FUNGAL nail infections, whilst they can occur on fingernails, are much more common on toenails, due to the warm and damp conditions that our feet can be kept in, hidden away in socks and sometimes unbreathable shoes.
This less breathable, warm and moist environment of shoes and socks is perfect for fungi to grow and multiply. Athlete’s foot is a common issue for sports players who sweat a lot in their training boots, or for anybody with naturally hot and sweaty feet, and this can spread and become a fungal infection of the nail. Alternatively, there may be no athlete’s foot present, and just a fungal nail infection.
When a fungus gets into the nail bed, it usually begins to show on the edge of the nail first, then gradually spreads into the middle, making the nail discoloured, brittle and inclined to lift off. While it doesn’t cause any pain to begin with, if pieces of the nail start to break away it can lead to pain and swelling in the skin around the nail. Over-the-counter treatment of a fungal nail infection can be successful, using a combination of a product that can be applied to the surface of the nail, aided by first lightly filing the surface of the nail in order to penetrate fully into the infected area. Because you need to be able to treat the nail in this way, nail varnish during the treatment process is not advised, which can be challenging if you wish to wear your sandals in the meantime while covering up the damage. Depending on how many nails are affected, you may need to see your doctor to oversee the treatment process.
Patience is key in treating fungal nail infections because toenails grow very slowly, and it can take 9-12 months for the infected part of the nail to grow out; during that time the nail that grows will be fungus-free, and without the visual damage.
These tablets can have side-effects of headache, itch and/or diarrhoea in some cases, and run the risk of liver damage, so they are prescribed with care and are not suitable in pregnancy or some medical conditions. Very occasionally, the infection becomes so bad that the nail needs to be removed.
For those with diabetes, foot care is very important as the nerve endings in this area may not be as sensitive as they should be and the usual tell-tale pain a person would normally experience as an alarm trigger with foot issues may not present as strongly, or at all, for somebody with diabetes. Therefore, it’s very important to have regular foot-checks, and to bring any issues related to your feet to a healthcare professional’s attention, rather than ignoring or attempting to self-treat.
Some practical things you can do to prevent fungal nail infections in the first place is to keep your feet clean and dry as much as possible, wear clean socks every day, wear flip flops in the showers at gyms and swimming pools, and, should athletes foot occur, treat it as soon as possible to prevent it getting into the nailbed.
One shouldn’t share nail clippers or scissors, or wear footwear that makes the feet hot and sweaty.
Avoiding fungal nail infections in this way, and treating them appropriately if they occur, will make sure that you don’t progress to pain and swelling around the nail, and will allow you to be flip flop ready this summer!
Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company.
Her research lies in the area of mental health education, and through InTuition she delivers health promotion workshops to corporate and academic organisations nationally.