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Fungal Toenail Infections: The Ugly Truth

What is it?
Fungal infection of the toenails (onychomycosis) is a common condition especially as people get older. It affects 1 out of 10 people overall. The toenails are more commonly affected than fingernails since your toes tend to be confined in shoes which are typically warm, moist environments. Dermatophytes (a common mold) is the most common type of fungi that causes onychomycosis.

How do you get it?
An infection occurs when you come into contact with the fungi and it seeds it’s way under the toenail. Anyone can get a fungal infection of the toenails. However, you are more at risk if you are 60 and older, immune compromised, diabetic, have poor blood circulation, or have history of toenail injuries. You are also more at risk for getting onychomycosis in settings such as locker rooms, public showers, poolsides, and areas where people tend to walk barefoot. 

What does it look like?
A fungal infection may cause the nail to become thick, brittle, and discolored (yellow, brown, and/or white). The nail may grow abnormally, may lift from the nail bed, may crack or split, and may develop debris under the nail. 

Does it hurt?
A fungal infection of the toenail can make the nail unslightly, but is not typically painful.

Can it cause infection elsewhere?
The fungi that infect the toenails tends to infect only nail and skin. Hence the infection can spread to skin. However, if this does occur it is likely to affect the surrounding skin along the toes and possibly the foot (Athlete’s foot or ringworm). It is unlikely that the infection will seed deeper and travel to other parts of the body.

How is it diagnosed?
Many times a doctor can diagnose a fungal infection of a toenail based on the clinical exam alone. However if there is any question, or if there needs to be a confirmation, a small trimming of the affected portion of the nail can be sent to a lab to evaluate for a fungal infection. 

What are the treatments?
Fungal infections of the toenail can be treated with topical anti-fungals, laser therapy, and oral ant-fungals. The treatments are meant to target and kill the fungi, resolving the infection. Mild to moderate infections may improve with just use of topical treatments and/or laser therapy. More severe infections may require treatment with oral anti-fungals.

How can I prevent fungal toenails?
Good foot hygiene is key to prevention. Change socks and alternate shoes daily if possible. Use anti-fungal shoe spray before and after wearing your shoes. Air out the shoes you have worn. Avoid wearing socks for too long around the house especially on warmer days. Let your feet breath and avoid trapping them in warm environments for too long. Avoid walking without shoes or sandals in public areas where people tend to walk barefoot.

Questions or concerns about fungal toenail infections? Call our office at 949-365-2525 today for an appointment.

Visoth Chan, DPM Dr. Visoth Chan is the owner and medical director of Aloha Foot and Ankle Associates. She graduated from the University of California, San Diego with a Bachelor's Degree in Animal Physiology and Neuroscience. Following this, she received her Doctor of Podiatric Medicine degree at the California School of Podiatric Medicine in Oakland. She subsequently completed her podiatric surgical residency at White Memorial in Los Angeles. She takes great pride in her role at Aloha Foot and Ankle Associates and strives to make sure her patients have the best care possible. When not treating patients, she enjoys reading, traveling, and spending time with her friends and family, especially her daughter, Emmylou.

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