Onychomycosis

Onychomycosis is a fungal infection of the nails that can affect both fingernails and toenails. It is also known as tinea unguium.

Causes and Risk Factors

• Fungal infections, such as dermatophytes, yeast, and molds, are the primary cause of onychomycosis.
• Warm and humid environments can contribute to the growth of fungi, increasing the risk of infection.
• Poor foot hygiene, sharing personal care items, and walking barefoot in public areas can also increase the risk of developing onychomycosis.
• Certain medical conditions, such as diabetes, circulatory problems, and weakened immune systems, can make individuals more susceptible to fungal infections.

Symptoms

• Thickening or brittleness of the nail
• Discoloration of the nail, which can range from yellow, green, brown, or black
• Distortion of the nail shape
• Pain or discomfort in the affected area
• Foul odor emanating from the infected nail

Types of Onychomycosis

• Distal subungual onychomycosis: infection occurs under the nail plate and in the nail bed.
• Proximal subungual onychomycosis: infection occurs in the nail plate and at the base of the nail.
• White superficial onychomycosis: infection occurs on the surface of the nail plate, causing white spots or patches.
• Candidal onychomycosis: infection caused by yeast, typically affecting the fingernails.

Diagnosis

Diagnosis of onychomycosis is typically made through a combination of physical examination and laboratory tests, including:

• Nail scrapings or clippings for fungal culture or microscopy
• Potassium hydroxide (KOH) preparation to dissolve skin cells and other debris, allowing for easier examination of fungal elements
• Fungal culture to identify the specific type of fungus causing the infection

Treatment Options

Treatment for onychomycosis depends on the severity and location of the infection. Common treatment options include:

• Topical antifungal medications, such as creams or ointments, applied directly to the affected nail.
• Oral antifungal medications, such as terbinafine or itraconazole, which are taken by mouth and can help clear the infection more quickly.
• Nail debridement, a procedure where the infected portion of the nail is removed.
• Laser therapy, which uses a laser to heat and kill fungal cells.

Prevention

To prevent onychomycosis, it is essential to practice good foot hygiene, including:

• Washing feet daily with soap and water
• Drying feet thoroughly, especially between the toes
• Trimming toenails straight across and avoiding sharing personal care items
• Wearing shoes that fit well and are made of breathable materials
• Avoiding walking barefoot in public areas, such as swimming pools or locker rooms.