Nail fungus (tinea unguium): symptoms, causes, drugs, etc.

Definition of toenail fungus

Nail fungus (tinea unguium) is a condition when the nails of the fingers or toes have white or yellow patches. One of these diseases of the nails is caused by a common fungal infection.

This condition, also known as onychomycosis, has the same causes as athlete's foot (athlete's foot). In this disease, the fungus will live in the keratin which forms the outer layer of the skin. When the fungus spreads to the nail keratin, the nail becomes infected with the fungus.

Generally, the treatment of these nail problems is not difficult. However, when not handled properly, it can certainly infect the nails again.

How common is toenail fungus?

Anyone can experience nail fungus, especially for people with diabetes. In addition, the elderly are also more at risk of developing this nail disease due to age.

You can prevent tinea unguium by avoiding risk factors. Please consult a dermatologist for more information.

Types of nail fungus infection

Although tinea unguium is not life threatening, this nail problem still needs to be treated as soon as possible. The reason is, the nails will change color and make them break easily which can become a gateway for other bacteria to the body.

If untreated, moldy nails can cause pain and make it difficult for you to walk. However, the treatment of this nail disease will vary depending on the pathogen causing it. Here are the differences.

Distal and Lateral Onychomycosis (DLSO)

DLSO nail fungus infection is caused by a type fungus Trichophyton rubrum. This fungus can develop on the fingernails, but often attacks the toenails.

This infection begins when pathogens colonize the nail bed and under the nail. Then, this infection spreads to the nail matrix and damages the outer skin layer around it. As a result, the nails are yellow-brown.

Proximal Subungual Onychomycosis (PSO)

PSO yeast infection is also caused by Trichophyton rubrum. However, this type of infection is less common and commonly affects the toenails of HIV patients.

Generally, pathogens will enter through the cuticles at the nail bed and enter the nail matrix to attack the new nails that will grow. Then, the fungus will rise to the surface. As a result, the nails also have white spots and over time the nails fall off and get damaged more easily.

White Superficial Onychomycosis (WSO)

WSO is caused by Trichophyton interdigitale and only about 10% of the other types of nail fungus. This one infection occurs by the direct entry of pathogens in the outer layer of the nail.

Candidal onychomycosis

Candida yeast infection is certainly caused by the candida fungus which also causes ringworm and ringworm. Candida albicans later it will enter all parts of the nail and cause a whitish discoloration.

Endonyx onychomycosis

This type of fungal infection is rare and is usually caused by Trichophyton soudanense or Trichophyton violaceum. The clinical symptoms that appear in this infection are the appearance of a milky white discoloration of the nails.

Total Dystrophic Onychomycosis (TDO)

TDO nail fungus infection is the most severe degree of onychomycosis and is a continuation of untreated DLSO or PSO until complete recovery. The nails will be thickened and yellowish in color.

Signs and symptoms of tinea unguium

Initially, toenail fungus did not show any symptoms. However, over time symptoms will appear that are quite disturbing, such as:

nail discoloration, such as blackened, yellow, or brown nails,
nails thickened and deformed,
nails fall off easily and are more brittle,
the buildup of dirt under the nails is moldy and smells bad, and
Nail fungus is separate from toenails or fingernails and rarely causes pain.

Keep in mind that moldy nails is a different disease than psoriasis. For example, both psoriasis and yeast infection tend to get worse with time.

Even so, psoriasis doesn't spread by contact like yeast infection, so yeast infection tends to spread faster. People with a fungal infection of the toenails may also notice discoloration between the toes and other signs of infection.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When to see a doctor for tinea unguium?

If the above symptoms do not get better and get worse, consult a doctor immediately, especially for people with diabetes. Delayed doctor visits can lead to the spread of the yeast infection and cause pain.

Everyone has different symptoms and conditions. Always discuss with a dermatologist to determine the best diagnosis and treatment for you.

Causes and risk factors for tinea unguium

Moldy nails can be caused by various types of fungi and one of the most common types of fungi is dermatophyte.

The cause of this nail fungus can be caught in places such as swimming pools and public locker rooms. Apart from that, dermatophytes can also infect your nails when traveling barefoot.

You can also become infected with fungus if you share nail clippers or towels that have been contaminated with fungus. Fungal infections don't just pass from person to person, they also occur as a result of not keeping your nails clean.

For example, the habit of wearing damp socks and shoes is a good place for mold growth. Pathogens will later infect the nails by entering through various ways, namely:

small cuts in the skin around the nails,
cracked nails
the skin between the nails and fingers, both hands and feet

What factors increase the risk of getting toenail fungus?

Quoted from the Mayo Clinic, certain factors that increase your risk of experiencing this condition are as follows.

Elderly due to slowed nail growth.
People who sweat easily.
Men who have a family history of this disease.
Work in a humid or prone to wet environment.
Accustomed to wearing wet socks or shoes.
Travel barefoot in wet areas, such as swimming pools.
Sores on the skin or nails.
People with psoriasis.
People with diabetes, blood flow problems, and Down syndrome in children.

Diagnosis and treatment

How to diagnose this condition?

Nail fungus is usually diagnosed clinically. The doctor may take a piece of the nail that looks damaged and send it to a laboratory. In addition, how to diagnose moldy nails can also be done through a potassium hydroxide (KOH) preparation test.

This aims to see what pathogens are infecting your nails. That way, it will be easier for your doctor to determine what type of treatment you need.

What are the ways to treat nail fungus?

Although not dangerous, the treatment for moldy nails is quite long and depends on the type of pathogen and its severity.

Your doctor may recommend one of three drug options for treating nail fungus or a combination of medications, including:

antifungal ointment or cream,
oral antifungal medications, such as terbinafine or fluconazole, as well
antifungal nail polish.

In addition to the three types of medication above, your doctor may cut any infected nails short.

In fact, the same thing can be done on the skin area of the nails with mold. In addition, the doctor will also scrape the dirt that has accumulated under the nails to trim fungal growth.

Keep in mind that over-the-counter nail care products are not recommended as a tinea unguium remedy. This is because over-the-counter drugs have not been proven to give satisfactory results and can even cause relapses.

Home remedies

Yeast infection is one disease that spreads quickly. That is why, you can come back with these nail abnormalities. Here are some ways to treat nails so they don't get infected with fungus.