What is 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. Fungus 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 weak immune system are also at increased risk of fungal infections.

Fungal infections can easily spread between individuals and thrives in warm dark moist places, with limited airflow, which makes footwear a perfect breeding ground.

It is commonly found:

  • Amongst soil.

  • In communal showers and change rooms.

  • Around public swimming pools & spas.

  • Throughout carpet fibers.

  • In socks, panty hose and bed linen.


Fungal Infections of the Nails:

Fungal infections in the nails are 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 under the nail plate.


Classification of Fungal Nails:

  • Distal subungual onychomycosis (DSO) is the most common form, which gets 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 distinguished 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. It usually affects those who are immune-compromised and forms at the base of the nail.

Tinea and Fungal Nails Snapshot

  • Commonly occurring in athletes or the elderly
  • Can be itchy or painful
  • Responsible for foot odour and skin peeling
  • Easily treatable with conservative care


Causes of Tinea:

  • Genetic factors for fungal immune resistance.

  • 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 instruments are not sterilised.


Causes of Fungal Nails:

  • Genetic factors for fungal immune resistance.

  • 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 sterilisation 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 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.


Symptoms of Fungal Nails:

  • Rarely causes discomfort and often non-symptomatic.

  • May be uncomfortable in tight footwear or if nails become thick.

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 nail edge.

  • Odorous under the nail on removal.


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.

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 meets your needs.


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. Prevention strategies to prevent re-infection will be provided.

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