Fighting Fungal Nail Infection

Onychomycosis, of fungal infections of nails often become troubling ailments that create not only physical, but also mental discomfort, due the ugly nature of the lesion that they result in. Their treatment is simple, but needs care, expert advice, and perseverance. More importantly, it is a disease that can be prevented by simple precautions and awareness about how it spreads.  
Fighting Fungal Nail Infection
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Fungal Infections may not always be life threatening, but they can still cause enormous damage, especially to one’s mental peace and sometimes even to one’s self esteem. This is particularly so in case of disfigurement as happens in Onychomycosis or Fungal Nail Infections. Greater awareness about the condition can help prevent it and also help in early identification and treatment.


Onychomyosis: An Ugly Disease

FUNGAL NAIL INFECTION may not be a deadly disease, but it can badly affect your social life apart from a possible source of complications.

Fungal nail infection is technically called ONYCHOMYCOSIS, but another common name is TINEA UNGUIUM. It

affects elderly people more frequently and appears as discoloration and disfigurement of nails. Toe nails are more commonly infected because of being increasingly subjected to humidity within shoes and socks, but finger nails can also be infected.

Causes of Nail Disfigurement : Need for Differential Diagnosis

Not all nail disfigurements are because of fungal infections. In fact more than half of nail disfigurement and discolorations occur because of reasons other than fungus. These include psoriasis, lichen planus, other autoimmune diseases, paronychia and yellow nail disease, all of which can appear similar to fungal nail infection. Hence the importance of confirming the diagnosis before the treatment for fungal infection is begun. Confirmation can be done by way of microscopic and culture tests of nail scrapping in a pathology lab.

Treatment of Fungal Infection of Nails

The treatment of this condition takes a long time. It can be treated by topical agents that are applied locally, as well as oral medication. Topical agents can provide some relief but are rarely able to cure it. Oral agents are more effective and can provide a cure but can also cause serious side effects, specially liver toxicity and hence need to be used with a lot of precaution and under constant monitoring.

Most fungal infections are caused by dermatophytes, among which Trichophyton Rubrum is the most common culprit. For treating dermatophytes, the best option is oral TERBINAFINE (Lamisil) which is to be taken once every day, with meals, for 12 weeks in case of toe nails, and six weeks in case of finger nails. The total duration of treatment may be effected by the response to medication.

Apart from dermatophytes, yeasts like Candida and other fungal agents can also cause this condition. Candida infections are more common in those whose immunity levels have fallen, as in very old age or those on anti cancer treatment. In such cases, the treatment of choice is oral FLUCONAZOLE

given once weekly for 6-9 months. Another medicinal option for all kind of fungal nail infections is oral ITRACONAZOLE (Sporanox), which can be taken once daily for 6 to 12 weeks. Sometimes instead of daily doses, it is given as a 'pulse therapy' wherein double the dose is given for 7 days once in a month and repeated for 2 to 4 months.

Precautions to avoid Fungal Nail Infection

The oral anti-fungal medicines can damage liver and lead to liver toxicity, so their administration should be done under strict supervision of the physician and with regular monitoring of liver function by liver function tests or LFT. Another precaution that must be taken during this treatment is that these medicines interact with many other medicines, so any other medication must be taken after consultation with the treating physician to avoid complications.

For topical use, anti-fungal medicines can be used as adjunct to oral medicines though when used alone, they are seldom able to cure the disease. In very severe cases, if the whole nail is distorted, damaged or severely disfigured, surgical nail avulsion may be preferable.

Rising Incidence of Fungal Nail Infections: Sharing of Pool & Clubs

In recent times, onychomycosis has become more rampant. The reason for it is the rise in shared swimming pools and greater sharing of common resources which leads to increased infection. A higher life expectancy, more older people and lack of fast effective treatment have also contributed to its rise. some simple precautions can protect from it. These include using cotton socks and keeping them clean and dry. Less use of closed shoes is helpful, as is frequent change of socks. Walking barefoot in moist public areas like those around a swimming pool or health club should be avoided.

In the end, all fungal infections are prevented by two things - adequate hygiene, including prevention of infection, and keeping skin dry. Awareness of this fact used with common sense can be the greatest defenses against them.

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