Onychomycosis

Onychomycosis is a fungal infection that affects one or several nails. The microscopic fungi develop under the nail and feed on keratin, a protein found in nails. In so doing, they slowly destroy the nail by weakening it. This contagious infection can spread to other nails as well as other people. Anyone can contract onychomycosis but the elderly, particularly women, are more at risk. Toe nails are most often affected since shoes provide the perfect environment for fungi to thrive. Finger nails are not immune and can also be affected.

Causes

There does not seem to be any specific reason why certain people develop fungal infections while others do not. Various factors however, can encourage the appearance of these fungi:

• overlapping toes
• diabetes
• humidity
• hyperhidrosis (excessive sweating)
• poor circulation in the feet
• wearing shoes that are too tight

Symptoms

Onychomycosis changes the appearance of the affected nail. An infected nail will take on a yellowish or brownish colour and may also develop white spots. It thickens, becomes difficult to cut and may flake or chip. Wearing shoes may also become uncomfortable.

Prevention

Here are a few simple measures intended to reduce your chances of contracting onychomycosis:

• Disinfect any nail care tools (nail clipper, file, etc.)
• Dry between your toes after showering or bathing
• Do not lend out your shoes
• Wear sandals if you are going to the pool or taking a shower in a public place
• Wear breathable sandals and shoes (leather)

Diagnosis

Onychomycosis must be diagnosed by a physician or a dermatologist. To identify the fungi responsible (and to treat properly), a sample of the nail must be taken and analysed in the laboratory.

Treatment

Depending on the extent of the infection, there are several treatment options available. The dermatologist may try to remove the infected part of the nail in an effort to remove the fungi. He may also prescribe a cream to be applied around the nail in question. These infections take time to heal and are difficult to treat. Lotions and nail polishes are more or less effective once the infection has really taken hold because they do not treat the root of the nail. You may have to take an oral antifungal agent such as terbinafine (Lamisil™) or itraconazole (Sporanox™). These treatments last several weeks. It should be noted that despite treatment, the affected part of the nail will not look normal until it grows back and can be cut.