Fungal Nails

Fungal Nails occur in around 8% of the population in the UK 

There are different types of infection, or onychomycosis, but by far the most common is that which is caused by fungi  tracking from the skin of the foot.

It starts at the end of the nail and moves back towards the 'half moon' leaving yellow or brown patches and streaks as it progresses.  The nail is very crumbly when it is cut and may have a bad odour.

Another type  invades the top of the nail plate directly and causes a white, pitting effect. Less common variations  can cause complete destruction of the nail matrix, but it is worth remembering that  any one person can display a combination of all types and once one nail becomes infected, it can easily spread to the others.

Any fungus likes a warm, dark and moist environment and, these are the conditions you offer your feet when they are constantly encased in footwear.  Of course, the fungus needs to be present in the first instance , but it can be easily picked up from other warm and moist areas such as swimming pool changing areas and shower rooms. Once present, a fungus can survive in footwear  for up to six months. It usually enters the skin through small cuts  or through small separations between the nail and the nail bed.

People with poor circulation, those with diabetes and those with a weakened immune system should take extra care as they are more vulnerable to fungal nail infections.

Two dermatophytes are responsible for around 90% of all fungal infections. Trichophyton rubrum  is usually responsible for the fungus which progresses from the end of the nail towards the half moon, whereas Trichophyton mentagrophytes  is more often associated with the superficial white areas attacking the nail plate. An infection which starts at the 'half moon' moving towards the free edge is usually caused by non-dermatophyte moulds.

At first, a fungal infection will probably not cause any problems other than cosmetic changes in the nail, but it is possible that in severe cases they can become very uncomfortable and even  painful as the nail thickens and causes inflammation of the nail bed.

Treatment can be topical or systemic or both. There are obvious problems associated with any systemic medication and so the first line of treatment is usually topical. As the nail has a very hard top layer, it is advisable to file the nail to enable the antifungal agent to penetrate the nail plate more easily.  Research has also found that applying a urea cream to the nail prior to the antifungal lacquer, allows for better penetration and better results.

                                                                                                                            

 Progress of any treatment is slow. As a toenail grows on average 1.5 - 2mm per month, it can be disheartening when there appears to be little improvement after diligent treatment.  It is important to recognise that the affected part of the  nail will not improve in appearance, but as the yellow and white areas grow and are cut away, new growth should look nice and clear. Complete resolution can take around a year to eighteen months.

Perseverance is paramount. Application of the treatment must be carried out every day, preferably twice a day; alongside allowing the feet to breathe without permanently wearing occlusive footwear.

New therapies are becoming more widely available, such as laser treatment and aromatherapy products.

Body Essentials have developed an aromatherapy product for the treatment of fungal nails, Nourish Your Nails. This has been well reviewed and is definitley worth trying. If your nails are yellowed or if you think you may have a fungal infection in your nails, Nourish your Nails will gently lighten and brighten the nail plate.