Onychomycosis

 
onychomycosis-web.jpg

Onychomycosis is a fungal infection of the nails, commonly seen in adults that occurs in around 10% of the population and accounts for approximately 50% of all nail disease. 

Onychomycosis is caused by a fungus and symptoms vary depending on the type of fungus involved. Onychomycosis can affect the nails of the fingers and toes, though it is more commonly seen in the toenails. This is most probably due to the slower growth of toenails, a reduced blood supply to the extremities and also by being encased in shoes as enclosed footwear provides a warm, moist and dark environment, ideal for the growth of fungus. 

Who is at risk? 

Even though Onychomycosis is quite prevalent in the population, you might never experience this condition. It is however, common in certain people, so if you have any of the following risk factors, it is important that you are vigilant in caring for your fingernails and toenails. 

  • Athlete’s foot (Tinea Pedis) 

  • Psoriasis 

  • Diabetes 

  • Smoker 

  • Nail trauma or distorted nails 

  • Increased sweating (hyperhydrosis) 

  • A history of fungal infections 

  • Poor circulation 

  • Immunodeficiency 

  • A family history of fungal infections 

  • Sports player 

  • Elderly 

Diagnosing Onychomycosis 

Since Onychomycosis has specific characteristic features, the initial diagnosis is made by a visual examination of your nails. Affected nails tend to appear to be thickened and appear to be yellow/grey in colour. Laboratory tests can be used to confirm this diagnosis, however the results may take a few weeks before they are available. 

If you suffer from Onychomycosis, you may also experience a Candida infection of the nails, which is usually caused by an infection in the skin around the fingernails or toenails (paronychia). This can result in red and inflamed cuticles with yellow, white, green or black streaks appearing on the surface of the nail. The affected nail may even lift off its bed and it can be very tender when touched.

Treatment Options 

Laser

Recently, laser technologies have been introduced as a treatment for onychomycosis avoiding the disadvantages of systemic and topical drug therapies, offering a rapid treatment for an often persistent nail condition.  Using an Nd:YAG laser technicians are able to target the pigment within the fungal cell wall resulting in the elimination of the active fungus. 

Topical Anti-fungal 

Topical agents should be limited to cases involving less than half of the distal nail plate or for patients unable to tolerate the oral treatment. Topical treatments alone are generally unable to cure onychomycosis because of insufficient nail plate penetration. Amorolfine (Loceryl) and ciclopirox are generally the active ingredients in most topical solutions. 

Oral Anti-fungals 

Itraconazole and Terbinafine are both prescription medications that offer higher cure rates with less adverse affects of older prescribed medications. 

Surgery  

In some cases, surgery may be required to remove the infected nail plate. 

 
A correct diagnosis of Onychomycosis is important for the successful treatment of this condition as there are other conditions that can present similar.  Please see your Podiatrist or GP to confirm diagnosis before seeking treatments.