What is nail fungus? How do you get it?
Don’t be afraid of the commercials, let’s demystify nail fungus! It’s a fungal infection mainly divided into three categories: dermatophytes, non-dermatophytes and yeasts. Here, we’ll guide you through the different appearances of mycosis, how to prevent it and how to treat it.
Will I lose my nails?
There are many different types of fungal infections, each with a different appearance (don’t always rely on the advertisement!). Typical signs may include heterogeneous nail discoloration, delamination, brittle longitudinal striations, thickening and debris under the nails. Nail loss is not a consequence of mycosis! On the other hand, traumatic nail detachment can include some of these features, so don’t be fooled.
How can I tell if I have nail fungus?
With the naked eye, a podiatrist may have a strong suspicion of nail fungus based on the characteristics of your nail. However, a culture is required to confirm this diagnosis. This culture will also enable your podiatrist to prescribe the appropriate treatment.
Am I at risk?
The fungus thrives in a warm, moist environment. It can affect the nail following trauma, which creates a sufficient entry point for it to proliferate. Athletes are therefore more at risk due to perspiration and impact, hence its close link with athlete’s foot. Athlete’s foot (tinea pedis) is a fungal infection of the skin, most common between the toes, which can cause itching, redness and burning.
What precautions can I take?
Nail fungus is contagious. It is therefore possible to become infected in public places such as swimming pools, changing rooms, showers and training rooms. It can also be transmitted within the same family in suitable places such as the shower, or through the joint use of nail clippers.
If you have fungal infections, a good preventive measure is to disinfect your nail clippers with alcohol after each use, to prevent transmission to unaffected nails.
It’s also important to cut your nails short to minimize trauma, change your socks to control perspiration, disinfect your bathroom more often and apply antiperspirant products to your feet and shoes. It’s important to wear your sandals in public places!
How can I get rid of it?
The treatment chosen depends mainly on the degree of nail damage, the results of the culture and the patient’s medical history. There are topical treatments (varnish) to be applied to the nail and oral medications. In addition, the podiatrist can perform a thorough debridement/thinning of the nail to enhance the penetration of topical products, which will increase the effectiveness of your treatment.
Bonus questions
What about nail polish?
Repeatedly applying and removing nail polish can traumatize the nail and cuticle, making you more susceptible to fungal infection. Keeping nail polish on for an extended period of time prevents you from seeing the appearance of the nail, which could allow a superficial infection to worsen without your knowledge.
Is laser a good treatment for mycosis?
No, as of July 2019, Health Canada has issued a statement indicating that laser treatment is not authorized to treat nail fungus, given the lack of efficacy demonstrated in studies on the subject. Source.
See your podiatrist for a diagnosis and treatment plan. You don’t need a doctor’s bill or referral to see a podiatrist, just make an appointment today.
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RÉFÉRENCES
Ameen M. et autres. British Association of Dermatologists’ guidelines for the management of onychomycosis 2014. British Journal of Dermatologists 2014. Consulté le 29 novembre 2019 : https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjd.13358
Angelo, T., Borgheti Cardoso, L. N., Gelfuso, G. M., Taveira, S. F. et Gratieri, T. (2017). Chemical and physical strategies in onychomycosis topical treatment: A review. Medical Mycology. doi: 10.1093/mmy/myw084
Caputo R, De Boulle K, Del Rosso J, Nowicki R. Prevalence of superficial fungal infections among sports-active individuals: results from the Achilles survey, a review of the literature. J Eur Acad Dermatol Venereol 2001; 15:312–16.
Gupta AK, Daigle D, Foley KA. Network Meta-Analysis of Onychomycosis Treatments
Skin Appendage Disord. 2015 Sep;1(2):74-81. doi: 10.1159/000433473. Epub 2015 Jun 26.
Gupta A, Drummond-Main C. Systematic review of nondermatophyte mold onychomycosis: diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol 2012; 66:AB122.
Westerberg DP, Voyack MJ. Onychomychosis: Current trends in diagnosis and treatment. Am Fam Physician. 2013, Vol 88 (11), 762-770.
Yin Z, Xu J, Luo D. A meta-analysis comparing long-term recurrences of toenail onychomycosis after successful treatment with terbinafine versus itraconazole. J Dermatolog Treat 2012; 23:449–52.
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Dr Olivier Daigneault
Podiatrist and owner
