Fungal Nail Infection: Understanding Causes, Symptoms, and Treatment

Fungal nail infection, medically known as onychomycosis disease, are common yet often overlooked conditions that can affect anyone, regardless of age or lifestyle. While these infections usually do not cause severe harm, they can lead to cosmetic concerns and, in some cases, secondary infections. This article aims to provide a comprehensive understanding of fungal nail infections, including their causes, symptoms, diagnosis, and treatment options.

What is a Fungal Nail Infection?

A fungal nail infection occurs when fungi invade the nail bed, leading to changes in the appearance and health of the nails. These infections can affect both the fingernails and toenails, but they are more common in toenails due to the warm, moist environments created by shoes and socks. The nail plate, the hard part of the nail that is visible, becomes infected, leading to potential hypertrophy or thickening of the nails.

Causes of Fungal Nail Infections

Fungal nail infections are primarily caused by three types of toenail fungus:

1. Dermatophytes: These fungi are responsible for most nail infections. The toenail fungus thrives in warm, moist environments, making toenails particularly susceptible.
2. Yeasts: The most common yeast that causes nail infections is Candida. It can invade the nail, especially in individuals with weakened immune systems or those who frequently expose their hands to moisture.
3. Non-dermatophyte molds: Non-dermatophyte molds are common other Onychomycosis causes. These fungi can also cause infections, particularly in individuals with pre-existing nail damage or other health conditions.

Fungal infections often occur when there is a disruption in the protective barrier of the nail. Factors that can contribute to this include:

• Trauma or injury: Any injury, such as an athlete’s foot, to the nail, can allow fungi to enter and establish an infection.
• Poor hygiene: Lack of proper foot and nail care can increase the risk of infection.
• Moisture: Prolonged exposure to moisture, such as sweating or wet environments, creates an ideal setting for fungi to thrive.
• Health conditions: Individuals with diabetes, peripheral vascular disease, or weakened immune systems are more prone to fungal infections.
• Age: Older adults are more susceptible due to decreased blood circulation and slower nail growth.

Symptoms of Fungal Nail Infections

While fungal nail infections are generally not threatening, they can lead to several noticeable symptoms:

1. Discoloration: Infected nails may appear yellow, brown, or even white.
2. Thickening of the nail: Hypertrophy of the nails is common, where the nails become thick and difficult to trim.
3. Brittleness: The affected nails may become brittle and prone to breaking.
4. Distorted shape: The nails may lose their natural shape, appearing irregular or jagged.
5. Separation from the nail bed: In more severe cases, the nail may begin to lift away from the nail bed, leading to pain and discomfort.
6. Secondary bacterial infections: While the fungal infection itself may not produce symptoms like fever, it can create openings for bacteria to invade, potentially leading to more serious complications.

Diagnosis of Fungal Nail Infections

To diagnose a fungal nail infection, a healthcare professional will typically perform a physical examination and may recommend laboratory tests. These tests can include:

• Nail clipping or scraping: A sample of the affected nail is taken and examined under a microscope to identify the presence of fungi.
• Culture tests: The sample may also be cultured in a lab to determine the specific type of fungus causing the infection.
• Dermatoscopy: This technique uses a special device to magnify the nail and surrounding skin, helping to visualize any abnormalities.

Treatment Options for Fungal Nail Infections

Treatment for fungal nail infections can vary depending on the severity of the infection and individual patient factors. Here are some common treatment options:

1. Topical Antifungal Treatments

Over-the-counter or prescription topical antifungal medications can be applied directly to the affected nails. These treatments are typically effective for mild infections but may take several months to show results. Common topical treatments include:

• Ciclopirox: This antifungal lacquer is applied to the nail and surrounding skin.
• Efinaconazole: A newer topical solution that has shown effectiveness in treating fungal nail infections.

2. Oral Antifungal Medications

Oral antifungal medications may be prescribed for more severe or persistent infections. These medications work systemically to eliminate the fungi from within the body. Common oral antifungals include:

• Terbinafine: This medication is often the first line of treatment and is taken for several weeks to months.
• Itraconazole: Another option that may be used for fungal nail infections, particularly in cases of onychomycosis.

3. Laser Treatment

Laser therapy is an emerging treatment option for fungal nail infections. It uses targeted laser energy to destroy the fungi without damaging the surrounding tissues. While still relatively new, some studies have shown promising results.

4. Nail Removal

In severe cases where the nail is significantly damaged or painful, a healthcare provider may recommend surgical removal of the affected nail. This allows for a new, healthy nail to grow in its place.

Prevention of Fungal Nail Infections

Preventing fungal nail infections involves taking steps to maintain good foot and nail hygiene:

• Keep feet dry: Ensure feet are thoroughly dried after bathing, particularly between the toes.
• Wear breathable footwear: Choose shoes made from breathable materials to reduce moisture buildup.
• Practice good nail care: Keep nails trimmed and clean, and avoid injury to the nail bed.
• Avoid walking barefoot in public places: Use sandals or protective footwear in communal areas like pools and locker rooms.
• Change socks regularly: Opt for moisture-wicking socks and change them if they become damp.

Conclusion

Fungal nail infection, while generally not threatening, can lead to cosmetic concerns and potential complications if left untreated. Understanding the causes, symptoms, and treatment options is essential for effective management. With proper care and attention, individuals can prevent fungal infections and maintain healthy nails. 

If you suspect a fungal nail infection, it is advisable to consult a healthcare professional for an accurate diagnosis and appropriate treatment. By taking proactive steps, individuals can minimize their risk and promote overall nail health.

Dr. Saravanakumar G, MBBS, MS, DA, and FPS, a highly respected podiatric surgeon and foot specialist at the Madurai Footcare Center, provides advanced treatment options designed to meet each patient’s specific needs.

He specializes in diagnosing and toenail fungus treatment using advanced techniques and personalized care. With extensive experience in dermatology, he employs both topical and oral antifungal treatments, ensuring effective solutions tailored to each patient’s needs for optimal nail health and recovery. Schedule your consultation today!