What Causes Fungal Nail Infection and How Can It Be Treated?

What Causes Fungal Nail Infection and How Can It Be Treated

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Fungal nail infection, otherwise referred to as ringworm of the nail in layman's terms, is medically known as Onychomycosis or Tinea Unguium. It is the most common disease affecting human nails and can affect both finger and toenails, but more common on toenails. Fungal nail infection is usually suspected if ones nails can be broken easily, are thickened, with change in colour, detaching from the nail bed, have increased dirt or debris underneath, with change in shape and loss of their shiny surface. Fungal nails are also often painless, except in very severe cases.

Fungal nail infection, just as the name implies, is caused by infection of the finger or toenails by fungi which are mould-like or yeast-like germs often found naturally on human skin, hair and nails. Some of these fungi hosted on the human body are often useful to the body, but given the right conditions, they can multiply rapidly and cause infections. Fungi thrive well in moist and warm environments, so fungal nail infections occur frequently in people who use public bathrooms, swimming pools, gyms and in people who sweat a lot, especially those who frequently wear tight fitting occlusive footwear (cover shoes). Other factors which increase the risk of developing fungal nail infections include a positive family history of fungal nails, prior trauma or injury to nails, increasing age, reduced immunity (e.g. from HIV or drug use), frequent submersion or hands in water, poor general health and hygiene.

Treatment of fungal nail infection is not very easy as the infection is embedded within the nail, which is quite difficult for drugs to penetrate. The primary aim of treatment is to eradicate the fungi from the nails as demonstrable by microscopy and culture, but this does not guarantee a return of the affected nails to their normal look. However, as the nails grow the abnormal ones are, sometimes, gradually replaced by healthier looking uninfected nails, but this process could take more than a year as nails grow very slowly. The drug of choice for treatment of fungal nail infection is terbinafine (Lamisil), which is taken orally as a daily 250mg dose for 6-8 weeks in fungal fingernails or 12-16 weeks in fungal toenails. Another alternative drug is griseofulvin (Fulcin), which is also taken orally as a daily 500mg dose for 6-9 months in fungal fingernail infection or 12-18 months in toenail infections. Fulcin is less expensive than Lamisil, but it has to be taken for much longer and the cure rates for Fulcin is also less than that for Lamisil. Other drug choices include oral itraconazole or topical medications (nail paints) containing ciclopirox or amorolfine, which can be applied directly on the infected nails. Sometimes a combination of an oral drug and a nail paint can also be prescribed, but the oral drugs are generally more effective. If treatment fails for one drug, another one could be tried or the nail could even be removed surgically.

A note of warning though, most of these antifungal drugs can cause damage to the liver, harm to an unborn child and many other adverse reactions or drug interactions, so be sure to contact your doctor for a proper prescription before taking them.

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