What is Toenail fungus?
Nail fungus, known medically as onychomycosis, is a common fungal infection of the nail. It is said that 1 in 10 people have nail fungus. It is usually caused by the same group of fungus that causes athlete’s foot and ringworm, called dermatophytes. Other causes are moulds and Candida. These fungi are often found in warm locations, such as swimming pool, changing room or in moist occlusive footwear.
Usually in toenail fungus, fungus infects from the edge of the toenail and gradually spreads to the nail bed, causing the toenails to become discoloured, thickened and fragile. Unlike athlete’s foot, toenail fungus does not cause itchiness and so is often left untreated.
However, toenail fungus is contagious, and may cause infection to other areas of the skin, and family if left untreated. Worsening deformation may also affect daily activities such as wearing shoes and walking, and may become a cause of pain.
Risk factors for toenail fungus
Advanced age
Wear occlusive shoes
Nail trauma
Low immunity (Diabetic patients, HIV patients)
Frequently visits swimming pools, gyms
Athelete's foot
Toenail Fungus is contagious
Fungal nail infection may seem like a small issue. However, it is highly infectious, if not treated properly, not only will it affect the appearance, the fungus may also spread to other parts of the body (such as hands, feet or groin area). Or even worse it can infect family members and friends.
See a doctor for Toenail Fungus
Your nails should be checked by a doctor to get a correct diagnosis of toenail fungus.
Abnormal appearance of the nails can be caused not only by fungal infection, but also by bacterial infection, repetitive external trauma to the nails; and other less common non-fungal conditions that cause frail nails and discoloration.
Doctors will conduct a visual examination of the nails and surrounding skin for the diagnosis. In case toenail fungus is suspected, they may also take a sample from the nail bed to confirm the presence and type of fungus.
Treatment of Toenail Fungus
Usually, an antifungal medicine is used to kill the causative fungus. These are available in oral and topical form. Oral antifungals such as Terbinafine tablets and Itraconazole capsules are delivered systemically. These have the benefit of high efficacy but come with the risk of systemic side effects and require frequent liver monitoring.
On the other hand, topical lacquers such as Amorolfine and Ciclopirox have the benefit of direct application to the infected nail, but require frequent debridement.
Efinaconazole is a new topical prescription drug with demonstrated clinical efficacy for cure of onychomycosis and does not require debridement.
Foot Hygiene
Whichever method you take, toenail fungus treatment requires patience, as it takes 1-1.5 years for new toenails to grow out. During treatment, be careful to keep good hygiene practice.
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Clean your feet regularly and keep them dry
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Keep your home clean to prevent infection to family
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Fungus can survive in nail clippings and fallen skin. Clean the floor and carpets regularly.
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Avoid sharing bathmats and slippers.
~1 year