Infections of the nails with a fungus are common. Millions of individuals are affected and most of them go through a difficult time with both the diagnosis and treatment. When the nail is infected by a fungus, this is medically known as onchomycosis. Both the nails in the toes and fingers can be infected, but the former infection is more common.
The fungus can infect nails in all age groups but the incidence is particularly higher as we age.
In some cases, the fungal nail infections run in families due to an inherited tendency. However, this does not mean that the entire family is affected but a few individuals in each generation
The fungus most commonly associated with nail infections is the dermatophytes- which causes about 90% of all fungal nail infections. The most common type of fungal nail infection is that involving the most distal part of the nail.
Fungal nail infections are common. Worldwide, anywhere from 2-20% of the population has a fungal nail infection at any given time. Fungal nail infections are common in the elderly and rare in children, affecting less than 1% of children at any given time.
Most individuals who develop a fungal nail infection have no diea that an infection is present. This is because the fungus is very slow growing and the nail changes are initially not present.
The fist signs of any symptoms may take a few weeks to months to show.
Fungal nail infections can present in a variety of ways. Initially one may not have any signs or symptoms of the infection. The majority of the nail changes are seen much later on. The typical clues to a fungal nail infection include
- cracked nail
- discolored nail
- streaked or spotted nail
- Brittle, crumbly or ragged
- Distorted in shape
- Dull, with no luster or shine
- A dark color, caused by debris building up under your nail
In most cases, a fungal nail infection is very unattractive and most individuals attempt to hide it rather than seek a cure.
A fungal nail infection can make wearing narrow or tight shoes, walking, or standing for long periods of time uncomfortable and in some cases painful.
Over time, a fungal nail infection can cause permanent nail damage. As it invades more of a nail, it becomes more difficult to cure. An untreated nail infection can also spread to other nails and skin.
Infected nails may also separate from the nail bed, a condition called oncholysis. You may even feel pain in your toes or fingertips and detect a slightly foul odor.
In many cases of fungal nail infection, the diagnosis is not obvious and often the treatment is delayed.
The majority of individuals who have a fungal nail infection present to the physician late. Initially, attempts are made to treat or hide the unattractive nail with nail polish and trimming. However, for treatment to be effective, the diagnosis must be made early.
The diagnosis of a fungal mail infection is obtained by the history, physical examination and testing the nail for fungus.
The diagnosis can be easily be made if the individual goes to a dermatologist. Scrapings from the nail can be seen under a microscopy and the fungus can be visualized.