Fungus Infections of the Nails

Fungal infections of the nail are common. In most cases only one nail is infected but multiple nail infections by a fungus is not rare. The typical nail infection by a fungus usually starts off as a whitish scar on the tip of the toe or finger nail. With time, the nail starts to thicken and the fungus starts to spread deeper into the nail. With time, the nail starts to show graying discoloration, the edges crumble and the nail appears ugly

Fungal infections of the nails are common when the nails are exposed to warm moist or humid environments such as tight warm shoes, swimming pools, locker rooms or gyms. The fungus which affects the nail does not affect the skin.

Fungal nail infections are difficult to treat and have a tendency to recur. Medications have to be applied or taken in orally for long periods



Causes

The majority of fungal nail infections are caused by a fungus known as dermatophytes but sometimes yeast and molds can also cause nail infections

Fungi are commonly found in warm moist environments like the lockers room, swimming pools and shower stalls. The fungus gets on to the skin through small cuts or abrasions and then attaches to the nail bed. In the majority of cases, the fungus just dies off. However, if the nail is continually exposed to the warm humid environment the nail will definitely get infected. These environments are ideal for fungal growth

Toe nails are more commonly infected compared to finger nails because the former are always confined to a dark, warm and constrictive environment - where fungi love to grow

Fungi also occur in individuals whose blood supply is compromised like diabetics. The lack of blood supply means that even drugs in the blood are unable to get to the site of infection to eliminate the fungi.

Risk factors

Even though fungal nail infections are universal, the majority of individuals infected are the elderly. This is because these individuals have decreased blood circulation; the nails grow slowly and thicken which makes them more susceptible to infection. In general, the risk of fungal nail infections is greatest in individuals who:

- sweat profusely

- work in hot and humid environments

- are constantly exposed to warm water

- wear tight constrictive shoes and have sweaty feet

- frequently visit locker rooms swimming pools and gyms

- are diabetic

During the initial stages, fungal nail infections are asymptomatic. As the infection progresses, the nail changes become permanent, unattractive and can cause pain. In individuals who are immunosuppressed, the nail infection can even spread into the systemic circulation.

Because the initial stages of the fungus infection are not always obvious, most individuals have no idea that they may have an infection. The only way to make a diagnosis of a fungus nail infection is to examine the scrapping from the nail underneath a microscope.