Nail Fungus

By Dr. Loretta Lanphier, ND, CN, HHP, CH

If your toe or finger nails have ever turned crusty and dark, and the symptoms seem to linger forever, then you know what it is to have nail fungus. While not usually dangerous, it can be very annoying and painful in some cases, in addition to being hard to treat. Let’s take a look at some of the particulars of this quite common fungal infection.

What is Nail Fungus?

Nail fungus is a fungal infection of the toenails or fingernails that is the result of fungi that  attack these tissues and often spread deeper into the nail beds the longer the infection is present. They can be particularly difficult to treat, and are a recurring problem for many people. They can be painful, and also tend to make the nails discolored, brittle, and very aesthetically displeasing to certain folks. If you like to go barefoot, you may be particularly sensitive to their unsightly presence, and as we shall see, going barefoot may have exposed you to the infection in the first place. Nail fungus is often found in conjunction with athlete’s foot, and in fact may be caused by the same fungus, but it is a distinctly different condition.

What Are the Symptoms of Nail Fungus Infections?

The official name for nail fungus infection is onychomycosis, and it may be caused by a number of fungal agents. Cases of this illness range from minor to severe enough to cause the nail to separate from the bed, and condition known as onycholysis. Fungal infections can occur in both the toe and finger nails, but they are much more common in the toenails. The most typical symptoms of nail fungus infections include:

  • A small white or yellow spot under the nail (often the first sign of infection)
  • Unusually thick nails
  • Abnormal brittleness
  • Crumbling nails
  • Twisted, distorted nails that change noticeably in appearance
  • Dull nails that lose their characteristic shine
  • Pain in the nail beds and surrounding areas of the toes or fingers.
  • A foul odor from the toes or fingertips
  • Possible separation from the nail bed (in extreme cases)

What Causes Nail Fungus Infections?

Fungi are one of the most common life forms on earth, with an estimated 1.5 million different species. In fact, only about 70,000 of them have been identified and classified. Many of them serve useful purposes as agents of decay in the ecosystem and some as food sources as well. However, certain types of  fungi can be harmful and cause disease and infection. They like to live in dark, moist areas such as on your foot inside of your warm, moist socks and shoes. They also thrive in damp areas such as locker rooms and pool areas. Therefore, wearing socks and shoes that are damp and have poor ventilation can be just as much a risk factor for developing nail fungus as walking barefoot at your health club.

Most nail fungus infections are caused by fungi that are classified as dermatophytes. Less often, certain yeasts and molds can be responsible as well. They typically get their “foothold” (pun intended) in gaps or wounds near or on the nails. These susceptible areas can be so small that they are literally microscopic, invisible to the naked eye. Most of the time they afflict folks that are continuously exposed to damp, warm environments. Wearing shoes and socks, especially in warm weather, often triggers infections. That is one reason why the fungus more easily attacks the toes than the fingers. The toes also generally have less blood circulating through them, so the immune system has less chance to fight off the invaders. People who constantly have wet hands, such as dishwashers or food preparation workers, may also more easily get nail fungus infections on their fingernails.

Another factor you should be aware of is the risk involved with getting your nails (fingers or toes) treated in a salon, especially if artificial or acrylic nails are applied on top of your natural nails. Gaps between the two can be perfect breeding spots for fungal (and bacterial) agents, and the result may be an infection. It kind of ruins the effect if your natural nails turn dark and ugly under the pretty acrylic surface. In addition to aesthetic concerns, infections can spread to surrounding tissues in the fingers and toes. If you do go to a salon, be sure to choose one that is properly licensed, and where the technicians are licensed as well. The facility should be clean and well-ventilated, and before the procedure the technician should wash her hands carefully and scrub down your fingers or toes as well. It is also very important that the tools and equipment used are cleaned and sterilized between each client. Precautions such as these will greatly diminish the chances of developing an infection.

Other factors that may increase the risk of developing nail fungus infections include:

  • Hot, humid environments
  • Damaged or broken nails
  • The presence of another infection (such as athlete’s foot)
  • Foot gear (shoes and/or socks) that cause the feet to perspire and provide inadequate ventilation
  • Going barefoot in public locker rooms and pools (Always wear shower shoes!)
  • Age: Older people tend to have poorer circulation, and their nail beds are often thicker and more brittle, making them more susceptible to gaps where infection can form.
  • Family history: For reasons that are not yet fully understood, nail fungal infections tend to run in families.
  • Gender: Again, for unknown reasons, more men than women develop nail fungus. Perhaps the reason is simply that more men are exposed to locker room type environments, but researchers do not know for sure.
  • Certain conditions:  This factor deserves special mention. People with compromised immune systems are more likely to get all kinds of infections, and nail fungus is no  exception. Illnesses that harm the circulatory system, such as diabetes, can be especially troublesome. In addition to decreasing the immunes system’s ability to travel to the site of the infection, diabetes also tends to make it more likely for patients to have difficulty fighting infections, especially in the extremities. Nerve and circulatory damage make it very critical that diabetics examine their bodies regularly, especially the feet, for any signs of injury or infection. If not caught early, these abnormalities can worsen quickly and in extreme cases may necessitate amputation if they are not treated promptly.

What Treatments Are Available for Nail Fungus Infections?

It must first be confirmed that the source of the infection is a fungus, and not a yeast or bacteria, before the best course of action can be determined. Your health care provider can scrape a  sample of the material under your nail and have it tested to find out what is causing it. A simple examination of the debris under a microscope is usually all that is necessary.

Allopathic medicine has several medicinal alternatives available to treat nail fungus, but as is typical of drugs, they all have significant, potentially dangerous side effects. Oral medications such as terbinafine (Lamisil), fluconazole (Diflucan), and itraconazole (Sporanax) are often prescribed, but they can be toxic to the liver and other organs, cause heart problems, and seriously conflict with other medications. Other topical prescription drugs are also an option, but they are frankly not very effective in most cases, with one study finding that a particular drug called ciclopirox (Penlac) cured infections in only 10% of patients with nail fungus.

Let me provide you with just a couple of more natural alternatives that are much safer, cheaper, and effective than most prescription drugs:

  • Tea tree oil:  This oil  is a derivative of the melaleuca plant native to Australia, and it has wonderful healing properties. One of them is that it is an excellent antifungal agent. Tea tree oil will stop the spread of nail fungus infections, and may be safely applied as often and as long as needed. Be aware that while nail fungus infections may be stopped relatively quickly in some cases, it may take up to a year for the discoloration of the nail to disappear, or for a new nail to grow back. Tea tree oil should be a staple in everyone’s medicine chest and first aid kit.
  • Vinegar:  Application of vinegar has been very helpful to many folks afflicted with nail fungus infections. Vinegar is a terrific healer, disinfectant, and cleansing agent, and it apparently has antifungal properties as well. Your best choice would be an organic, natural vinegar product. Apply with a cotton swab or soak the affected area several times a day for as long as necessary.

Can Nail Fungus Infections be Prevented?

The answer is that there are precautionary measures that can be taken to avoid initial infections and prevent recurring ones as well. Nail fungus infections can be very difficult to get rid of, so it is important that you don’t keep exposing the affected areas to environments that encourage the growth of the fungi. Some practical steps to minimize risk include:

  • Don’t let your feet get sweaty. If they do, be sure to change socks and shoes often, several times a day if necessary. It might be a good idea to alternate pairs of shoes every other day.
  • Use foot powder, either plain or medicated. If you choose medicated, be sure you know what the ingredients are. You don’t want to expose yourself to chemicals that may increase irritation and only worsen the problem.
  • Keep your finger and toenails clean and short. Be careful while trimming them that you do not damage the nails or adjacent skin. Also, wash your hands after handling affected areas.
  • Keep your hands dry, especially if they are exposed to dampness constantly. Wearing rubber gloves is a good idea, as long as you are not allergic to latex. One good tip is to turn the gloves inside out when you are not wearing them so that they can fully dry from any perspiration or other moisture that may be present.
  • Never go barefoot in public areas, especially if they are damp. It’s a great way to pick up a fungal infection.

As with all wellness issues, prevention is far better than treatment. Taking care to avoid nail fungus will eliminate having to deal with this stubborn, persistent condition that can make your life difficult. A little preventative, proactive intervention can really help to lessen the risk of nail fungus infections.

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