Onychomycosis: Causes, Symptoms And Treatment

Onychomycosis is the medical term for nail fungus infection. It’s an extremely common nail disorder affecting an estimated 35 million people in the US according to Podiatry Today.  Toenails are more commonly affected than fingernails with the big toenail being the nail most often infected.

Causes of nail fungus infections

Onychomycosis is the result of invasion by a dermatophyte fungus that feeds on keratin proteins in the nails.  The same fungus also causes skin infections such as athletes foot and cross infections between the skin and nails are frequent. The fungus is ubiquitous, particularly in moist, protected and dark environments. That’s why it’s important to always wear rubber thongs or another type of protective footwear whenever you’re walking around public showers or changing rooms. In addition, any type of injury to the nail will make it more susceptible to fungal infection.  Proper foot hygiene is important during treatment and for prevention.

Symptoms of Onychomycosis

The most obvious early sign of onychomycosis is a yellowish discoloration to the neck. This normally start at the tip of the nail (know as the distal edge in nail anatomy terms) and spreads towards the cuticle. It is normally accompanied by an increased brittleness and lots of texture. The nail may also start to distort and lift off the nail bed with debris collecting under the nail plate. At this stage there may be pain when moving around or when wearing tight fitting shoes. The condition often causes considerably embarrassment among sufferers and a loss of quality of life.

Treatment approaches

Unfortunately the disease rarely goes away without treatment and should not be ignored. It’s also far harder to treat than skin fungus infections as the fungus is usually located in a subungal position (i.e underneath the nail) and so is protected by the nail.  There are a number of different options when it comes to toenail fungus treatment.

1. Home remedies such as tea tree oil, Listerine and white wine vinegar. Although some sufferers claim that these work well, it is unlikely that they are effective at eliminating moderate or severe infections when the fungus is deeply entrenched in the nail.
2. Given the prevalence of the disease there are a wide range of specialized topical antifungal nail treatments available. These are effective but only if sufferers stick to a regular treatment schedule over several months. It takes time for the antifungal agents to soak into the nail and reach the fungus.
3. While a number of oral antifungal drugs exist, these have been associated with serious side effects. As a result they are not generally used as a first-line treatment for mild to moderate cases of infection.
4. A treatment approach that is starting to attract the attention of health professionals in the US is laser therapy. But while early indications are positive, more clinical trials are needed to determine its efficacy over the long term.
5. If the fungus results in very distorted nails that are causing pain or impaired movement, surgical removal is an option. Unfortunately it is often the case that when a new nail grows out it is also infected with the fungus.