Fungus nail - onychomycosis
Fungus Nails is an unsightly infection of the nails, causing thickened, brittle, yellow, discolored and sometimes painful nails. It is very difficult to cure. It is caused by one of several microscopic organisms, similar to those that cause Athlete's Foot (dermatophytosis). These are plant like organisms that thrive in a dark, warm, moist environment, such as within shoes and stockings. They grow in the nail bed beneath your nails, and live off Keratin, the protein in the nail. The condition usually begins toward the far end of the nail and may cause white or yellow-white areas that appear to be rotten or dead. If the infection continues to the base of the nail it can invade the nail root (matrix) and cause the nail to grow thickened and deformed. Many people complain of a foul odor associated with this condition. It can also spread to other nails. The fungus often spreads to the adjacent skin surrounding the nail.
How Does it Feel?It may not be painful in the beginning, and may only look slightly different than the normal nails. Later the nail may begin to show small patches of white or yellowish-tan color and may become brittle and split. As it progresses, the nail becomes thicker and deformed and may begin to grow at an angle and become and Ingrown Nail. Pain develops, due to the ingrown or thickened nail deformity, and becomes aggravated by pressure applied by shoes. Inflammation can develop due to this pressure and a secondary bacterial infection may occur, leading to more pain. Even without inflammation, shoe pressure on the fungal nails can cause pain, making it difficult to walk or stand for periods of time. This can also influence one's involvement in day to day activities.
Many types of fungus are common in our environment. Among them are the dermatophytes, a group of opportunistic parasitic plant organisms, similar to molds or mildew, that, lacking chlorophyll, do not require sunlight for growth. Sweaty tennis shoes and moist socks crate the perfect conditions for them. The funguses thrive in a warm, moist, dark environment and they eat the protein keratin that our skin produces. Although funguses may be present in the skin around the nails, one may not develop a nail infection without history of injury, such as bruised nails from short shoes, inflammation from an ingrown nail, or from cutting the nails incorrectly or too short. In other words, the organisms do not invade intact, healthy, normal skin or nails. Other contributing factors would be excessive perspiration, and Dermatophytosis (Athlete's Foot), which is caused by similar fungi. Some individuals appear to be more susceptible to infection. These would include those with medical conditions such as diabetes and poor circulation and HIV. For that reason, even if treatment is successful in eliminating the condition, the susceptible person may become re-infected in the future.
Topical medications are ineffective in most cases, because the infection starts growing under the nail. No topical medicines penetrate deep enough into and through the nail, to treat the living organisms under the nail plate. Any clearing of the nail surface is eventually overtaken by infected nail replacing it from underneath. Unfortunately, in this condition, any self treatment is, at best, temporary. Use of a topical antifungal medicine may, at best, prevent spread of the fungus to, as yet, unaffected nails or the surrounding skin.
First of all, Dr. Karr will do a physical examination to determine if there is a fungus present and not some other kind of medical condition. After determining the type of fungus, treatment may range from topical solutions to oral, systemic medications. Too often oral medication are only prescribed and they are ineffective because there is too much fungus present in the nails for the oral medication to be effective. Dr. Karr starts with a topical medication treatment to the infected nails with monthly toenail thinning of the toe nail until the load of fungus has been minimized so the oral mediation will be effective. At that point you will be placed on a oral anti fungal medication.
How Does it Feel?It may not be painful in the beginning, and may only look slightly different than the normal nails. Later the nail may begin to show small patches of white or yellowish-tan color and may become brittle and split. As it progresses, the nail becomes thicker and deformed and may begin to grow at an angle and become and Ingrown Nail. Pain develops, due to the ingrown or thickened nail deformity, and becomes aggravated by pressure applied by shoes. Inflammation can develop due to this pressure and a secondary bacterial infection may occur, leading to more pain. Even without inflammation, shoe pressure on the fungal nails can cause pain, making it difficult to walk or stand for periods of time. This can also influence one's involvement in day to day activities.
Many types of fungus are common in our environment. Among them are the dermatophytes, a group of opportunistic parasitic plant organisms, similar to molds or mildew, that, lacking chlorophyll, do not require sunlight for growth. Sweaty tennis shoes and moist socks crate the perfect conditions for them. The funguses thrive in a warm, moist, dark environment and they eat the protein keratin that our skin produces. Although funguses may be present in the skin around the nails, one may not develop a nail infection without history of injury, such as bruised nails from short shoes, inflammation from an ingrown nail, or from cutting the nails incorrectly or too short. In other words, the organisms do not invade intact, healthy, normal skin or nails. Other contributing factors would be excessive perspiration, and Dermatophytosis (Athlete's Foot), which is caused by similar fungi. Some individuals appear to be more susceptible to infection. These would include those with medical conditions such as diabetes and poor circulation and HIV. For that reason, even if treatment is successful in eliminating the condition, the susceptible person may become re-infected in the future.
Topical medications are ineffective in most cases, because the infection starts growing under the nail. No topical medicines penetrate deep enough into and through the nail, to treat the living organisms under the nail plate. Any clearing of the nail surface is eventually overtaken by infected nail replacing it from underneath. Unfortunately, in this condition, any self treatment is, at best, temporary. Use of a topical antifungal medicine may, at best, prevent spread of the fungus to, as yet, unaffected nails or the surrounding skin.
First of all, Dr. Karr will do a physical examination to determine if there is a fungus present and not some other kind of medical condition. After determining the type of fungus, treatment may range from topical solutions to oral, systemic medications. Too often oral medication are only prescribed and they are ineffective because there is too much fungus present in the nails for the oral medication to be effective. Dr. Karr starts with a topical medication treatment to the infected nails with monthly toenail thinning of the toe nail until the load of fungus has been minimized so the oral mediation will be effective. At that point you will be placed on a oral anti fungal medication.
