Have you noticed changes to your toenails such as discolouration or thickening – you may have a fungal toenail infection.
What are fungal toenails?
Onychomycosis, also known as fungal toenails, is a condition where nails have become infected by a fungus that causes discolouration of the nail (yellow, white or brown). The most common fungi present in nails are dermatophytes as they require keratin for growth.
A fungal nail infection may involve just a small portion of a single nail or could spread to nails of all 10 toes if not treated early. Fungal nails can become inflamed and painful when left untreated, and the brittle nature of the affected nail makes trimming difficult and increases risk of ingrown toenails.
The skin under the nail and the nail itself may also thicken and develop a white powdery appearance. The nail may become free from the nail bed and only remain partially attached (known as nail lysis). Fungal nails may also develop a distinct, unpleasant odour.
Fungal nail infections are not just limited to the toes and may occur on (or spread to) fingernails. As it is a fungal infection, onychomycosis (fungal nails) is able to spread from person to person through direct contact, shared items such as nail clippers and shoes or walking barefoot in contaminated areas (including showers and swimming pools).
How do I know if I have a fungal nail infection?
Sometimes it can be difficult to differentiate between a fungal nail infection and a traumatic nail injury. Similarities can include nail lysis, discolouration and thickening. Nail changes resulting from trauma will not resolve with fungal nail treatment protocols.
Dermatophyte testing (nail scraping pathology) is the most effective method to determine and confirm the presence of onychomycosis (fungal nail infection) to ensure the correct treatment path is undertaken. There are a range of other conditions that may cause nail discolouration and thickening, including trauma, psoriasis, paronychia. These conditions will not respond to fungal nail treatment and require alternative management strategies.
Adelaide Foot and Ankle have in-clinic dermatophyte testing available which gives a result within 5 minutes to give you peace of mind and commence your treatment sooner.
Treatment of fungal nails
Nails, much like hair, contain no living cells. This means that they are unable to heal from fungal infection without intervention. It also means that the nail will remain discoloured, even after the fungus has been destroyed, until it has grown out (which may take several months)
There are a range of management options for fungal nails and choice of treatment will be determined based on patient factors including age, number of nails affected, medical history and current medications. It is important the management strategy is individually tailored to the individual’s situation.
Treatment management options may include:
- Topical anti-fungal medication
- Oral anti-fungal medication (this may be prescribed by a GP or endorsed podiatrist)
- Infared laser therapy
How does laser treat fungal toenail infections?
Hot (thermal) laser treatment works by penetrating the nail and generating heat at the site of the fungal nail infection. This change in temperature kills fungal cells without damaging the healthy tissue surrounding them. Laser fungal nail treatment is pain-free and requires no recovery following the procedure.
Management of fungal nail infection
Whilst anti-fungal treatments are essential for fungal nail infection management, it is important to reduce risk of contamination to other nails.
Follow these steps to help ensure the most effective treatment of your fungal nails:
- Seek a diagnosis – your podiatrist will help you to undertake diagnostic testing (such as dermatophyte testing) to confirm the nail changes are a fungal nail infection.
- Reduce the amount of fungal nail – trimming the length of nail and reducing thickness allows for increased treatment efficacy.
- Rotating footwear – avoid wearing the same pair of enclosed shoes two days in a row to give them time to air out.
- Use an antifungal spray in shoes – spray your shoes with an antifungal spray such as Glen20 to reduce risk of reinfection from contamination.
- Use an antifungal laundry rinse – antifungal laundry rinses are available at any supermarket (Canesten and Dettol make readily available liquids) and are great to add to washing cycles of socks.
- Avoid sharing towels, socks and shoes and ensure thorough washing using appropriate detergent and antifungal rinse.
- Follow your treatment plan as advised by your podiatrist or GP.
Fungal nail management at Adelaide Foot and Ankle
Adelaide Foot and Ankle can manage your fungal nail infection from start to finish. We have 5-minute in-office dermatophyte testing available that allows us to make an accurate diagnosis. Where indicated we can prescribe oral and topical medication to kill the fungal infection. We also use infrared laser to also kill the infection and increase blood flow to the nail bed assisting with healing. In conjunction with our skilled podiatrists who will clean and trim your nails, Adelaide Foot and Ankle can diagnose and clear your fungal nail infection.