What is Onychomycosis? — Answers from the Leading Podiatrist of Naples, FL
Onychomycosis, a fungal infection of the nails, is characterized by notable discoloration, yellow streaks, or white patches appearing on the toenails. Occasionally the fungus will also turn the flesh beneath the nail a dark color. The nails themselves noticeably thicken and become brittle, the edges crumbling and flaking away when disturbed. In some cases the nail may even separate completely from the nail bed and fall off the toe.
The infection is not life-threatening though it can cause those with severe cases pain and possibly permanent disfigurement. Negative psychological issues can also result from the effect that the unsightly appearance and pungent smell of the affected nails have on a person’s self image.
There are several different types of nail infection caused by fungi. Each type is classified by the kind of organism causing the infection and the location of the infection in the region of the affected nail.
There are four main types of Onychomycosis. Distal Subungual Onychomycosis affects the nail bed and the underside of the nail. White Superficial Onychomycosis attacks the top layers of the nail and appears as white streaks across its surface. Proximal Subungual Onychomycosis appears in the proximal nail fold, where the nail exits the skin of the finger or toe. Lastly there is Candidal Onymychosis, a rare type attributes to frequently having one’s hands immersed in water.
More than 90% of all cases of Onychomycosis are caused by two species of dermatophyte: Trichophyton rubrum and Trichophyton mentagrophytes. These are ringworms which, despite the name, are not worms but rather a type of fungus. The remaining 10% is divided up mostly among nondermatophyte molds (Fusarium, Scopulariopsis, and Aspergillis species) and the yeast Candida. Cases of Candida infection are generally rare.
It is estimated that anywhere from 2 to 13% of the North American population have been affected by Onychomycosis. Infections have been more common in men than in women and often affect adults, especially elderly individuals, more often than children.
Fungal infection should be treated by a foot specialist as quickly as possible. If left untreated the infection could spread to the neighboring nails as well as the adjoining skin. This can lead to further complications such as compromising a person’s ability to walk due to pain caused by the thickened nails forcing unnatural pressure upon the nail bed. Tissue decay and ulceration from this pressure can result, leading to possible further infection.
A number of factors can lead to the development of Onychomycosis. The most common agent is moisture. Wearing shoes with poor ventilation can result in perspiration building up and keeping the food moist. Wet socks or shoes are a veritable breeding ground for molds and fungus that can wreck havoc on the feet. This is exacerbated in humid environments. Walking barefoot in wet locations, such as shower rooms or pools, or wearing shoes without socks, can also expose feet to possible infection.
Properly washing clothing can help to prevent the spread of fungi. Washing machines that use low temperatures to conserve energy are often times not enough to properly eradicate any fungal spores that may be present in socks or hosiery, allowing those spores to propagate even despite being cleaned. Since shoes are not frequently prone to being washed, clean socks usually offer a sufficient stopgap between any spores within the shoe and the feet if kept dry while being worn. Furthermore, washing one’s feet with soap and water every day can also significantly cut down the chances of developing a fungal infection.
Having a compromised immune system, either due to illness, drugs and certain medications, or an immunosuppressant disease (as with cancer, HIV, or AIDS), makes an individual significantly more prone to contracting an infection. In such a state the body has less capability of fighting off weak fungal infections and instead allows the spores to infect the nails and spread unhindered. It can also lead to complications such as cellulitis, a bacterial infection that, if ignored, can lead to the necessary amputation of the affected limb.
An individual with Onychomycosis may not feel any distinct pain or discomfort early in the infection, though some have reported cases of paresthesia – that tingling “pins and needles” sensation. Over time increasing discomfort, pain, and dexterity loss could result. It is extremely important that this be treated with all due urgency. The grotesque appearance and malodorous smell of the infection have led to many people avoiding treatment out of shame and embarrassment. The longer one waits to get treatment the more likely they are that complications will arise.
Onychomycosis can be treated by podiatrists though, due to the difficulty of the infection laying beneath a nail, it may take up to a year to properly treat the infection. The podiatrist will grind down the thickened nail to relieve pressure, analyze a sample to determine the exact fungal culprit, and treat accordingly.
If you have toenail fungus, and if you live in or near Bonita Springs, FL, take advantage of the most revolutionary and effective treatment available today, by calling now to set up an appointment with Dr. Christopher Paladino.