How to Tell if You Have a Fungal Infection in Your Toenail?

Do you have a Fungal Infection in Your Toenail?

Fungal infections of the toenail are very common. Fungal infections that affect toenails affect between 10 to 12% of Americans.

A fungal infection in the toenail is caused by microscopic organisms, known as fungi, that wedge themselves in the tiny cracks around the toenail and around the cuticle. Since your feet are typically inside shoes, which are dark and damp, fungal spores can easily become a problem. Symptoms of fungal infections of the toenail are pretty consistent across the affected population.

The first noted symptom is typically a whitish, or yellowish, spot on the nail. This is only the beginning of the infection. The spot can be very small, and unless you pay attention to your feet, it may be easy to miss. Over time, this spot will grow and cover more and more of the toenail. Most people do not notice any pain or discomfort. Some people do not notice it simply because their nail is covered with nail polish.

Over time, the infection will cover the entire toenail. Some people have reported a dark spot, either where the infection originally started or around the edge of the toenail. This is normally only with severe cases though. Sometimes, the infection gets bad enough that the nail actually breaks away from the nail bed.

Other Changes In The Nail

There are a lot of changes that occur in a fungal infected nail. One of these changes is that the nail will become thicker and yellow. Sometimes, the nail flakes or crumbles when the disorder is at a point considered severe.

Only a doctor can determine whether your symptoms are nail fungus or a disorder that looks like nail fungus. There, he or she will be able to take a sample of your toenail and look at it under a microscope. A second portion may be sent out to a lab for more tests. Let your doctor know if you spend a lot of time barefoot in wet, public areas such as pools or locker rooms.

Talking to your Doctor

After your doctor and laboratory has been able to examine your toenail, you will have a chance to discuss what treatment would be best for your specific case. The type of fungus plays a huge role in what treatment is used to best eradicate it. Realize that the infection is not going to go away immediately. Toenail fungi can be extremely hard to get rid of.

While you may feel the need to run out and get an over the counter treatment, there are a lot of disorders that can mimic nail fungus. It is important to work with your doctor to ensure that the problem you are facing is a fungal infection and to come up with the best treatment.

Over the Counter Nail Fungus Treatments

Fungi prove to be the strongest strain of the microorganisms. Bacteria are much harder to kill than viruses. Dermatophytes, molds, and yeasts can burrow deep into your nail and shield themselves with keratin. What makes this difficult to treat is that powerful antimycotic medications are not always effective. Due to this, we question if any over-the-counter fungus treatment are worth the time and money.

Unfortunate facts show us that prescription and over-the-counter treatments do not completely help with curing nail fungus infections.

Amorolfine

Amorolfine is a topical drug proven to be effective in clinical trials. Amorolfine is sold without a prescription in only a few countries such as, the United Kingdom and New Zealand. Also known by the name Loceryl, the treatment is applied as a nail polish on the nail.

It continues to penetrate into the nail after drying, continuously working. It needs reapplying once a week.

Amorolfine helps treat infection by breaking down the cell membrane of the fungus. This treatment only works on subungual onychomycosis. It does not treat proximal onychomycosis or white onychomycosis. Because of this, it is important to know what type of fungus you have.

Amorolfine has very few side effects, and with proper usage these very rarely occur. There have been reports of some burning after applying but that goes away shortly after applying. A 5 ml tube can cost around $100.00-$150.00. Although you cannot acquire amorolfine in the United States, online pharmacies are becoming more popular and you may eventually be able to obtain it through these.

There are a few over-the-counter anti-fungal treatments that don’t help kill off the nail fungus.

Lamisil is a tablet prescribed for onychomycosis that also comes in an over-the-counter topical cream. This medication has not proven an effective nail fungus treatment.

Lotrimin (also known as clotrimazole) is not effective for nail fungus but is very good at treating athlete’s foot and jock itch.

Tolnaftate (or Tinactin) does nothing for nail fungus but works extremely well for skin fungi.

Two papers, one from 1965 and the other from 2008, show that undecyclenic acid combined with cyanoacrylate and hydroquinone have positive effects. Even so, there have been no studies proving that undecyclenic acid works on its own.

Tea Tree Oil
has proven to have some positive effects against nail fungus. It is a natural fungicide and insect repellent. Applying a 100% concentration to the infected area has shown to have a 20% cure rate. While using Tea Tree Oil on the infected area, two thirds of the patients said the appearance of the nail fungus had improved.

Studies have shown that a Tea Tree Oil application two times a day with a 1% solution of clotrimazole was a more effective nail fungus solution.

Topical Products or Removing the Nail

The above topical products were applied to a nail before it had been taken off. There are times where removing the nail is necessary before improvement can occur. This can be done either mechanically or chemically. Removing the nail allows the medication to be applied directly to the infected area. If a doctor removes the nail, ask about any follow-up on your nail fungus treatments.

Even if you don’t want to go the way of surgery, you will still need to take an oral medication that can only be prescribed by your doctor. These will help cure the nail fungus.

Available Toenail Fungus Prescriptions

Prescriptions Available for Toenail Fungus

The most commonly used treatments for toenail fungal infections are anti-fungal medications. Typically, these medications are given in oral or pill form. While they can be helpful in treating toenail fungal infections, they also have a long list of side effects, and possible risks.

There are many topical treatments prescription strength that can be obtained with a doctor’s recommendation. Regardless of what treatment your doctor has determined best for you, expect that the treatment will take at least 12 weeks for toenail fungus and at least 6 weeks for fingernail fungus. Treatment will be differ from person to person and will vary depending on the severity of the infection.

Eradicating toenail fungal infections can be extremely difficult. It is also very time consuming. Before your doctor offers treatment, they will want to determine what type of infection you have. This is because each type of infection has its own type of treatment and some medications do not treat certain infections.

Once your doctor has determined what type of fungal infection you have, they will give you medication or recommend an over the counter treatment for your specific infection. Make sure you have told your doctor about all medications and supplements you take. Be sure to advise them of any herbal treatments you are using as well, as some herbs can cause adverse side effects with anti-fungal medications. There are many types of treatments available, but they can be very hard on the body and do not mix well with all medications.

Terbinafine

Terbinafine (also known as Lamisil) is one of the most popular medications available for fungal infections. It is effective for most types of fungal infections that affect finger and toenails. A typical prescription is 250 mg per day for about 6 to 12 weeks.

Unfortunately, one of the prerequisites to getting this prescription is to have blood tests to check your liver enzymes. Your doctor may order blood tests throughout your 6-to-12-week treatment to ensure that the medication is not doing any damage to your liver. Because of this, the treatment with this prescription medication can become quite expensive. However, these tests are necessary because the ingredients in Lamisil are processed by the liver. In rare cases, there are several hepatic, or liver-related, side effects including but not limited to hepatitis, blood dyscrasias and Stevens-Johnson Syndrome.

Diflucan

Another popular treatment for fungal infections is Diflucan (also known as fluconazole). While this medication is typically used to treat yeast infections, it can treat most fungal infections that are developed in warm, moist conditions such as fungal infections under the nail.

Medication can be very expensive. However, most pharmacies are offering these two medications in generic form for about $4.00. The pharmacies that offer these generic medications at a low price are Target, Wal-Mart and Publix.

There are other medications commonly used to treat toenail fungal infections. These medications are:

Itraconazole (also known as Sporanox) – This is a newer medication on the market. It works similarly to Lamisil.

Ciclopirox (also known as Penlac) – This is a paint-on nail lacquer. When painted on, it soaks into the nail and provides medication inside and below the nail.

Griseofulvin – This is an older drug that is very well-known. It is not prescribed a lot anymore because it is not as effective as newer medications that are available.

Keotconazole (also known as Nizoral) – It is extremely effective in treating nail fungus. However, it is only prescribed in severe cases of nail infection because it does carry a high risk of liver toxicity.

With so many options to choose from, it is best to work with your doctor to determine what the best treatment would be for your specific situation. One of the most important steps in treating toenail fungus is to prevent the infection you already have from growing. Fungus breeds in damp, dark, warm locations. It is important that you keep your feet dry and clean while wearing breathable shoes and socks.

Where Toenail Fungus Starts

Where Toenail Fungus Hides

The nail fungus likes to work its way under the nail where it’s moist and warm. The nail acts as a shield for the fungus, making it difficult to kill off. Also, since it is harder to clean under the nail, the fungus can easily re-grow after any treatment you undergo.

How does a Nail Fungus Grow?

A fungus is like a mushroom. It prefers living in the dark, spreading through spores and having roots that it grows from. The spores that spread the fungus do so in dark and damp places. The number one way of getting nail fungus is shoes. This is due to people not having more than one pair of shoes to alternate every other day. Shoes keep your feet in darkness, and due to sweat and humidity help fungi survive. With your body temperature and not allowing your shoes to air out or dry, it’s the perfect breeding ground for the nail fungus. Fungus also loves flip-flops because they can stay wet a lot of the time. This is why you should have more than one pair of shoes that you can alternate every day. This allows your foot protection to stay dry and not become the breeding ground for your feet’s worst enemy.

Remedies to Treat Nail Fungus

Ointments and solutions for nail fungus are the best first option, since anti-fungal medications having risky side effects associated with them. The most commonly used treatment is mixing Tea Tree Oil and Mineral Oil. You then soak the surrounding nail in the solution. These remedies are both an anti-fungal and an antiseptic. Treating fungus can take a while but will work if you keep up with it regularly. You must also keep up with it like oral antibiotics. Use it until it is fully gone and the fungus does not return.

Koilonychia

Koilonychia is a conditon considered hereditary. It typically affects fingernails. The nail gets thinner and the edge of the nail begins to rise up. This condition is commonly known as spoon nails. This disorder is caused by the inability to absorb iron in the bloodstream, a disorder called anemia.

What Causes Koilonychia?

There are many causes of Koilonychia. Here are some of the most common causes currently known:

Reduced circulation
Low thyroid hormone
Muscle conditions
Universal lupus
Hemochromatosis
Patella Syndrome
Raynaud’s Syndrome
Erythematosus
Poor health
Iron deficiency anemia
Using too much soap or oil
Glossitis
Cheilosis
Pica
Malnourishment

Symptoms And Solutions For Koilonychia

This disorder is a symptom of anemia. It must be caught as soon as the visual symptoms become present.

This condition can also be caused by worrying the edge of the nail. This causes them to detach and curl up. There are many ways that this condition can be prevented.

Wear gloves while your hands are submerged in water
Do not chew your nails
Eat a healthy diet
Take vitamin supplements
Work with your doctor to find supplements to treat iron deficiency
Do not eat or drink items that make absorbing iron more difficult
Take vitamin C on a regular basis

Typically, the treatment surrounding this disorder revolves around managing your iron level.

This can either be through diet or vitamin supplementation. Iron supplements can be purchased over the counter, by prescription, or can be given via injection to those who have an intestinal disorder that prevents iron absorption.

Nail Fungus – Proximal Subungual Onychomycosis

Proximal Subungual Onychomycosis

This one of the least common nail fungi in people who have healthy immune systems, but it is found very frequently in those whose immune system is compromised. Proximal subungual onychomycosis is different from most fungal infections of the nail because this form begins at the cuticle and works its way toward the tip of the nail.

Just like other nail fungus infections, this fungus causes the nail to become disfigured. However, the disfigurement starts at the cuticle and works its way from there. This type of fungal infection is more likely to affect the nail bed early in the infection, which causes the nail to develop ridges and bumps. Because the infection starts at the cuticle, the nail may become detached and fall off, which can expose the nail bed to more significant infection.

Most cases of proximal subungual onychomycosis are caused by the same dermatophyte as distal subungual onychomycosis. This type of infection is not only caused by a fungus, but it can also be caused by a mold as well. Another symptom that is characteristic of this specific type of fungal infection is swelling and redness around the nail. This area can become extremely swollen and can start to ooze puss. Typically, this is more common in infections caused by molds than it is fungus.

Because of the strange characteristics of this specific fungal infection, it is commonly misdiagnosed as a bacterial infection. Antibiotics do not have the ability to kill fungi so the antibiotics given will not work to get rid of the infection. To properly destroy molds, yeasts, and dermatophytes an anti-fungal medication must be used.

This type of fungal infection typically occurs in those with an unhealthy immune system. It is most common in those with HIV. This is so common, that if a patient is present with this type of fungal infection and no other symptom, a doctor will likely request a test for HIV.

It is important to note that just because you have a diagnosis of proximal subungual onychomycosis, does not mean you will receive a diagnosis of HIV.

Lamisil

The only method of treating proximal subungual onychomycosis is to take an anti-fungal medication, typically given in pill form. If the infection is determined to be caused by dermatophytes, trichophyton rubrum, or trichophyton mentagrophytes, your doctor might prescribe Lamisil. The typical dose for Lamisil is one 250 mg pill per day for 6 weeks if the infection affects the fingernail. If the infection affects the toenail, the treatment is typically one 250 mg pill per day for 12 weeks.

Itraconazole or Sporanox

Another type of treatment that is commonly used is Itraconazole, or Sporanox. This treatment is used when the type of fungus is unknown. This is because it is effective against almost all fungal infections. This treatment is typically more expensive than other medications, but it works great because it is a broad-spectrum antifungal.

Fluconazole

Fluconazole, which is also known as Diflucan, is not used as often but is effective in treating proximal subungual onychomycosis. This medication does stop the growth of the fungus, but it does not kill existing fungus. This makes other medications more effective in getting rid of the fungus.

Overall, Diflucan is known to slow down or stop the growth of the infection so that the body can take care of the infection. For someone who is immune deficient or who has a weakened immune system, this is not a great option, as they are not as able to fight off an infection.

Gyms Are a Breeding Ground for Nail Fungus Infections

The Danger of Gyms for Nail Fungus

People go to the gym to become healthier and build muscle. They want to lose weight, feel that adrenaline rush, and feel better about themselves. It rarely crosses anyone’s mind that the gym and public pool are a breeding ground for fungus and nail fungus infections to spread.

So, why are they the perfect place? Most gyms and public pools have a place to change. This place may be a dressing room, a locker room equipped with a shower, or an open place to rinse off after your work out. These places have tile floors to make cleanup easier. However, grout is the perfect place for fungus to breed.

When you walk barefoot over this grout, you are risking having the spores from other people’s fungal infections stick to your feet and slowly work their way up under your nails. It is terrible that one of the places that you go to take better care of yourself and to feel better about yourself can lead to you developing an infection, no matter how hard the gym works to keep the shower floors clean.

How To Prevent Toenail Fungal Infections

The place to start when you are trying to prevent toenail fungal infections is what you wear on your feet. Gym shoes that are older and worn can be a breeding ground for all kinds of bacteria and fungus by themselves. This means that if you do get fungal spores on your feet, they are sure to breed in your shoes and become an out of control fungal infection in no time.

It is advisable, for the gym and in your everyday life, to have at least two pair of shoes. Never wear the same pair of shoes two days in a row. This allows one pair to dry out between uses so that you are not breeding fungus that is just waiting to attack your feet. Either way, make sure that your feet stay dry. Wear clean, breathable, cotton socks so that moisture is wicked away.

If you still feel at risk, use an anti-fungal spray in your shoes between uses and allow them to dry completely before you put them back to help prevent contamination.

If you use the shower at your local gym, do not do so barefoot. Rubber flip-flops, shower shoes, or water shoes are a great way to ensure that you are not exposed. As with your other shoes, make sure that these shoes are completely dry before you put them back on. You may also want to spray them with anti-fungal spray between uses (after they dry) to ensure that any fungal spores that you pick up from the shower floor are eliminated before you wear them again. Another option is to place them in your clothes dryer and use high enough heat to kill the fungal spores.

What To Do In Case Of Infection

When you first notice any sign of infection, it is important to begin treatment. This means that you need to catch it when your toenail begins to change color, or looks different than it normally does. It is important to catch it before your nails become brittle or start to get thick.

If caught early, start soaking your toes in a vinegar solution twice daily for about 20 minutes. This solution should consist of 1 part vinegar to 1 part water. Continue this treatment until the affected toenails have cleared up.

Vinegar gets rid of the infection by changing the pH of the growing environment, which makes the nail uninhabitable to the fungus.

The fungus will then quit breeding, and when the existing spores die off, the fungus should be completely gone.

The choice between apple cider vinegar and white vinegar is up to you. Both are shown to work, so whichever you have on hand will work great.

Acrylic Nail Fungus Infections

Acrylic nails are stronger and help those who have weak nails that split and break easily. Because of this, many people choose to use acrylic nails so that they may have attractive, healthy looking nails.

Fungus growth is a possibility with acrylic nails. This happens when there is bleeding and the application of the nail is not done in a properly clean way. Fungus can set up between the real nail and the acrylic nail. Most nail salons are very clean and practice proper hygiene, but some don’t. So make sure the salon you go to cleans and sterilizes their equipment with antibacterial products.

Trying as hard as you can doesn’t always help keep fungus out. If a fungus is already attached to the nail or passed through non-sterilized equipment, you can be infected. The nail salon specialist is trained to recognize any nail anomaly. Knowing this, they will tell you that you should not have the acrylic nail put on; that it will give the fungus a perfect place to thrive.

If the acrylic nail was placed over the fungus attached to the real nail, it would give the fungus protection, warmth and humidity that it needs to thrive. The nail salon specialist will tell you how to manage and what treatment options there are for getting rid of the fungus.

What If I do Become Infected?

Apply Lamisil cream (an over-the-counter product) to the top, bottom and surrounding skin of the affected nail.
Apply Tea Tree Oil, an antiseptic and antifungal, to the top, underneath and surrounding skin, and affected area every day.
Cleaning out dirt, food and gunk from under the nail can help keep the fungus thriving. Afterwards, swab the area with rubbing alcohol to kill any fungal growth that’s already there.
Your last option is going to your doctor and getting a prescribed medication to help get rid of the fungus. These typically come with serious side effects that can damage the liver. This means you need to ask your doctor if you are healthy enough to use these medications.

Nail Fungus Prevention Tips

General Nail Fungus Prevention

Preventing infection of the nail is easier than curing it. It is much easier to keep your feet fungus free than getting rid of it. It is easy to prevent your feet from getting fungus, but that means you need to keep up on it. While it takes a little time each day, it is less time and work than trying to fix nail fungus. Nail fungus attacks anyone and everyone. No one can run from it, just prevent it.

People Who are Most Subject to Nail Fungus Infections are:

People who sweat excessively from both their hands and feet.
People who already have a nail disorder.
People without a good, offensive defense.

There is no order to this disease for attacking someone. It can live wherever.

Prevention Ideas

When in public places where there is water, such as baths, swimming pools and locker rooms, wear protective footwear. These are perfect places for spores to be transferred from someone who already has a nail fungus.

Clean your nails with soap and keep them short and trimmed and mostly dry since fungus likes dampness the most.

If your feet sweat, let your shoes air out and dry. Also change socks regularly or wear sandals, since they will help your feet to stay dry. If you have already come in contact with fungal spores, use anti-fungal spray to help fight them off.

Nail polish also acts as a shield that locks in humidity and blocks light that helps the fungus thrive.

Make sure your nail salon sterilizes all their equipment properly.

Wash and dry your hands thoroughly before applying anything to your hands or feet and after applying ointment or medication anywhere else.

Picking at the skin around the nail can irritate the skin and allow a fungus to invade your skin.

Keep an eye out for any symptoms that may develop; and if they show up, treat them early to keep the infection from getting any worse.

Keep your immune system in tip-top shape to fight off infection by eating a healthy and balanced diet.

Brittle Nail Disease – Onychorrhexis

Onychorrhexis, its Symptoms & Treatment

What is Onychorrhexis?

Onychorrhesis is a condition where fingernails and toenails break easily because they are weak.

Why is it?

Keratin is composed of protein, and as the nail grows the thickness is determined by your body. The thickness of your nails is genetically chosen and is already set at birth.

What Causes it?

A common cause is humidity around the base of the nail. If you soak your hands in water, take a long bath, do dishes for a prolonged period of time, and perform these tasks on a regular basis, you can develop weak nails. Some people notice that as they grow older their nails become weaker. They also become more prone to breaking. There are some diseases and conditions that cause nails to become more brittle and fragile:

Low levels of thyroid hormones
Reynaud’s Syndrome
Skin disorders
Poor diet

Signs Of Onychorrhexis

Parts of the nail flaking off
The nail breaking in places
The nail falling off

Basic Treatment

As a rule of thumb, if you have brittle nails, don’t spend a lot of time with your hands wet. Also be careful about the type of soap you use and only use mild hand soaps.

Right after washing, use a moisturizer that softens the skin or a healing moisturizer that softens and provides herbal or medicinal remedies. This acts as a barrier between the nail and water.

Preventative Measures for Brittle Nails

Wear gloves or protective covering when immersing hands or feet in water.
Do not participate in sports or activities that involve being submerged in water.
Avoid irritating chemicals.
Ensure that you are get enough vitamins and minerals in your diet.

Side Effects of Brittle Nails Treatment

The only possible side effect to the above treatment is an allergic reaction to specific moisturizers.