Tinea and Fungal Nails

Causes, prevention and treatment for Tinea and Fungal Nails

If you have ever experienced Athletes Foot (Tinea) you will know just how irritating and itchy the foot can be.

Tinea is an opportunistic infection of the skin, that is generally more common in the summer months when the humidity rises and this condition is easily spread in warm and wet environments.

People with diabetes or a compromised immune system are also at increased risk of fungal infections.

Tinea is easily spread between individuals and thrives in warm dark moist places, with limited airflow, which makes footwear a perfect breading ground.

It is commonly found:

  • In soil.
  • In communal showers and change rooms.
  • In public swimming pools & spas.
  • Throughout carpet fibers.
  • In socks, panty hose and bed linen.

Causes of Tinea:

  • Genetic factors are believed to be involved.
  • Fungal spores are everywhere in the environment so if the conditions are right your skin may become infected.
  • Borrowing or wearing someone else’s shoes, socks etc.
  • Using an infected shower or walking barefoot around swimming pools or on infected carpet etc.
  • Having a pedicure where the instrument are not sterilised.

Symptoms of Tinea:

  • Itchiness  and/or a white sogginess between the toes, which if left untreated may lead to painful splitting and peeling between toes.
  • Patches of flaking skin on the soles of the feet.
  • Red pustules or “dots”.
  • If severe the foot can be odorous.

Treatment for Tinea:

  • Keep areas infected dry and clean, especially between the toes.
  • Wear breathable socks and footwear, avoid synthetic fibres.
  • Take a pair of thongs to wear in the shower, change rooms and around spa and pool edges.
  • Wear protective footwear when walking on carpets in motels/hotels.
  • Do not share your socks, sports shoes or towels.
  • Topical antifungal preparations (creams, sprays, powders and antifungal laundry rinse) for feet, shoes, sock and linen.

Note: there are many topical antifungal preparations on the market, so it is best to ask the podiatrist for assistance in selecting the one that meet your needs.

Fungal Infections of the Nails:

Fungal infections in the nails are a very common, but unlike tinea they are very difficult to treat, generally having  a poor prognosis and high re-occurrence rate.

The most common fungus to infect the toenails,  is usually caused by Trichophyton rubrum, which invades the nail bed and get under the nail plate.

Causes of Fungal Nails:

  • Genetic factors now believed to be involved.
  • Previous trauma or damage to the nail bed/matrix  that has weakened the nail and made it more susceptible to fungal spores (e.g. dropping heavy item on toe, stubbing toe, tight footwear).
  • Open toed footwear in the garden, as soil has a high content of fungal spores.
  • Pedicures at a beauty salon or overseas where sterilization is insufficient.
  • Wearing or borrowing someone else’s shoes, nail cutter, nail files, socks etc.
  • Walking barefoot on infected carpet or around swimming pools.
  • Using communal showers without thongs.

Symptoms of Fungal Nails:

  • Rarely causes discomfort and often non-symptomatic.
  • May be uncomfortable in tight footwear or if nails become thickened.

The characteristics of a fungal nail infection depend on the infectious agent, but may include:

  • Lifting of the nail plate off the nail bed.
  • Thickening of the nail plate.
  • Crumbling of the nail plate.
  • Yellow, brown, green or white discolouration, usually in streaks.
  • Flaking and pitting of the nail plate surface.
  • Scaly skin around the infected nail edge.
  • Odorous under the nail if removed.

Classification of Fungal Nails:

  • Distal subungual onychomycosis (DSO) is the most common form, which get in under the tip of the nail.
  • White superficial onychomycosis (WSO) appears as white chalky lines on top of the nail and is present in 10% of fungal cases.  It needs to be differentiate from “keratin granulations”  a reaction to nail polish that is not a fungal infection.
  • Proximal subungual onychomycosis (PSO) is not common in the healthy population, but usually effects those who are immune-compromised and forms at the base of the nail.

Treatment for Fungal Nails:

  • Antifungal medication prescribed by your GP if a positive nail scraping is undertaken by a podiatrist.
  • Over the counter antifungal nail paint.
  • Mechanical cutting and thinning of the nail by a podiatrist.
  • Surgical removal or the nail (temporarily or permanent) by a podiatrist.
  • Laser treatment.

Well Heeled Podiatry is experienced in treating all fungal nail and skin infections and can provide you with a treatment regime that is best suited to your specific type of fungal infection. Strategies will also be given to prevent re-occurrence and spreading.

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