A highly contagious nail fungal infection called onychomycosis seems to be on the rise in the United States. Onychomycosis is very common in the toenail. People with diabetes and foot ulcers are at higher risk for developing onychomycosis. They are not only diagnosed more frequently than the rest of the population, but are also more prone to develop a serious complication if the infection is not recognized or treated properly.
The appearance of onychomycosis can vary, but most cases begin at the tip of the nail and slowly progress into the nail over a period of months to years. The nail will thicken as the fungus continues to grow. The fungus takes up space in the nail causing it to swell. The nail can be yellow, white, or even green to black. The nail also begins to be chalky and flaky. The nail becomes unsightly, extremely difficult to cut and debris can build underneath the nail causing it to have a bad smell.
If you have diabetes, it’s important not to ignore your fungal nail infection. Its spread could impair your ability to work or walk. This happens because it is frequently accompanied by thickening of the nails, which cannot easily be trimmed and may cause pain while wearing shoes. When nails become thick and brittle the skin on the toes can crack. A break in the skin can lead to an ulcer, which could become infected. If gangrene or a bone infection develops, removal of the infected toe or finger may be the only option a doctor has to preserve the rest of a patient’s foot. Nearly 18% of gangrene and 10% of foot ulcers in people with diabetes can be attributed to onychomycosis. Thus, people with diabetes should treat their onychomycosis quickly, since it may lead to a more serious problem.
PREVENTION
- Wash your feet with soap and water and remember to dry them thoroughly.
- Wear socks made of cotton, wool, or similar absorbent material.
- Apply antifungal foot powders to shoes daily.
- Wear shoes of correct size and fit.
- Avoid walking barefoot.
- Keep toenails short, cutting them straight across. Do not round out the edges. Do not use the same clippers to cut normal and abnormal nails.
- Don’t apply regular nail polish to nails suspected of infections - on toes that are red, discolored, or swollen, for example.
- Return to the doctor’s office if there is any abnormal itching, redness, blisters, or scaling. Also return if there is any abnormal appearance in nails that previously appeared normal.
TREATMENT
Depending on the nature of the infection and the severity of each case, treatment may vary. A daily cleaning, over a period of many months, may temporarily suppress mild infections. White markings on the surface of the nail can be filed off, followed by an over-the-counter liquid antifungal medication. If caught early, an over-the-counter treatment may work to treat a fungal infection. However, a fungus may work its way through the entire nail, penetrating the nail plate and the nail bed. If an infection is not overcome, or continues to reappear, further medical attention and possible prescription medication is recommended.
