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Fungal nails


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PACT
Med fungal Nail Therapy

Fungal nail is an infection of the nail plate, it is not considered harmful, however it is unsightly, and if left untreated the infection will spread to other toes and to the nail matrix (this is the nail root). Once the infection has attacked the nail root, the effect may be permanent damage of the matrix. This can result in a permanently disfigured nail. As it is an infection if you or a family member has it, other members of the family may be at increased risk of acquiring fungal nail.

What are fungal nails?

Fungal nail (onychomycosis) is a type of infection. This infection is not bacterial but instead is caused by a fungus which can cause the nail to become thickened and discoloured. A number of fungi can cause fungal nail, the most common culprit is a dermatophyte called trichophyton rubrum.

Fungi thrive in warm, moist dark environments, therefore footwear; particularly trainers provide the perfect breeding ground. The Big toe nail is most commonly affected.

What causes fungal nails?

Fungal nails occur as a result of fungi which infects the nail and/or skin. The infection occurs when the nail plate is damaged, this is how the fungus invades the nail, and it then spreads due to the dermatophytes ability to take nutrients from keratin. Keratin is a protein found in the skin and nail.

There are two types of fungi responsible for fungal nails:

  • Yeast
  • Dermatophytes

It is important that these two are distinguished, as the treatment is different for yeast and dermatophyte infections.

Who gets fungal nails?

Anyone can contract a fungal nail infection, however some people are more at risk of fungal nails than others, and these include:

  • Older people (over 55) and Children
  • People with diabetes ( twice as common)
  • People with sweaty feet
  • Athletes and people who frequent gyms and swimming pools
  • People who live with someone who has a fungal nail
  • People with athlete's foot
  • People who have a nail that has been damaged
  • People with psoriasis
  • People who have a weakened immune system
  • People with peripheral vascular disease (poor circulation)

What are the signs and symptoms of fungal nails?

The signs of a fungal nail vary, but may include:

  • Thickened nails
  • Discoloured nails
  • Debris beneath the nail plate
  • Cracks in the nail

Types of fungal nails:

There are different types of fungal nail. Each type is named according to the site and amount of nail infected. These include:

Distal subungual onychomycosis:

  • Infection is at the tip of and underneath the nail, typically this affects the outside corner. This is the most common.

Proximal subungual onychomycosis:

  • Infection is at the base of the nail. Often this type of infection presents with red and inflamed surrounding skin. This type of infection is more common in those with a weakened immune system and less common in healthy individuals.

White superficial onychomycosis:

  • Begins on the surface of the nail as opposed to underneath. White patches on the surface of the nail are characteristic of this infection. It is the second most common.

Candida Onychomycosis:

  • Is caused by yeast, usually begins at the cuticle and affects the surrounding skin. The infection can produce white, green or brown discoloration of the nail. Usually people with this type of infection will have a yeast infection elsewhere in the body.

Total dystrophic onychomycosis:

  • Total dystrophic onychomycosis describes the more advanced stage of any of the above. This name is given when the entire nail is affected. Sometimes this can damage the nail matrix (the root); if this happens the result may be a permanently disfigured nail.

How are fungal nails diagnosed?

Your podiatrist will diagnose whether or not you have a fungal nail infection based on the signs and symptoms and an examination of the nail, sometimes it is necessary for a sample of nail to be sent away for assessment.

Benefits of podiatry for fungal nails

The podiatrist can advise you on treatment, as well as provide information and advice on how to prevent the infection from either spreading or recurring. If nails are thickened your podiatrist can thin the nail/s making them less unsightly. Thinning the nail will also allow any topical antifungals to penetrate the nail; making treatment more effective.

What would podiatry for fungal nails involve?

Following assessment, this will include taking down a medical history as well as a history of the problem. This information along with examination of the affected nail/s and an assessment of the foot will enable the podiatrist to reach a diagnosis.

There are a number of treatments for fungal nails, this is dependent upon the extent of the infection and the individual patient. At chiropody.co.uk we provide the innovative PACT® med fungal nail therapy photodynamic light therapy, this invoves the painless application of a LED light beam to destroy nail fungus.The decision on what to do next will be one that is mutually agreed between the patient and the podiatrist, and in some cases the GP. Treatment may one include the following:

It is important to remember that the treatment of fungal nail takes time and patience; this is because it takes time for new, uninfected nail to grow through. If the whole nail is infected this can take up to one year.

Summary

Fungal nail is a type of infection caused by dermatophytes or yeast. Some people are more susceptible to fungal nail than others. Nails may appear thick,yellow and cracked,with debris beneath the nail plate. There are a number of treatments for fungal nail, your podiatrist will advise you on the one most suitable for you.

To arrange an assessment with one of our podiatrists please email office@chiropody.co.uk or call 0330 088 4222.

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