Why Do Patients So Often Relapse
There are multiple factors that may contribute to the high rate of fungal nail infection recurrence. Patients with a genetic predisposition to onychomycosis, who are immunocompromised, or who have diabetes, are likely to experience relapse and may never achieve a permanent cure .
This may be due either to failure to eradicate the infecting fungus or to re-infection with a new fungal strain following subsequent exposure. Arthroconidia, which are chains of fungal conidia that are formed by breakage of the fungal hyphae, are considered to be the primary means of nail invasion. These arthroconidia, which have thicker cell walls than conidia formed in vitro, have been shown to be more resistant to antifungals and, thus, may remain in the nail bed as a reservoir for recurrent disease . However, the incidence of innate resistance among dermatophytes is low. Our Center conducted in vitro susceptibility testing of 140 sequential isolates from subjects who failed treatment in an oral terbinafine clinical trial. In all cases, the minimum inhibitory concentrations of terbinafine against each patient set were identical or within one tube dilution, implying no resistance development. The same results were obtained within each set with fluconazole, itraconazole, and griseofulvin . This further indicates that there was no crossresistance between antifungal agents . This study showed that failure to cure the infected nails may be due to host/family factors.
Why Does It Develop
A fungal nail infection occurs from the overgrowth of fungi in, under, or on the nail. Fungi thrive in warm, moist environments, so this type of environment can cause them to naturally overpopulate. The same fungi that cause jock itch, athletes foot, and ringworm can cause nail infections.
Fungi that are already present in or on your body can cause nail infections. If you have come in contact with someone else who has a fungal infection, you may have contracted it as well. Fungal infections affect toenails more commonly than fingernails, likely because your toes are usually confined to shoes, where theyre in a warm, moist environment.
If you get a manicure or pedicure at a nail salon, be sure to ask how the staff disinfects their tools and how often they do it. Tools, such as emery boards and nail clippers, can spread fungal infections from person to person if theyre not sanitized.
What Does Fungal Nail Look Like
Usually, it first appears on the edge of your nail, under the tip, as a white or yellow streak. This streak gradually spreads down the side of your nail to the base.
Eventually, your nail becomes brittle, discoloured, thickened and distorted. It can become so thick that it hurts when pressed against the side of a shoe.
The nail may end up crumbling and splitting, and separating from the skin. It often turns yellow or brown.
The surrounding skin may also become infected and may itch, crack, form a blister, or appear white especially between the toes. Its important to act quickly if you notice any of these symptoms. If you dont treat the infection, theres a chance it will worsen and spread to other nails.
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How To Get Rid Of Nail Fungus
Toenail fungus is notoriously difficult to treat.
In order to be rid of the fungus, youâll need the nail to fully grow out while treating it. And, nails grow slowly, so change can take time.
A fungus is not like a bacteria that can be washed away with some soap and water, or treated with antibiotics. A fungus infection will require an antifungal treatment and the growth of new healthy toenails.
How To Prevent Toenail Fungus
Because fungi are everywhere , they can be present months before they find opportunities to strike and before signs of infection appear. By following certain precautions, including proper hygiene and regular inspection of the feet and toes, chances of the problem occurring can be significantly reduced.
- Regularly clean and dry feet to resist disease. Follow a strict regimen of washing the feet with soap and water.
- Change socks and hosiery daily and change out shoes on a regular basis.
- Clip toenails straight across so the nail doesnt extend beyond the tip of your finger or toenails.
- Wear socks that are made of synthetic fiber to wick away moisture. Cotton and wool socks dont wick away moisture as fast as synthetic fiber does. This can be helpful in denying a hospitable environment for the fungi to grow in.
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How Can I Stop My Nail Fungus From Returning
Chances are, if youre exposing your feet to the same spaces in which they previously became infected, theyll likely get infected again. Instead of walking barefoot through communal areas like public pools and showers, try wearing flip-flops or other appropriate shower shoes. Just make sure you thoroughly clean and dry your feet afterward.
When you treat yourself to a pedicure, make sure the establishment is clean, licensed, and in accordance with state standards. Are the nail techs sterilizing their equipment between each use? If not, this could be why nail fungus keeps popping up on your toes. Time to find a new favorite spot!
If youve taken medication for nail fungus or used antifungal creams or polishes and stopped using them at the first sign of healthier nails, this could be why your nail fungus keeps coming back. Although it seems like the fungus is gone, some that isnt visible to the naked eye could remain. If treatment is stopped too early, some remnant fungus may continue to grow, which will lead to what is perceived to be another infection.
If your doctor gives you oral medication, make sure to finish it in accordance with your doctors recommendations. If youre using over-the-counter polish or cream, its recommended that you keep using it up to a couple of weeks after the appearance of a healthy nail.
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Staying One Step Ahead Of Toenail Fungus
An established fungal infection is hard to eradicate, but you can stop its spread and improve your toenail’s appearance.
Toenail fungus isn’t a pressing health problem. Yet a fungal infection can ruin the appearance of your nails and cause pain as it lifts the nail away from the nail bed. And fungal infections are notoriously difficult to get rid of. “You may want to consider fungal toenail a condition to be managed rather than cured,” says Dr. James P. Ioli, chief of the podiatry service at Harvard-affiliated Brigham and Women’s Hospital.
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Tips To Prevent Fungal Nail Infections
Making a few simple lifestyle changes can help prevent a fungal infection of the nails. Taking good care of your nails by keeping them well trimmed and clean is a good way to prevent infections.
Also avoid injuring the skin around your nails. If youre going to have damp or wet hands for an extended amount of time, you may want to wear rubber gloves.
Other ways to prevent fungal infections of the nails include:
- washing your hands after touching infected nails
- drying your feet well after showering, especially between your toes
- getting manicures or pedicures from trustworthy salons
- avoiding being barefoot in public places
- reducing your use of artificial nails and nail polish
Products to help you avoid nail fungus
If youre prone to excessive moisture around your fingernails or toenails, consider buying:
Treatments For Fungal Nail Infections
Treatment isn’t always needed for a mild fungal nail infection because it’s unlikely to cause any further problems and you may feel it’s not worth treating.
Whether you decide to have treatment or not, you should still practise good foot hygiene to stop the infection getting worse or spreading to others.
Speak to your GP or pharmacist if you’re bothered by the appearance of the affected nail, or it’s causing problems such as pain and discomfort. They’ll probably recommend:
- antifungal tablets tablets taken once or twice a day for several months
- antifungal nail paints special paints applied directly to the nail over several months
- nail softening kits where a paste is used to soften infected parts of the nail, before they’re removed with a scraping device
A procedure to remove the nail completely may be recommended in severe cases. Laser treatment, where a high-energy laser is used to destroy the fungus, is also an option. But this is only available privately and can be expensive.
You can reduce your risk of developing a fungal nail infection by:
Nail salon equipment can sometimes be the source of fungal nail infections. If you regularly visit a salon, make sure any equipment used is properly sterilised between uses.
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Protect Your Feet In Public
You can lock down your home against fungus rather easily, but the world is another matter. Fungus thrives in warm, damp, moist environments, and there are plenty of them out there with a lot of foot traffic.
If you are going to high risk areas such as gyms, locker rooms, and public pools, you need to keep your feet protected. A pair of sandals oreven bettershower shoes will provide a good amount of cover in the worst of it.
Of course, wash your feet well after your time in a shower room or pool, and make sure they are fully dry before you put socks and shoes back on.
Who Gets Nail Fungus
Nail fungus is common, and anyone can get it. However, some people have a higher risk of developing a fungal nail infection. Your age, health, and even your lifestyle can increase your risk.
Age. The risk of developing a fungal nail infection increases with age. Its most common in old age and least common in children.
Before the age of 6, its rare to develop a fungal nail infection.
Climate. Living in a hot, humid climate increases the risk of developing a fungal nail infection.
Health. You have an increased risk of developing a fungal nail infection if you have one or more of the following:
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Athletes foot
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Cancer and are receiving chemotherapy
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Diabetes
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Injured a nail or recently had nail surgery
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People in your family frequently get nail infections
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Poor circulation
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Weakened immune system due to a disease like human immunodeficiency syndrome
Do you have frequent nail infections?
If you get frequent nail infections, you may have untreated athletes foot.
Lifestyle. Your risk of getting a fungal nail infection increases if you:
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Have wet feet or hands frequently throughout the day
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Smoke
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Spend a lot of time in water
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Walk barefoot in a hot, humid place like a pool, public shower, or locker room
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Wear tight-fitting, closed-toe shoes, especially if you have sweaty feet
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Wear plastic gloves for hours every day
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Why Does My Nail Fungus Keep Coming Back
Are you dealing with stubborn nail fungus that just doesnt seem to go away and stay gone? However frustrating it may be, the good news is, youre not alone! Nail fungus is very common, with an estimated 3 to 12 percent of the population being affected.
It isnt always easy to determine if whats happening under your nails is a fungal infection or another skin condition. To be sure, go ahead and make an appointment with one of our experienced podiatrists, Samantha Childers, DPM, or Ricky Childers, DPM, at North Central Texas Foot & Ankle. In addition to our Decatur, Texas, location, we have an office in Roanoke, Texas, as well.
In the meantime, lets go over the causes of nail fungus, why it might keep recurring, and some ways to try to prevent it.
What To Do If Your Toenail Is Falling Off
Firstly, stay calm! This happens to the best of us.
If your nail is falling off but is still attached — donât rip it off. This can invite a pretty nasty infection. Just let the nail naturally detach itself or see a doctor for the removal.
If itâs bleeding, apply pressure and cold water until the bleeding stops.
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Mayo Clinic Q And A: Toenail Fungus Often Difficult To Eliminate Completely
DEAR MAYO CLINIC: What causes toenail fungus, and what can be done to treat it? Is it contagious?ANSWER: Toenail fungus is an infection thats usually caused by a microscopic organism called dermatophyte fungus. These infections can be contagious, and they are often difficult to eliminate completely. Fortunately, for most healthy adults toenail fungus doesnt pose any serious health risks.
Toenail fungus is a common condition that begins as a white or yellow spot under the tip of your toenail. As the infection goes deeper, nail fungus may cause your nail to discolor, thicken and crumble at the edge. Fungal infections are more likely to happen in your toenails than in your fingernails because toenails often are confined in a dark, warm, moist environment inside your shoes where fungi can thrive. Toes also have less blood flow than fingers, making it harder for your bodys immune system to detect and stop the infection.
The older you are, the more likely you are to get toenail fungus. Thats because as you age, your immune system changes. In addition, your nails become more brittle and drier over time, creating more cracks where fungus can live.
You may see ads publicizing laser treatments for toenail fungus. I usually dont recommend them. They tend to be quite expensive, and at this time most medical insurance does not cover that type of treatment.
When Should I Call The Doctor
In rare cases, toenail fungus can cause an infection called cellulitis. Without prompt treatment, cellulitis may pose a serious danger to your health.
You should seek treatment guidance from a trusted healthcare provider if you have:
- Circulation problems.
- Redness, pain or pus near the toenail.
- Weakened immune system.
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Side Effects Of Toenail Fungus Medication
One of the many benefits of using a homeopathic remedy is that there are little to no adverse side effects. Topical treatments often prescribed to treat toenail fungus can potentially burn or blister the skin. Oral medications for treating onychomycosis can cause liver or gastrointestinal damage. Be sure to read your medications list of potential side effects. Consult your pharmacist, physician, or specialist if you are concerned about side effects of prescription drugs.
What Is The Outlook For Someone With Toenail Fungus
While toenail fungus is common, its usually not harmful. Symptoms mostly affect the look of your toenail.
Toenail fungus may spread to the skin between your toes or other areas of your body. When getting dressed, put your socks on first to reduce the chance of spread.
Treating toenail fungus takes a long time, and it doesnt always work. Even then, toenail fungus often returns. Discuss the pros and cons of treating toenail fungus with your provider to determine whats best for you.
Practicing good hygiene and foot care reduces the chance toenail fungus will come back. If you have diabetes, getting regular foot exams may help you address foot problems before they get serious.
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What Causes Toenail Fungus
Toenail fungus is a common problem that can be rather challenging to get rid of. While toenail fungus can happen to anyone it most often occurs in older adults. If you are noticing that one of your toenails has thickened, become brittle and turned yellow then chances are good that you are dealing with a toenail fungus.
What causes a fungal infection in the toenail?
A toenail fungal infection, known as onychomycosis, is the result of a fungal known as a dermatophyte. While less common, molds and yeasts can also infect the toenails. The reason older adults are more prone to fungal nail infections is because nails dry out as we age, which leads to cracks within the nail. These cracks make it easier for a fungal infection to get inside the nail.
Fungal is all around us. They are more often found in warm, dark, and damp places such as communal locker rooms and showers, gyms, and local swimming pools. Its also possible to get a toenail fungus from a nail salon so its important to know the hygiene and sterilization practices of your local nail salon to make sure that you arent at risk for developing a fungal infection.
Treating Toenail Fungus
Other treatment options include:
- Laser fungal treatment
- Nail removal surgery
If you are dealing with a pesky nail fungus then turn to your podiatrist to discover the best strategies for getting rid of this infection as quickly as possible.
What To Do After Toenail Falls Off
After the nail falls off, your nail bed is going to be raw and vulnerable to infection. So, the first thing you want to do is keep that nail bed clean and wrapped in a fresh bandaid.
Use run-of-the-mill wound care like Neosporin and large bandaids. Keep the area dry and clean.
Once the skin of the nail bed has healed, you should begin using a topical antifungal treatment on your toenails .
Use this treatment until the nail has fully grown back. If new growth is looking healthy — great. But donât stop treatment unless your doctor recommends it.
Using this antifungal medication ensures that the new healthy nail wonât get infected by the fungus that still remains. Unfortunately, recurrence of toenail fungal infections is common, so be diligent about using the medication.
If you stick with it, you could have a perfectly healthy nail to show for it.â
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Your Body Is Trying To Tell You Something
In less common cases, the reason you are dealing with a reoccurring fungal toenail infection could be because you are suffering from some medical condition. For example, people with nerve damage, poor circulation, a compromised immune system, or diabetes are much more likely to suffer from fungal toenail infections. It is worth taking a trip to your primary care physician to get a health and wellness examination and confirm whether or not something else is going on in your body. Once you get to the root of the problem, you will have an easier time keeping your toes healthy and clear of fungal infections. Additionally, you could be suffering from repeated fungal toenail infections because you have toenails that are more sensitive than normal. Although it is not very common, some women who wear nail polish deal with frequent fungal toenail infections. But it isnt the nail polish that is causing the infection. When you have polish on your toes, it traps moisture underneath the toenails, thus making you more susceptible to fungal infections. If you routinely wear nail polish, try taking a break from it for a few weeks, and if your fungal toenail infections go away. In the meantime, make sure you return to your podiatrist to get the proper medical treatment to effectively clear up the infection.
Looking for more information related to fungal toenail infections or any other foot-related ailment? Dont hesitate to contact us today with any questions that you have.