Fungal nail infection is a condition that causes brittleness and discolouration of the nails. This condition commonly affects feet nails, especially the toes. Formally known as onychomycosis, this condition is quite similar to an athlete’s feet. However, instead of attacking the bottom of your feet or between your toes, it attacks your nails. The fungal infection usually starts as a white or yellow spot beneath your fingernail or toenail’s tips. However, as the infection worsens, it goes deeper and causes more prevalent symptoms like thickening and crumbling the nails from the edge. It is worth noting that the condition can also affect your hand nails, though rarely. This write-up discusses the causes and symptoms of nail fungal infection.
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What causes fungal nail infections?
Most fungal infections of the nails occur due to the fungi responsible for the athlete’s feet. This is why the two conditions are often compared. Fungi can be present anywhere in your body. The fungi can be picked up from the air or soil. The fungi live harmlessly on your skin or body most of the time. However, as they multiply, they can cause infections, known as fungal infections. Wet, moist, warm, and dark environments encourage the fungi to grow and result in profound infections. When the fungi multiply, they penetrate your skin and nails, causing a host of infections, including nail fungal infections. You can also develop a fungal infection on your nails if you:
• Do not keep your feet clean and dry
• Wear shoes that promote heating and sweating in the feet
• Walk barefoot in places where fungal infections are prone to spread, like communal showers, gyms, and locker rooms
• Have damaged nails and a weak immune system
• Have a pre-existing health condition like diabetes, psoriasis, or a peripheral arterial disease
It is also worth mentioning that fungal infections are highly contagious. This means that if they originate on one part of your skin, they can quickly spread to another. For instance, if they start on the skin of your feet, the high chances are that they will spread to your nails also. The infections can also spread to other people around you.
Types of fungal infections of the nail
These infections can be categorized into different forms. The most common ones are:
Distal subungual onychomycosis
Also known as lateral subungual onychomycosis, DSO is the most common type of fungal infection of the nails. It is caused by a fungus known as dermatophyte and can develop in your finger and toenails. It usually begins in the nail bed or beneath the nail. It starts as a yellowish-coloured area and spreads to all parts of your nail as it gets severe.
White superficial onychomycosis
This type is less common. It only affects the surface of the nails and mainly occurs on toenails. This type starts as white spots. As it worsens, the spots become powdery, resulting in crumbling toenails.
This infection is usually caused by yeast, and it often affects the fingernails. The symptoms of candidal onychomycosis include swelling and inflammation of the nails. As the condition worsens, the nails may fall off. It often affects nails that another infection or an injury has damaged.
Proximal subungual onychomycosis
This fungal infection of the nail starts with white spots at the centre of the nail bed at the cuticle. The spots move towards the finger or toenails as they grow. This type is quite rare and mainly affects people with immune system problems, such as HIV.
Risk factors for nail fungus;
The following are some factors that can increase your risk of developing fungal infections of the nails;
• Age– older people are more prone to nail fungus because of their reduced blood flow and several years of exposure to fungi. Older people also have slower growing nails, which increase the likelihood of infections.
• Heavy sweaters– people who sweat heavily and often are also at a higher risk of developing nail fungus because sweaty and warm feet promote the growth of fungus
• A history of athlete’s foot– people who have suffered from athlete’s foot in the past, are also prone to nail fungus because of the existing fungi in their nails and feet
• Medical conditions- people with specific medical conditions like diabetes and HIV are more prone to nail fungus. Diabetes causes circulation problems, and HIV causes weakened immune systems, which increase the chances of infections.
Symptoms of fungal nail infection
Detecting a nail fungal infection can be relatively challenging, especially in the early or developing stages. This is because the initial stages do not cause physical discomfort. For this reason, a lot of people ignore the symptoms until the infection worsens. Fungal nail infection symptoms include:
Discolouration of the nail
Most fungal infections of the nails start with discolouration (regardless of the type). Your nails may turn white, black, yellow, or green, depending on the type of fungal infection. The discolouration may also occur from the nail bed or the sides. However, more often than not, it starts at the nail bed and progresses to the sides, cuticles, and the rest of the nail.
Thickening of the nail
As the infection progresses, your nails may start to thicken. They become thicker than usual and harder to fit between nail cutters. While some people may have naturally thick nails, with an infection, the thickness worsens and mostly starts at the centre of the nails.
Distortion of the nails
In addition to the thickening, the nails also become distorted. They form an unusual shape and texture. The distortion also makes them hard to trim.
Pain or discomfort
Pain and discomfort do not happen until the infection has progressed significantly. This is why most people only seek help or realize a problem after reaching this stage. Most people experiencing fungal infections of the nails only feel pain when using or placing pressure on the affected toe or finger. As the infection progresses, some people have reported feeling a throbbing sensation without applying pressure or using the finger or toe.
Brittleness and crumbling
Another common symptom of fungal infections on the nails is brittleness and crumbling. Infected nails often break off as easily as chalk. This usually happens if the infection is not treated or addressed earlier. In worse cases, the nails end up coming off entirely. This often occurs if the condition results from injury or a weakened immune system.
Curling or loosening of the nail
Your nails may also start to curl up or down as the infection continues to progress. Eventually, especially as they curl up, they loosen from the nail bed. This could lead to the entire nail coming off.
Itchiness and cracking of the skin
The infections also affect the skin around the nails. As explained earlier, fungal infections are highly contagious. Therefore, a nail infection can easily affect the skin around the nail. You can tell if your skin is infected if it becomes itchy, cracked, swollen, or red.
A foul smell also characterizes severe infections. Your nail may produce a similar smell as feet with athlete’s foot. This symptom is not common to all types of nail fungal infections.
A severe case of nail fungus can lead to permanent damage to your nails. It can also lead to other severe infections spreading beyond your feet, especially if you have a suppressed immune system or take medication for conditions like diabetes.
Fungal nail treatment
Many people do not consider treatment for mild fungal infections because the symptoms are usually non-threatening and may not seem worth treating. However, failure to treat the infections can lead to it becoming severe, as the symptoms progress. Most physicians will recommend the following treatments for fungal nails:
• Antifungal tablets – they are often taken once or twice per day over several months
• Antifungal nail paints – this is a unique paint applied directly to the nail over several months
• Antifungal powder or spray– applying these products on your feet and in your shoes can kill the fungi living in them and prevent the condition from worsening
• Nail softening paste– this product is usually applied to the nail to soften them before they are removed using a scraping device. This is a treatment for extremely severe nail infections.
In worse cases, a doctor may recommend complete removal of the nail or laser treatments. In laser treatments, high-energy lasers are applied to destroy the fungus. Such treatments are usually expensive.
Prevention and self-care for nail fungal infections
The treatments above are only used for moderate to severe nail fungal infections. For mild cases, the following self-care steps can help. The steps can also prevent the infections from developing or worsening;
• Keep your hands and feet clean and dry
• Wear well-fitting shoes manufactured with natural materials
• Wear clean cotton socks to allow your feet to breathe and prevent sweating or warmth that causes fungi to multiply
• Keep your nails short
• Do not share clippers or scissors with other people
• Do not share towels or socks
• Ensure that your towels are cleaned frequently
• Do not walk barefoot, especially in public or communal spaces like pools, showers, gyms, and locker rooms
• Do away with your old footwear, especially if you have suffered an infection in the past
When do you seek treatment for these infections?
You will need to see a physician or a doctor if the prevention or self-care steps do not prove fruitful. You will also need to seek treatment if your nails worsen or the symptoms become severe. People with pre-existing conditions like diabetes also need to seek professional treatment as soon as they develop fungal infections of the nails.