You’re an avid exerciser. You work out almost every day, sweating profusely. You take showers at the public gym where you work out; sometimes you forget your flip-flops, but you hop in the shower anyways. You’re on such a tight schedule; you pretty much just throw on your clothes, directly from the shower, soaking wet, putting your socks and shoes on your wet feet. Your body temperature has not yet gone down to normal following your workout, so you are still sweating, even though you took a shower. This is your daily routine, especially on the days you work out; your feet are constantly sweating, creating and maintaining a warm, moist environment, which breeds and feeds bacteria and fungi.
One day, you feel your toenails start to hurt. You take off your shoes and socks, and notice how ugly your toenails have become. They have become this gross colour, and have quadrupled in thickness. You also notice cracking on the skin around your toenails; you now believe you’ve got toenail fungus.
Now I personally have not suffered from this toenail fungus, but I’ve known several people who have, and being that this can be something quite common for fitness enthusiasts. In fact, I’m actually doing this in the hope to help a friend get rid of his fungus situation, so he can be proud to show off his feet.
HOW DO YOU GET TOENAIL FUNGUS?
Toenail fungus, or Onychomycosis, occurs mostly in the toenails, especially the big toenails, and not in the fingernails. On the toenail, the fungus usually develops at the front of the nail, or at the side edge. The fungus doesn`t usually travel to the nail root. The fungus that causes the infection of the nail is the same fungus that infects the skin, and is called a dermatophyte; the more prominent of the dermatophytes causing toenail infection is T. Rubrum. That being said, toenail fungus can also be caused by mold or yeast infections, although yeast infections usually cause the issue on the fingernails. It is believed that toenail fungus stems from athlete`s foot, as many people who have their toenails infected also have athlete`s foot. Onychomycosis is not a thing in tropical climates, probably because people keep their feet exposed to the air to `breathe ‘as opposed to retraining them in a sauna, which is a confining shoe and sock. Warm, moist environments are food for fungi. Public shower stalls, lockerooms and bathrooms are perfect places for the fungus to spread, as the floor surfaces are usually wet and people are walking around barefoot! Furthermore, if you are of the elderly population, the slightest damage to your toenails (stubbing your toe, for example) further increases your risk for nail infection.
ARE THERE RISK FACTORS THAT MAKE YOU MORE SUSCEPTIBLE TO TOENAIL FUNGUS?
There are some things that put you at higher risk of developing Onychomycosis. For instance:
-If you`ve already had athlete`s foot, being that the fungus for athlete`s foot is believed to be the same as that of toenail fungus, there is an increased chance that you may get your toenails infected.
-If you keep yourself open to constant contact with the fungus, be it by walking around public showers or lockerooms barefoot, or the like, you are increasing your chances of getting the toenail infection.
-If you have damaged toenails, you are leaving yourself open to easy entry of the toenail fungus, should you be in contact with it at any time.
-If you wear tight shoes, where your toes are cramped and could possibly cause toenail damage, along with the warm moist environment of the tight shoes, you are increasing your risk of developing toenail infections.
-If you have a skin condition, such as psoriasis, you could be open to developing other infections, such as toenail infections.
-If you have poor circulation in your lower extremities (ie: legs and feet) due to diabetes or some peripheral artery disease, you are at a higher risk of developing Onychomycosis.
-Anything that suppresses your immune system leaves you wide open to developing toenail infections, such as HIV or some medication.
-and lastly, like most other things, if you are genetically predisposed to developing toenail fungus, you are at a higher risk.
GET A DIAGNOSIS BEFORE ATTEMPTING TO GET RID OF TOENAIL FUNGUS
The reason I say this, is, sometimes it`s difficult to tell a fungus toenail infection from other nail problems, so if you`re putting on topical drugs and taking pills to get rid of your infection, but it`s not even what you thought it was, well.....you get my point?
Apparently, psoriasis can have the same affect on the nails, to the point that it actually looks like a fungal toenail infection. When you go to the doctor, it`s advisable for them to take a sample of your toenail, and test it with a special dye that will help doctors see under a microscope what fungus is actually causing the infection. There are also other tests that can be performed.
WHAT STEPS CAN YOU TAKE TO GET RID OF TOENAIL FUNGUS?
Getting rid of toenail fungus, once you`ve got it, is a very long and arduous process, as these types of infections are very persistent due to the toenails growing in very slowly.
Even so, at least beginning treatment may keep the nail from thickening, and the fungus from spreading elsewhere on the nail, toe or foot.
Of the methods of treatment for toenail fungus, there is topical treatment, and oral treatment, in pill form. The topical treatment for this is infection is basically a colourless nail polish, which you can purchase over the counter; they contain amorolfine or ciclopirox, which in theory is supposed to halt the growing of the fungus, or even kill it. In order for these polishes to work, they must be applied consistently for a long time...going on over a year. A major setback with this treatment is its inability to penetrate through the nail plate all the way to the nail bed in order to zap the infection; they just bind to the nail plate and stop travelling down any further. In all obviousness, if the drug cannot penetrate to reach the fungus, it can`t treat it. Another topical treatment involves the use of a urea-based cream. The urea helps soften the toenail, so it can then be removed manually by scraping a spatula; once the toenail is removed, a cream containing bifonazole is used to treat the skin underneath for several weeks. That being said, topical treatments actually aren’t that effective.
The oral treatment is mainly tablets containing the drugs itraconazole and terbinfine. These tablets have to be taken for at least three months, and have side effects to them, including stomach problems and liver damage, though the liver damage is rare.
WHAT CAN YOU DO TO PREVENT TOENAIL FUNGUS?
The main thing to do to prevent toenail fungus, or athlete’s foot is to keep your feet dry. Following these tips should help, those there are not enough studies to show their effectiveness:
-Dry your feet with both a towel and a hairdryer when you have finished your shower, or pretty much whenever your feet get wet.
-Wear breathable footwear that allows air to circulate around your feet and toes.
-not wearing closed off shoes as much as possible, again, to allow your feet you breathe.
-Wearing flip-flops around pool areas, public showers, etc. This will prevent the souls of your feet from touching the floor, which may contain the fungus.
-Do not wear the same pair of shoes two days in a row. So in essence, you are allowing your shoes to dry out too.
-Do not share towels, shoes, or socks.
-Wash your bedding at a temperature of at least 60 degrees Celsius (140 degrees Fahrenheit) or higher in order to kill the fungus and stop the transfer of the fungal spores to other clothes or bedding.
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1. Informed Health Online. (2018, June 14) “Nail fungus: Overview” https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072731/ (Accessed 30 October, 2018)
2. Ghannoum, M., & Isham, N. “Fungal Nail Infections (Onychomycosis): A Never-Ending Story?” (2014). PLos Pathogens. Retrieved October 30,2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047123/