Medically called onychomycosis, nail fungus causes the nails to become thick, discolored, and crumbly at the edges. As many as 10% of all adults in Western countries have some degree of infection, which increases to 20% for those over 60.
And while you can get an infection in your fingernails, it's more common in the toes.
At Florida Foot & Ankle, podiatrist Dr. Mark A. Matey and our team know that Floridians love their open-toed shoes for the warm weather but that many people hide their feet because they're embarrassed by toenail fungus.
That's why we offer toenail restoration at our two Jacksonville offices. Many people ask if toenail fungus is contagious. Here's what our expert has to say about that and more.
What does nail fungus look like?
Nail fungus has a number of characteristic symptoms:
- Thick nails, white to yellowish-brown color
- Crumbly or ragged nail edges
- Altered nail shape
- Debris buildup under the nail
The affected toe may also be painful and have a foul odor.
Causes, risks, and contagion
Fungal nail infections may be the result of any number of different fungi, yeasts, and molds.
When a dermatophyte is responsible, the condition is called tinea unguium. A dermatophyte is a type of mold that needs keratin, a protein found in nails and hair, to grow. Dermatophytes cause 90% of nail-related fungal infections.
The condition is known as athlete's foot when the infection affects the skin between the toes. If it spreads to the groin area, it's called jock itch. It can even apply to your scalp. Of course, it can quickly spread from one toe to another, and it's common for more than one nail on a foot to be affected.
You can spread the infection to someone else through direct contact or by touching an infected surface. The dermatophyte spreads from one person to the next in the same way it gains access to your body through cracks and cuts in the soles of your feet.
Fungi thrive in damp, warm, dark places, like the inside of your shoes and socks. That means you're at greater risk if you:
- Sweat a lot but don't change your socks often enough
- Have a history of athlete's foot
- Walk around barefoot in communal areas such as gyms, pools, locker rooms, and showers
You can spread the infection by walking barefoot, shedding the mold as you go, or if you dry off your feet with a towel, allow someone else to use the towel.
Fungal nail infections are more common in older adults. With age, the nails often become brittle, dry, and cracked, and the fungi take advantage of the cracks to enter the body.
Other conditions, including diabetes (with its reduced blood circulation to the feet) and a weakened immune system, may also play a role in who gets infected.
OK, so you have a fungal nail infection — what now? There are several options.
Oral antifungal drugs
These drugs clear up the nail infection more rapidly than topical drugs while helping a new, uninfected nail slowly replace the infected part.
You usually take oral medications for 6-12 weeks, but you won't know if they're effective until the nail grows back completely — in about 9-12 months.
Oral antifungal drugs have a number of unpleasant side effects, from a skin rash to liver damage, so you might need occasional blood tests to ensure your safety. These medications aren't appropriate for people with liver disease or congestive heart failure.
Medicated nail polish
Ciclopirox (Penlac) is a topical antifungal that you paint on the infected nails and surrounding skin every day. After seven days, you use alcohol to remove the layers and start again. Most people need to apply the polish daily for at least a year to see results.
Medicated nail cream
Medicated antifungal creams work best if you thin the nails first; that allows the medicine to penetrate the hard nail surface to reach the fungus. You can try a nonprescription lotion containing urea, or Dr. Matey can thin them with a nail file or other tool.
A focused single-wavelength beam directed at the nail heats the fungus or mold up to the point that it kills it, eradicating the infection.
Dr. Matey may choose to temporarily remove the nail so he can apply the antifungal medication directly to the infection. But if you have a severe infection or are in a lot of pain, he might suggest permanent nail removal since some infections don't respond to these drugs.
Do you have a case of fungal nails? At Florida Foot & Ankle, we can help. To get started, give us a call today at 904-268-3686 to book a consultation at one of our two Jacksonville, Florida, locations.