Information on Nail Fungal

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 Causes and Treatments of Nail Fungus (Onychomycosis)

What is Onychomycosis?

Onychomycosis stands as the most prevalent nail infective disorder, accounting for roughly half of all consultations for nail-related issues. It exhibits gender- and age-related trends, with higher prevalence in males and an increasing incidence with age. In the elderly population, onychomycosis can have an incidence exceeding 40%. Predisposing factors include conditions like diabetes mellitus, peripheral arterial disease, and immunosuppression due to factors such as HIV or immunosuppressive agents.

Onychomycosis primarily manifests in toenails, with causative fungi belonging to various categories, including yeasts, dermatophytes, or molds. However, dermatophytes are the predominant causative agents, affecting not only nails but also skin and hair, which contain keratin.

The condition initially appears as white, yellow, or black spots at the edge or base of the nail, near the cuticle. As it progresses, these spots spread and cover the entire nail surface. The infection infiltrates the nail, leading to detachment, softening, and deformation. Being infectious, it can spread to other nails of the same person and to other individuals through surfaces contaminated with fungi or fungal spores.

Types of Onychomycosis

Onychomycosis can be categorized based on the parts of the nail affected. These classifications include Distal and Lateral Subungual Onychomycosis, White or Black Superficial Onychomycosis, "Endonix" Onychomycosis, Proximal Subungual Onychomycosis, Mixed Pattern of Onychomycosis, Total Dystrophic Onychomycosis, and Secondary Onychomycosis. Diagnosing a specific type can be challenging due to the variability of causative pathogens.

Causes of Onychomycosis

Over 90% of cases are attributed to dermatophyte fungi, specifically Trichophyton, Epidermophyton, and Microsporum. The remaining 10% are caused by yeasts of the Candida spp. genus or other opportunistic fungi.

Diagnosing Onychomycosis

A doctor will visually examine the nails and may take clippings or debris samples for laboratory analysis to identify the type of fungus causing the infection. It's crucial to differentiate onychomycosis from other conditions like psoriasis, nail trauma, or bacterial infections.

Prevention of Onychomycosis

Adopting certain habits can help prevent nail fungus and reinfections:

• Regularly wash hands and feet, moisturizing nails afterward.
• Trim nails straight across, smooth edges, and disinfect clippers after use.
• Wear sweat-absorbing socks and change them throughout the day.
• Opt for breathable shoe materials and discard or disinfect old shoes.
• Use footwear in pool areas and locker rooms.
• Choose nail salons with sterilized tools for each customer.
• Consider giving up nail polish and artificial nails.

Treating Onychomycosis

Initial treatment typically involves topical antifungal therapy. Given the challenging nature of these infections, treatments are often prolonged. If symptoms persist or worsen, systemic treatments may be prescribed, although they may have side effects. It's crucial to adhere to treatment protocols due to the high likelihood of recurrence.