Nail fungus and skin ringworm
What is a fungal nail infection?
Nail fungal infections are also known as onychomycosis or tinea nails . The fungus responsible is usually the same one that causes the athlete's foot (common skin infection on the feet), especially between the toes. In athlete's foot, the responsible fungus lives in the keratin that makes up the outer layer of the skin. When the fungus spreads to the keratin of the nails, the result is a fungal infection of the nails.
What Causes Nail Fungus?
Athlete's foot fungi (called dermatophytes) cause most nail infections. Less often, a nail infection is due to other types of fungus, usually yeast (eg Candida). Nails that are already damaged are easier for the fungus to invade. Fungal infections of the toenails are very common (1 out of 4 people can be affected at some time), therefore, in the fingernails, the incidence is lower.
Where do these fungi come from, how does contagion happen?
Fungi are creatures that live in the environment: they can be contaminated in sand, locker rooms, damp work environments, sports fields and many other situations. There is no need to avoid these places, the most important thing is to keep the skin dry, as moist skin, even from sweat, favors development. Skin fungi that act on the surface are generally not very pathogenic.
They most often affect the elderly, those with poor immune systems, and people with diabetes and poor peripheral circulation. Athletes or gym goers with warm, humid locker rooms help fungus to grow and cause infections. Wearing closed shoes for a long time can increase the risk of fungal infections.
Are fungi hereditary?
Generally speaking, no. However, in some extremely rare cases, there is a genetic risk factor and other family members may also be affected.
What are the symptoms of fungal nail infections?
At first there are usually no symptoms. Afterwards, nails can become so thick that they hurt when they press on the inside of a shoe, making it difficult to cut. Nearby skin may also have a fungal infection; it may itch, crack, blister, especially between the toes.
How is the nail affected by fungi?
When the fungus infects the nail, it usually starts at its free edge, spreading along the side of the nail to the base of the cuticle. Infected areas turn white or yellowish, and become thickened, and there may be white patches on the surface of the nails. The nails most affected by fungal infections are those on the first toe. Sometimes, especially in those who do regular damp jobs, such as housewives, housekeepers and cleaners, it causes the skin around the nail to become red and swollen. This is called paronychia and can allow the infection to enter the nail.
How are fungal nail infections diagnosed?
Fungal nail infections are usually diagnosed clinically, in the presence of tests. The exam requires a lot of experience and sometimes more than one collection.
Many nail problems can look like a fungal infection, for example the changes seen in psoriasis after a bacterial infection or an old lesion. So antifungal pills in this case will not help. The right treatment may depend on which fungus is infecting. Knowing the origin, the most appropriate drugs are directed, as some fungi have been showing resistance to some antibiotics.
How is the treatment of nail mycoses?
Treatment will depend on mycological examination (direct collection by scraping the nail, without any pain), which indicates the most accurate medication for each case. There are almost 10 types of fungi in the RGS that infect nails. Each fungus has a medicine that is more specific to cure it. Generally speaking, 3 months is possible to notice improvement, but complete healing takes 6 to 12 months, depending on how much the nail has been affected and which fungus has affected it.
How can fungal nail infections be treated?
It is important to treat people whose infections can lead to health problems, such as those with diabetes or immune suppression. The goal of treatment is to get rid of the fungus: the nail usually returns to normal. A simple ringworm of the feet can often serve as a gateway to stronger infections such as erysipelas . Treatment options include:
antifungal nail polishes
They are most effective if the infection is treated at an early stage. The most used treatments are enamels with amorolfine, ciclopirox and tioconazole. Alone, they may not be able to heal the deepest parts of an infected nail. Used in combination with an oral antifungal remedy, they increase the chance of a cure. They may have to be used for a period of 4 to 12 months before an answer is noted. The cure rate with only topical agents is low, approximately 15% to 30%.
Tablets: terbinafine and itraconazole
Terbinafine should be considered as a first-line treatment for dermatophyte fungi. It should be taken daily for 6 weeks for nail infections, 12 to 16 weeks for nail infections.
Itraconazole is effective in treating dermatophytes as well; it is useful for treating other fungi such as yeast. It is deposited on the cuticle of the nail and remains effective for a few weeks. Two of these weekly courses, 21 days apart, are usually sufficient for nail infections.
The fluconazole may be effective for candida yeast infections. It appears to be less effective than itraconazole and terbinafine, but it remains an alternative if the body does not support the other medications mentioned above.
Laser for nail fungus treatment
Treatments with laser application to the nail are painless and serve to reduce the amount of medication needed, accelerating the cure of nail fungus that normally takes months to heal, sparing the patient's liver from ingesting medication.
Surgical nail removal
Sometimes very thick nails that are unlikely to respond to pills alone may have to be removed by surgeons under a local anesthetic. However, this is rarely done as cure rates are not high enough to justify the discomfort of surgery.
What can I do to prevent fungi or help with a cure?
Keep your nails short, dry and clean;
Use a nail clipper for infected nails and another for normal ones;
Don't just treat your nails; use an antifungal cream to treat skin that has athlete's foot as well;
Avoid cutting the cuticle, either yourself or by a manicure, as this increases the risk of nail damage and infections.
For fungal toenail infection:
Wear well-fitting shoes without high heels;
Keep your feet dry, wear cotton socks, change daily, and wear ventilated shoes;
Wear clean slippers when using the shower.
IMPORTANT:
Ointments containing corticosteroids (Cortisoba) remove all immunity from the skin and allow the disordered growth of fungi. Unfortunately, they can be easily purchased without a prescription in pharmacies.
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