Expert Commentator: Dr. Carlos F. Smith - 03/07/2010

Fungal Nail also medically known as Oynchomycosis or Tinea Unguium is perhaps the most common disorder of the toenail. It is estimated that 22% of the United States population may have fungal nail. It is a very common disorder that is routinely seen by podiatric physician. Once patients seek treatment for fungal nail they usually ask these questions. 1) What is fungal nail? 2) How did I get it? and 3) How do I treat it?

What is Fungal nail?

Fungal nail or onychomycosis is a fungus of the nail which is caused by organisms such as Tinea Rubrum, Tinea Mentagrophytes and Candida Albican. Some of these same organisms may cause Athlete’s foot, Jock itch and ringworm. These organisms infect the nail which transforms the growth and appearance of the nail, causing it to become discolored (yellow, brown, white or green), thickened and in severe cases malodorous and painful.

How did I get it?

The fungal organisms that infect the nail thrive in a moist, dark and keratinize environment -- hence the feet in shoes. The fungal organism can be contracted from wet communicable environments. Fungal nail is often seen in individuals with diabetes, peripheral arterial disease (poor circulation), immune compromised disease. Trauma to the nail root may also lead to fungal nail, such as stubbing your toe, running which damages the nail and blood blister under the nail.

How do I treat it?

The best form of treatment is prevention. It is recommended keeping your feet dry and clean by wearing cotton socks and changing your socks more than once a day if you have sweaty feet. Shower or swim shoes should be worn when utilizing community facilities. Spray disinfectant or antifungal to affected area and shoes often, as well as avoid sharing personal items. Also alternate shoegear every 24 hour.

Once contracted fungal nail treatment can be difficult and lengthy ( months to years). There are many over-the-counter antifungal treatments one can use; however, the success is very marginal. Prescription antifungal lotion, creams, nail polishes has improved success. However, the best treatment is the oral (pills) medication which is prescribed by podiatric physicians, dermatologist or internist. These doctors will also monitor the patient due to the potential side effects of the drugs. The best candidates for the oral medication are those with no or few medical conditions and who take few medications.

Fungal nail is not just an unsightly disorder. It can cause physical (pain) and psychological (depression) disorders if untreated. Fungal nail also can be a sign of medical condition that has manifested initially in the nail. Finally, fungal nail can be confused with other conditions, such as a traumatized nail, psoriasis, yellow nail syndrome (associated with lymphedema), which can be diagnosed by your podiatric physician.


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