Austin Podiatry House
What are Fungal Foot and Toenail Infections?
(Officially known as "Onychomycosis")
The fungal toenail infection is one of the most commonly known design flaws of the human body. There are varying reports on how many people statistically have it, some studies showing up to 50% of people have this during the span of their lives. Our doctor has seen fungal toenails all the way from young children to much more commonly in the elderly populations.
How do people get a fungal nail infection?
Here are some ways that people can get fungus in their nails:
Injury to the nail plate: Stubbing a toe, dropping a heavy object on the nails, a nail injury that causes the nail to come off.
Fungal skin infection progresses to the toenail(s) and stays there.
Circulatory and health issues increase susceptibility to fungal infections. This can be due to poor circulation, high blood sugar levels, peripheral neuropathy.
Genetics. Yes genetics. Some people are just more susceptible to fungal infections than others.
Wearing shoes that someone else with a fungal infection wore.
How are fungal toenails treated?
Depending on one's age, circulatory status and fungal nail progression, there are several treatments. Fungal nail infections are stubborn and take a lot of patience to treat.
Trimming (we call it nail "debridement") of the nails. Special nail nippers and electric files are carefully used. If the instruments or electric file nicks the skin, infections can occur, so it is important to be very careful with these. Most patients request having this done every 2 months, give or take a little time depending on how fast their nails grow.
Topical Antifungal use: There are MANY different types of good topical antifungals. The thing about these is that you have to use them consistently and many people aren't compliant to the point of applying these as often and long as they are needed, in order to treat the fungus. The toenails take around 6-9 months (or longer) to grow out, and the medication may take a growth cycle or two in order to fully work. That means twice daily use for a year or more, which may work, but doesn't work for everyone.
Oral Antifungal medications: These are often taken for only 3 months (6 if doubling up) and as they often are metabolized in the liver, liver function blood tests are recommended before and during treatment to make sure it is ok to take it. These work on the fungal load in the blood (yep) and helps heal the toenails from the inside out. That said, they only are taken for a few months and we know that the toenails take longer than that to grow out. We often recommend topical antifungal use in addition to the oral medications when oral ones are prescribed. [*Interesting facts: Fingernail fungal infections are less common and treatments are quicker for them. Fingers are closer to the heart, so they have better circulation (growth cycle time is half as long for fingernails as for the toenails) and fingernails are usually uncovered, so they are less likely to get fungal infections as they are not in dark humid environments like the feet often are.]
Laser toenail treatments: These are often very expensive (some places charge around $1000) and so far the research reports are contradictory on how well these work. We've seen some good reports in the mix. These treatments can be found at some podiatrist and dermatologist offices, but we do not offer this service.
Last ditch effort: Permanently remove the fungal nail(s). This can be done, depending on the circulatory and healing status of the client.
Fungal Foot Infection of the Skin
(Athelete's Foot, aka "Tinea Pedis")
What is Athlete's Foot and why are non-athletes getting it?
This is a fungal skin infection that is most often caused by the right combination of circumstances. First off, fungi are EVERYWHERE. If there's a chance for them to get in, they'll take it. Typically a warm, moist, dark environment is the ideal breeding ground for fungal infections to occur. Things that increase the chances of having this growth environment: closed toe shoes (especially second-hand shoes), tight socks, sweating of the feet / hot feet, moisture between the toes, public showers, circulatory issues and edema / swelling. For this reason, for people susceptible to fungal infections, it is recommended not to put much (or any) lotion between the toes. Clean and dry between the toes after each shower.
There are many medications to treat this and it is also recommended to clean out the shoes and shower periodically to prevent re-infections. There are several types of fungal infection and also other infections that mimic Athlete's Foot infections, so if a medication is not working, please get a professional evaluation.