Nail fungal infection: You may not be aware that you have it

Feb 03, 2019 Dr Zulfikar Bux, Features / Columnists

Assistant Professor of Emergency Medicine
Nail fungal infections are very common in our part of the world. Research shows that it can affect up to 25 percent of some populations. In Guyana, we are at risk of getting nail fungal infections because of our humid climate. Many patients present with damaged nails and smelly feet. Those that are diabetic can have severe infections that can lead to them losing their feet. Today, we will look at nail fungal infections so that you may be able to treat it early and prevent it from becoming complicated.

WHAT ARE SYMPTOMS OF A NAIL FUNGUS?
The following are changes to your nail that can indicate that you have a nail fungus:
• Discolored (usually white or yellow)
• Brittle
• Crumbly, or have rough, jagged edges
• Thick
• Separated from the nail bed
• Curled up or down, or are distorted in shape
The infection can cause pain if it is severe. Some people with fungal nail infections have athlete’s foot. This is a similar condition that affects the skin around the toes. If left untreated, nail fungus can cause you to have repeat toe and foot infections; some can be dangerous. It can also cause you to lose nails very often.

WHAT CAUSES A NAIL FUNGAL INFECTION?
The infection is usually caused by exposure to a fungus. The fungus grows in wet, dark conditions. The fungus grows when your feet are in warm, sweaty environment (socks, work boots). It enters your nail through a crack in the nail.
Nail fungus infections happen at any age. They are more common in adults older than 60 years of age. They are common in people who have diabetes or circulation problems. They also are common in people with a weakened immune system. Men are more likely than women to get fungal nail infections.

CAN A NAIL FUNGAL INFECTION BE PREVENTED OR AVOIDED?
Avoid situations that expose you to a fungus. This includes walking barefoot in locker rooms and having wet hands or feet often. This might be a problem for people who work in restaurants or house cleaning. People in a family can get nail fungal infections at the same time. This happens when their immune systems aren’t able to fight off the infection. Or it could be the infection is spread when using the same towels.

IS THERE TREATMENT FOR NAIL FUNGUS?
Prescription medicines can treat a fungal nail infection. Oral antifungal medicines help a new nail grow. This will replace the infected nail. You may need to take antifungal medicine for six to 12 weeks and sometimes longer. Some oral medicines are not safe for people who have liver or heart problems. Tell your doctor if you have one of these conditions. Your doctor will decide which medicine is right for you. Topical medicines such as creams and ointments, usually do not cure fungal nail infections but can help to alleviate it along with the tablets.
In severe cases, a doctor might remove the nail completely. It can take several months to a year for the infection to go away.

WHAT STEPS CAN YOU TAKE IF YOU HAVE A NAIL FUNGAL INFECTION?
If you have a nail fungal infection, some things can help:
• Keep your nails cut short and file down any thick areas.
• Don’t use the same nail trimmer and file on healthy nails and infected nails. If you have your nails professionally manicured, bring your own nail file and trimmer from home.
• Wear waterproof gloves for wet work. Wear 100% cotton gloves for dry work.
• Wear socks made of wicking material. This pulls moisture away from the skin. Change your socks when they are damp from sweat or if your feet get wet. Put on clean, dry socks every day. Put over-the-counter antifungal foot powder inside your socks to keep your feet dry.
• Wear shoes with good support and a wide toe area. Don’t wear pointed shoes that press your toes together.
• Avoid walking barefoot in public areas, such as locker rooms