Nail fungus (onychomycosis)

Description

Infections of the nails on fingers and feet are called nail fungus. They are mainly caused by dermatophytes (filamentous fungi) such as Trichophyton rubrum. If athlete's foot is already present, the pathogen can also spread to the fingers and vice versa.

Infections caused by yeasts are also possible, although they occur less frequently in practice.

Damp spots are predisposing to nail fungus, which is why feet are more frequently affected than fingers. With increasing age, the frequency of the diseases increases.

The infection is caused by long-lived spores of certain fungi. Even in adverse conditions, they remain contagious for several weeks.

Transmission is possible from person to person or from animal to person, but it usually takes place in sanitary facilities such as swimming pools or showers and changing rooms in gyms.

The likelihood of infection is increased by close contact with affected persons, circulatory disorders (e.g. in diabetes), increased sweating or oppressive shoes.

With fungal infestation, the nail plate usually thickens. In addition, it discolours (yellowish, brownish) and becomes crumbly especially when cutting the nails.

Depending on the origin of the discoloration, one can distinguish between different triggers. If it starts at the nail wall (= base), yeasts are to blame, if it starts at the nail edge, filamentous fungi are the cause of the fungal infection.

Independent of a fungal infection, similar discolorations can also be caused by psoriasis.

For the diagnosis is necessary to see a dermatologist. Before visiting the doctor and during treatment should not apply nail polish!

Although nail fungus can be seen with the naked eye due to discoloration, thickness of the nail and deformations, the nail is thoroughly examined.

This involves first cutting the nail back as far as possible. The cut material is stained in the laboratory and makes fungal threads visible under the microscope. In order to be able to identify the causative fungus, a fungal culture is created, which enables a targeted treatment tailored to the pathogen.

Cut and file

Since an infected nail is a permanent source of infection for you and others, you should cut away as much of the affected nail as possible. After cutting the nail, it is recommended that you also file the surface thoroughly. Repeat nail care regularly and be careful not to injure yourself.

It is necessary to disinfect the used tools after each use. 70 percent isopropyl alcohol or another disinfectant can be used for this purpose. Sandblade files should be thrown away after only one use.

Nail polish and ointment

If only the edge of the nail is affected, external application may be sufficient. For this purpose, proprietary ointments or varnishes are suitable whose ingredients have fungicidal (anti-fungal) effects. They penetrate even the hardest parts of the nail where ordinary creams fail.

To optimize the effect, the surface of the nail should be roughened before each use.

Even after successful application and the fungus has been killed, it may take some time for the discoloration to disappear due to regrowth of healthy nail.

Medication

In severe cases of nail fungus (infected nail bed) or with several affected nails, taking medication is often the only way out.

A prerequisite for the success of drug therapy is adherence to the recommended dosage until the diseased nail has grown out completely. Depending on the localization of the infection, it takes between 3 and 6 months, but in exceptional cases up to more than a year.

With nail fungus there is usually a very good chance of cure. The only condition for successful healing is consistent adherence to the treatment plan. The likelihood of transmission to other limbs or individuals also depends on how the disease is managed.

Although the pathogens of nail fungus are found almost everywhere, they can be effectively prevented by the simplest measures.

Footwear

• Do not wear air-impermeable shoes (e.g. trainers) permanently. Give your feet a rest by wearing sandals, airy shoes or barefoot.
• Air and dry leather shoes. To do this, the shoes can be stuffed with newspaper. Regular disinfection is also necessary.
• Breathable materials are preferable to synthetic ones. Change socks daily, or several times a day if sweating increases.
• Do not share shoes and socks with anyone, as well as inline skates, rubber boots, etc.

Hygiene

• Feet also need to be cared for. After thorough washing, dry your feet well, also between the toes.
• Always wear bathing shoes in sanitary rooms.
• Foot disinfectant dispensers are particularly prone to germs. The disinfectant also attacks your skin flora.
• Wash home textiles such as bath towels, bath mats, bed linen and also socks at 90 °C if possible. Sensitive textiles can also be washed with laundry disinfectant (available at the pharmacy).
• After consulting your family doctor, immunocompromised persons can use a fungicidal spray as a preventive measure, e.g. after visiting a swimming pool.