking Or Scaling On The Nail
Flaking or scaling on the nails can be a symptom of toenail fungus, as it is one of the common signs that an infection is present. This type of infection usually affects the toenails and can cause white patches to form on them. Over time, these white patches may spread across the entire nail and may become rough and soft in texture.
10. Pus Or Discharge From The Nail
Pus or discharge from the nail may indicate a bacterial infection, which is different from onychomycosis. If self-care steps have not helped the nail to become increasingly discolored, thickened or misshapen, it is recommended that a person seek medical advice from a health care provider.
How can you prevent getting toenail fungus?
Step 1: Know The Common Foot Problems
Corns and calluses are some of the most common foot problems that can lead to toenail fungus. Additionally, plantar fasciitis is another common cause of heel pain that has been linked to toenail fungus. Poor hygiene practices, such as not washing or drying the feet properly and not using antibacterial soap, and improper footwear, including shoes that do not fit correctly or wearing them in wet conditions, may also increase the risk of developing fungal infections on the toes.
Step 2: Clean The Affected Area With Soap And Water
The first step in treating onychomycosis is to remove any footwear or contaminants from the infected area.
Step 3: Avoid Tight Shoes Or Socks
People with onychomycosis should avoid wearing tight shoes or socks to prevent the fungal infection from spreading. Tight shoes or socks do not allow air to circulate, which creates a moist and dark environment that is ideal for fungus growth. Additionally, clipping the nails regularly and straight across can help reduce the risk of catching onychomycosis, as well as spraying shoes with anti-fungal protection products and cleaning nail clippers between each use.
Step 4: Wear Comfortable Shoes
It is important to wear comfortable shoes when treating onychomycosis because tight and closed-toe shoes promote a humid environment which is conducive to the growth of fungus. Wearing breathable, well-ventilated shoes can help keep feet dry and reduce the risk of developing a fungal infection. Additionally, regular foot hygiene such as washing and drying feet thoroughly before putting on socks and shoes, wearing shower shoes when walking around public areas, and clipping nails regularly can help prevent the spread of fungus.
Step 5: Be Aware Of The 9 Home Remedies For Blisters
It is important to keep feet clean and dry in order to avoid blisters. Wearing flip-flops or sandals when in warm, moist areas is advisable. It is also advised to avoid tight-fitting shoes or shoes with nonbreathing material, and keep the toenails short and cut them straight across in order to prevent sharp angles that can lead to blisters. Dry skin should also be moisturized regularly. Nail clippers should be sanitized with soap and water followed by alcohol after each use. Furthermore, it is important to choose a nail salon that disinfects tools after each client, as well as ditching any footwear worn prior being infected or using an ultraviolet shoe sanitizer for extra protection against fungus returning.
Step 6: Wear The Correct Type Of Footwear
It is advised that to avoid getting toenail fungus, one should wear sandals or footwear that do not completely cover the foot when in public areas. Additionally, it is recommended to keep feet dry and wear socks made of natural fabrics. To prevent athlete’s foot, sandals or flip-flops can be worn when the weather is warm as well as a clean pair of socks each day and alternating shoes if possible. Keeping nails short by trimming them can also help reduce the risk of infection.
Step 7: Wear Protective Gear When Playing Sports
Wearing protective gear when playing sports, such as sandals or socks, can help prevent the spread of toenail fungus by decreasing the amount of direct contact with surfaces that could potentially be harboring fungal spores. This practice also ensures that shoes or clothes are not shared with other people and therefore reduces the risk of transmission.
Step 8: Use Antifungal Creams, Powders, And Sprays
The use of antifungal creams, powders, and sprays can help to prevent toenail fungus by killing the fungi that cause infection on the skin. When used regularly and as directed, these products can be effective in preventing re-infection and reducing discomfort caused by fungal infections. In cases where topical therapy is not effective, oral antifungal medications may be prescribed in order to thoroughly treat the infection.
Step 10: Get Regular Foot Checkups From A Doctor Or Podiatrist
It is important for individuals with compromised immune systems to get regular foot checkups from a doctor or podiatrist in order to prevent the development of toenail fungus. Regular foot checkups from a healthcare professional can help detect any problems early and take preventative steps to avoid infection, as well as helping those who already have an infection treat it effectively. Dr. Paul Ross at The Podiatry Center is a licensed podiatrist who specializes in treating foot and ankle pain, including onychomycosis caused by toenail fungus.
Fungal Infection Treatment
There are a number of treatments available for onychomycosis, ranging from over-the-counter (OTC) antifungal creams and ointments to prescription oral medications. In milder cases, OTC treatments can be effective in clearing up the infection. However, more severe cases may require prescription oral antifungal medication. It is important to see a doctor if the infection does not clear up with OTC treatment or if it appears to be spreading.