One of the major toe ailments that affect a large number of Americans is Onychomycosis, which is commonly known as Toenails fungus. It is rare with children, and the incidence grows with age. Essentially, this kind of fungal infection is caused by entrance of microscopic fungi through the small injuries in the nails. Gradually, the fungus starts growing and proliferates in the warm moist conditions inside the shoes and shocks of the patient.     

Such fungal infections are not only restricted to the toenails, rather they can also grow on the fingernails as well. However, it is hard to treat the toenails, since they grow slowly. Usually, this kind of infection occurs on the big or small toe; however, it might affect any toe. 

Symptoms

As there are different types of fungi, the symptom of toenail fungus varies. Some of the common symptoms include yellowing, thickening, swelling or crumbling of the nail plate, and streaks or spots down the side of the nail. However, in certain cases it causes complete loss of nail. The color of toenail may vary from yellow to brown or in some cases white depending upon the conditions. Usually the nails appear to be flaky and rough. In some case, the nails are separated from the nail bed. However, the symptoms are not associated with pain unless the case is serious.     

Classification

Onychomycosis can be classified into the following:

Distal Subungual Onychomycosis - It is common type of Onychomycosis, caused by Trichophyton rubrum. It attacks the underside of the nail plate as well as the nail bed. 

White Superficial Onychomycosis - This kind of a fungal infection invades the superficial layer of the nail plate that gives rise to "white islands" on the plate. However, this kind of onychomycosis cases is quite rare.  
    
Candidal Onychomycosis - This type of Onychomycosis is common with those who often immerse their hands in water. Such (yeast) fungal infections are followed by damage or trauma.   

Proximal Subungual Onychomycosis - It essentially involves infiltration of newly found nail plate through the proximal nail fold. This rarely affects healthy people; however, the immuno-compromised patients are most likely to suffer from this form of tinea unguium.    

Total Dystrophic Onychomycosis - This is a serious case, in which the nail plate is completely destroyed. This is ultimate affect followed by the above.

Diagnosis

As the toenail fungus grows uncomfortable, you should seek medical help. Get the toenails examined by a doctor. He would collect small samples from your toenails for examination. The sample is examined under microscope to detect the presence of fungi or any other infection.  If the results are positive, you should immediately look for a proper treatment. 

Treatment

In most cases, Toenail fungus becomes a chronic condition and not painful then it is not necessary to get the treatment. However, if the nail becomes thick, and it is difficult to walk or wear shoes then go and see a doctor immediately. In case, the infection is mild and localized, your doctor might prescribe a medicated nail polish with ciclopirox or amorolfine. However, for a persistent infection, which continues for long, the doctor, would prescribe an oral, systemic antifungal medication such as terbinafine or itraconazole. In case of extremely persistent infection, you would have to undergo for permanent surgical removal of the nail.   

Visit your podiatrist for more information and treatment options.    

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Dr. Maasi J. Smith
MyBadFeet.com

                           Things You Should Know About Toenail Diseases

Toenails mark the beauty of your feet. A healthy foot is evaluated by the growth of healthy clear toenails.

Understanding the growth of toenails .            

The toenails grow from the matrix, which lies hidden beneath the cuticle. The matrix is a growth of specialized cells. As the new cells grow in it, the old cells are pushed out morphing into hardened and visible part of the toenail, known as the nail plate. The nails are mainly composed of keratin, which is a kind of hardened protein found also in skin and hair. To be more elaborative, a toenail consists of many parts like the nail bed, the cuticle, the nail folds, the lunula and the matrix.

The growth rate of toenail is measured by 0.1 mm with every day count. Compared to the fingernails, the toenails tend to grow more sluggishly. Men typically have faster toenail growth than women.

             

Medical problems associated with toenails.

Sometimes, you feel defeated when you find weird problems with your toenails, despite your sincere efforts to keep them healthy. But remember that taking good care of your toenails is not always enough. Some of the toenail disorders are noticeable, while the others are obscure and painful in the long run. Most of the disorders are associated with a systemic diseases that you may have.

Brittle toenails are commonly observed in iron deficiencies, thyroid problems, circulation problems, impaired kidney function and biotin deficiency are some of the factors responsible for fragile nails. If you are suffering from frayed or split toenails, then the problem can be linked to a deficiency in protein, folic acid, vitamin C and most prominently psoriasis (psoriatic nails).

Many often complain about their nails getting thinner. Lichen Planus is a common skin disease that causes itching problems surrounding the toenail area and causes the nails to become thinner. Some hate their curved nails, which have a tendency to bulge downwards (ingrowing toenails). This is can be caused by lung, liver, heart disease or oxygen deprivation. On the other hand, there are certain kinds of nails that grow upwards and the reason can be a B12 or iron deficiency.



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Some nails have white lines running across them, this can sometimes indicate liver disease or heart disease or even high fever. Yellow toenails often plague many beautiful toes this may indicate lymphatic problems, liver disorders, chronic bronchitis and diabetes.

The market is infested with many products like nail polish and nail polish removers, which can cause damage to your nails. So be careful and check the label for harmful ingredients (acetone for example can over dry your cuticles) .

But at the end of it all, you could just have toe nail fungus (onychomycosis). A dermatophyte infects the nail and grows in the moisture rich environment (shoes).  This can lead to a thickening of the toenail as well a color changes.  Treated orally, Lamisil, Sporanox Pulse Pack, topically with Penlac, keralac nail gel or Naturally .

 remember you can always ASK DR. SMITH

 "Foot Care From The Doctor Who Cares."

Dr. Maasi J Smith / MyBadFeet Staff