What is fungus?
Fungus in its various forms grows all around us, especially in moist places. Some types of fungus & yeast involve skin and nails. Fungus infection often occurs after toenail injury. It can occur in anyone but is extremely common in the senior population.
How does fungus affect toenails?
Does my nail have fungus?
Often your doctor may have a good idea if your nail has fungus by its typical appearance. Other studies may be helpful such as microscopic examination of a nail sample or cultures. If nail cultures are taken, results may take up to one month as fungus grow slowly. Other conditions may mimic a fungus toenail such as injury to a nail, constant pressure from a bent toe or from shoes making it grow thicker, psoriasis or vascular disease.
Runner toenail that looks like toenail fungus, but is actually just thick and discolored
from repeatedly hitting the inside of the running shoe seen by San Francisco Podiatrist
Toenails with fungus (onychomycosis) often become thick, brittle, and tend to break apart easily. Yellow or brown discoloration is common. Streaks of discoloration may be seen at times. Often soft debris forms under the nail. It is common that a nail with significant involvement will not adhere well to the underlying skin. Shoe pressure on nails thickened by fungus can be painful and ingrown nails may also result.
There are various treatments for fungus toenails. Unfortunately, it is not as easy to treat as it might seem.
- Choosing to live with the fungus nail by filing, grinding, and trimming it. This type of fungus does not penetrate deeper layers of skin nor enter the bloodstream. Those persons with diabetes, poor blood flow, etc. whose feet are at risk for sores or infections should have nails trimmed by a podiatrist. This service is often not covered by insurance benefit s unless certain risk factors are present.
- Topical medications – Most topical medications (creams or liquids) are very ineffective for treating fungus which is under the nail. Their best use may be in slowing the progress of the fungus, or preventing re-infection of a nail or spread to others nails. The FDA has approved one topical medication which shows some promise of clearing nail fungus in certain cases. The colorless medication is applied daily much like nail polish for 11 months and removed weekly with alcohol or nail polish remover. It must be combined with good trimming and thinning of the nail.
- Matrixectomy – removing the nail & its root. Surprisingly, just removing the nail is usually not a cure. As a nail grows back it tends to get the fungus Again in nearly all cases. If the nail is removed and its root is destroyed by applying chemical or by surgical removal, the fungus is cured. Without a nail, the underlying skin toughens and loss of any protective function is minimal. The appearance is often better than that of a toenail with fungus.