Toenail fungus

If one of your toenails is white, thickened, brittle, or crumbling, you may have more than a cosmetic problem. Toenail fungus can affect the ability to stand, walk, and exercise. It can be particularly dangerous for older men with diabetes or peripheral vascular disease.

What does toenail fungus look like?

One look at healthy toenails demonstrates that the healthy nail is transparent, revealing the pink skin beneath it. As the nail grows out, it becomes white where it is no longer attached to the underlying skin. One of the first signs of fungal infection is a spreading of the white section of nail down to the part that is normally transparent. The patient may notice that the white seems to dip down on one edge. This is a sign that there is a fungus beneath the nail. As the fungus lives below the nail, it slowly forces the nail up from the living nailbed. If it is not treated, this spot of white nail will grow gradually as the fungus spreads further and further. Eventually, the entire nail can be affected. it appears totally white, so that there is no pink nailbed visible beneath it. The nail also becomes progressively more loosened as the fungus grows. It may begin to crumble or flake away. If this condition is not treated, the entire nail may be lost.

What other conditions look like toenail fungus?

White, brittle, crumbling toenails are also seen with other conditions such as psoriasis. If you have a diagnosis of psoriasis, you should visit your dermatologist for examination of the nails. If you have never had psoriasis, it is less likely to because of your nail problem. Trauma of the nail may also cause discoloration and/or loosening. However, if you have nail damage to the point of trauma, you should be able to easily remember the causative event.

Do I need to see a physician?

you will need to see a physician for diagnosis of the nail problem. Physicians can prescribe one of several antifungal products for toenail fungus. Oral tablets/capsules may be effective (eg. Sporanox, Lamisil). They may be prescribed in pulse doses that do not require daily dosing for a long period. One new product (Penlac) is a nail lacquer that is painted on the nail to cure fungal infection. Whichever therapy is prescribed for you, it is vital to follow directions exactly.

Preventing toenail fungus

You can take several steps to protect yourself from toenail fungus. Keep your feet clean and dry, and wear properly fitting shoes that allow your feet to breathe. Wear shower shoes at public swimming areas because swimming facilities and locker rooms are frequent sources of fungal infections. Dry your feet thoroughly with a clean, dry towel after showering or swimming. You may also want to use a foot powder, although you should avoid those containing corn starch. Be sure to trim your toenails regularly.

If you have any questions about preventing or treating toenail fungus, consult your pharmacist.