Causes of onychomycosis

All such infections are caused by fungal organisms that thrives in the moist environment the feet offer. The most common is called dermatophyte fungus. Other common offenders are common yeast and even mold.

This can happen to patients at any age, but as with many other foot problems it’s most common in older adults. Nails become brittle with age, resulting in the formation of tiny cracks, which give fungus a way in. If a person is diabetic or has a weakened immune system due to some medications, then the chances of infection go up.

As noted, the same fungus which causes athlete’s foot also causes nail fungus. It’s entirely possible to have one progress to the other, as well as the infection spreading from nail to nail. Person to person transmission is much rarer.

Risk factors for onychomycosis

The following is a list of the most commonly seen risk factors:

  • Older age often leads to both reduced blood flow to the nail bed, and more years of exposure to the fungus.

  • Heavy sweating, as seen in athletes, leads to a more moist environment.

  • A history of tinea pedis (athlete’s foot).

  • In moist, public areas such as locker rooms, showers, and swimming pools, a history of walking barefoot.

  • Having pre-existing injuries of the nail or surrounding skin. This can allow the fungus access to the tissue beneath the nail.

  • A history of other skin conditions of the foot, such as psoriasis.

  • Being a diabetic patient, which can mean decreased circulation in the feet.

  • Having a compromised immune system, as seen with certain medications and other infections such as HIV.

Possible complications

There are some things you can do at home to help relieve the symptoms of an painful ingrown toenail.If a case of onychomycosis is severe enough, it can be quite painful, as the skin beneath the nails is very sensitive. The nail can become ingrown. Permanent damage is also possible in severe cases. Another obvious complication is the infection spreading to other nails (or even the other foot).

With diabetes often comes a decreased nerve supply leading to reduced sensation. Poor circulation is also common. This means that diabetic feet are more prone to any type of infection, including fungal. The lack of sensation also means that people often damage their foot without them feeling it, such as repetitive trauma from tight shoes. As with any other type of trauma, this can allow fungus a way in. It bears repeating: it’s essential for diabetics to be under a podiatrist’s care.

Preventing toenail fungus

Good hygiene and foot care practices are the best way to prevent any type of infection, especially the fungal infections which cause onychomycosis.

  • Wash feet regularly and thoroughly with every bath or shower. Wash your hands after handling an infected nail.

  • When trimming nails, cut them straight across, smooth the edges with a file, and gently file down any thickened areas. Clean clippers with alcohol or other disinfectant after use.

  • Change socks as often as feasible. Cotton socks are best.

  • Choose breathable shoes, such as running shoes.

  • Don’t keep shoes beyond the point of their useful life. Older shoes contain more fungal spores. Conversely, treat all shoes, especially old ones, with antifungal powder.

  • In moist environments such as locker rooms, wear sandals at all times.

  • Make sure nail salons you frequent are hygienic in appearance. A new set of sterilized instruments must be used for each client.

  • Don’t wear nail polish or artificial nails. Both prevent the nail from breathing and make fungal infections worse.

Diagnosing nail fungus

This is done by physical examination. If there’s any doubt, clippings and debris scrapings can be sent in for identification. This will identify specifically which organism is causing the infection.

Some conditions, namely psoriasis, often look like onychomycosis. Once the true cause is known, the most appropriate treatment can be started.