Fungal nail infections

Fungal Nail Infections (Onychomycosis) are infections of the
nail. 

DESCRIPTION

The nail unit is made up of several structures. These include
the nail matrix, the nail plate (the surface of the nail), the
cuticle (eponychium), the nail bed (the skin underlying the nail
matrix) and the nail folds (the skin surrounding the nail).

 

Fungal Nail Infections affect the toe nails more often than
finger nails. Fungal infections can be the result of a primary
infection or they may occur as a secondary infection (due to a
previous infection or injury to the nail). More adults than
children suffer from Fungal Nail Infections.

 

Fungal Nail Infections are more likely to appear in older
people, in people with diabetes, HIV infection, AIDS and those with
poor blood and lymphatic drainage. Sports people who wear enclosed
and/or poorly fitted footwear such as footballers and skiers seem
to be more likely to suffer fungal infections of the toenails.
People who use communal bathing and showering areas may be prone to
contacting fungal infections.

SIGNS AND SYMPTOMS

Tinea unguium is the name given to a superficial fungal
infection of the nails. It can be caused by a variety of organisms
and they are often distinguished from each other by the different
sites of the body involved. In cooler areas of the world, the
organism dermatophytes mainly attacks the outermost layer of the
nail, skin and hair. In tropical areas, yeast may encourage the
growth of Candida albicans. 

There are four recognised types of Fungal Nail Infections.

1.  (DSO) or Distal Subungual Onychomycosis 

This infection is found underneath the nail towards the tip or
end of the nail. The infection is recognised by the separation of
the nail plate from the nail bed with yellowish thickening of the
nail plate. A mass of crumbly matter gathers beneath the separated
port of the nail.
 

2.  (WSO) or White Superficial Onychomyocosis 

This is a fungal infection which invades the nail plate and in
time may involve the nail bed. Initially, crumbly white areas
appear on the nail which may eventually join and the whole nail
surface becomes covered.
 

3.  (PSO) or Proximal Subungual Onychomycosis 

This is a fungal infection underneath the nail towards the
cuticle or the beginning of nail growth. This type of fungal
infection is not common and seems to appear in patients with
autoimmune diseases such as AIDS. 
 

4.  Candida Onychomycosis 

A yeast infection of the nail. People who frequently immerse
their hands in water may suffer from the problem. The yeast
infection may cause swelling and redness of the nail folds.

TREATMENT OPTIONS

It is important to see your Doctor for a correct diagnosis.
Symptoms may exist because of drug medication such as
tetracyclines; injury to the nail, particularly if it occurs often;
medical conditions such as psoriasis, tumours and contact
dermatitis and yellow nail syndrome.

Although topical applications are suggested for fungal nail
infections, they are not always effective because the thickened
nail prevents the medication from reaching the site of the
infection. It is suggested to file down the thickened nail for
easier penetration of any applications.

DIET HINTS

It is important to support the immune system. Some dietary
suggestions include-

• whole grains, raw fruits and fresh vegetables. These provide
  antioxidants which may help stimulate the immune system.
• Try to avoid excess sugar and white flour products.
• Try to eat unsweetened yoghurts. These provide acidophilus
  which help regulate bacteria levels.
• Include garlic in the diet. Garlic is a potent antifungal
  agent.
• Try to eat lactic acid fermented foods such as sauerkraut, sour
  dough breads and yoghurt to help prevent the spread of
  infection.

VITAMINS/MINERALS/HERBS

• Tea tree oil is known for its antifungal and antibacterial
  action. Bathe the affected area in a solution of water (1 litre) to
  tea tree oil (10 drops) daily.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. It is important to understand what type of fungal infection is
   present. There may be some confusion in cases of psoriasis, contact
   dermatitis, drugs such as certain antibiotics especially
   tetracyclines and injury to the nail.
2. Your Pharmacist may suggest a special anti-fungal nail paint.
   Ask your Pharmacist for the best brand. Remember to file down the
   thickened nail before applying medication.
3. A topical application containing amorolfine is sometimes used,
   because it promotes infusion through the nail plate. It is used in
   cases where dermatophytes are present and also in the treatment of
   candida Fungal Nail Infections. People suffering from Candida
   onychomycosis should try to keep the hands out of water and to use
   gloves if immersing the hands in water. Alw ays wear rubber gloves
   when washing clothes or dishes.
4. Keep feet dry using absorbent dusting powders.
5. Use absorbent insoles to prevent moisture build-up in
   shoes.
6. Wear leather shoes rather than synthetic or rubber sneakers to
   lessen moisture. 
7. If playing sport, make sure footwear is the correct size and is
   the type recommended.