Onychomycosis (Nail Fungus)
Onychomycosis refers to the fungal infection of the toenails. It is not a life-threatening condition, but it still may cause physical and occupational limitations, pain, discomfort, and embarrassment. As the nails thicken, they press against the shoe, causing pressure and pain. About 10% of Americans (23 million people) and as many as 90% of elderly people suffer from toenail fungus.
Once the common fungi that infect toenails become entrenched in the nail plate, they have a tendency to spread to adjacent toes in many individuals. Thickened fungal nails also have a tendency to become painful and ingrown over time.
Treating the fungus can be difficult because the nails receive little blood circulation, and the nails take a long time to grow out. Previously treatment has included oral medication or lacquers which can be painted onto the nails. Risk factors for toenail fungus include participation in fitness activities, trauma, occlusive footwear, living in a warm climate, having diabetes, and a having family history of the condition.
What causes toenail fungus infections?
Nail fungal infections are caused by microscopic organisms called fungi that do not require sunlight to survive. Most commonly, a group of fungi called dermatophytes (such as Candida) is responsible for nail fungal infections. However, some yeasts and molds also cause these infections.
Though Trichophyton rubrum is the most common dermatophyte that causes nail fungal infections, Trichophyton interdigitale, Epidermophyton floccosum, Trichophyton violaceum, Microsporum gypseum, Trichophyton tonsurans, and Trichophyton soudanense may also cause the infections. Common mold causes include Neoscytalidium, Scopulariopsis, and Aspergillus.
Pathogens that cause nail fungus infection usually enter the skin through tiny cuts or small separations between the nail and nail bed. The fungi grow when the nail provides a suitably warm and moist environment.What are the symptoms of toenail fungus infections?
Nails that are infected with fungus typically are thickened, brittle, crumbly, ragged, distorted, dull, and darker or yellowish in color. A patient may also experience onycholysis, where infected nails separate from the nail bed. Sometimes, nail fungal infections result in pain in the toes or fingertips, and they may even emit a slight foul odor.
Another symptom associated with nail fungus infections are fungus-free skin lesions called dermatophytids. These may be rashes or itchiness in an area of the body that is not infected with the fungus - much like an allergic reaction.