Fungal nails, or onychomycosis, are a common condition that affects around 35 million Americans. This germ-inflicted infection of the nail may range in severity from a slight cosmetic nuisance to a painful condition that limits a person's ability to wear shoes comfortably or even to walk normally.
Fungal nail infections can result in discolored, crumbling, loosening, thick and painful nails. Those who suffer from poor circulation or a lack of adequate sensation in the feet due to diseases such as diabetes may be more prone to developing other serious bacterial infections as a result. In severe cases, some of these secondary infections can lead to hospitalization or, even worse, amputation.
Toenails are hard structures, made up of a material called keratin, that cover the tips of the fingers and toes. They serve as protection of the bones at the end of the toes and fingers. They may also act, along with the sensitive, nerve-enriched skin at the tips of our fingers and toes to increase feel as we grasp objects or walk. Nails serve another important purpose, at least to doctors, as they often act as an external warning system because often it's there that the outward signs of internal disease are noted. The nail is comprised of a number of parts.
A fungus is a type of germ that falls under any one of three families: funguses, yeasts or molds. There are numerous types of fungal germs that can infect the nail. The most common type of fungus is a dermatophyte and reveals a characteristic spore appearance when examined under a high-resolution microscope. These germs thrive in a moist, warm environment and are prevalent throughout our environment including shower stalls, hotel floors, swimming pool decks and locker rooms. The germs can also live inside shoes, athletic footwear and sandals.
The pathogens that cause nail fungus infection usually enter the skin through tiny cuts or small separations between the nail and the nail bed (the tissue located beneath the nail). These cuts and separations can be caused by minor injuries to the nail or skin through repetitive microtrauma from activities such as running or tennis. They also can be caused by microscopic cuts in the skin due to overzealous pedicures and improperly sterilized instruments. Once the fungus enters, it then flourishes under and within the toenail due to the warm and moist environment.
As the fungus grows within the nail, as well as beneath the nail, it causes the nail to thicken and may cause it to grow abnormally, forming many layers as apposed to one thin, flat nail plate. Eventually, the fungus can spread toward the root of the nail and cause all future nail growth to be diseased. The fungus can attack either only part of the nail or the entire nail.
In addition to the physical effects of toenail fungus, it can also interfere with a person’s social life. For example, some people avoid wearing toeless shoes or taking their shoes off around others because they are embarrassed about the appearance of their toes. In some cases, a person’s toenail fungus will produce a foul odor that can heighten the social stigma.