Fungal Nail Infections

General Information
As the skin ages, it loses some of the defensive mechanisms involved in preventing fungal infection. Fungi that infect the skin are not particularly virulent, and they need breakdowns in the normal skin defenses to invade successfully.

Dry, healthy skin is resistant to fungal infection. Moist skin, particularly in a warm environment, creates a hothouse effect, within which fungi can flourish.

Feet
The feet are particularly susceptible to fungal infection at any age. This infection is called tinea pedis or athlete’s foot. Warm, sweaty feet in shoes rarely cleaned on the inside provide an optimum growth environment for fungi.

Prevention is best. Good foot care includes wearing clean socks, cleaning and drying the feet carefully, and using foot powder. If infections occur, the same basic foot care is essential. In addition, antifungal agents such as creams, powders, or lotions can clear up the infection. If the toenail becomes infected, oral medications for prolonged periods may be necessary.

Nails
Fungi that infect the skin may also infect the nails. This is called tinea unguium. The infection causes the nail to thicken and become distorted. Toenails can be painful, and a larger shoe may have to be worn.

Toenails are more often involved than fingernails. Nails grow slowly, and toenails notoriously so. Treatment of nail infection involves taking antifungal medication for long enough to allow all of the infected nail to grow out. This may take 18 months to 2 years for the toenails. Even with prolonged therapy, recurrence is common. Management of thickened and distorted nails by a podiatrist may be effective in relieving discomfort.

Fungal Infection of the Groin
The other common site for fungal infection is the groin. This is called tinea cruris. The groin area is often a high-humidity region that promotes fungal growth. Keeping this area clean and dry with powder and careful selection of clothing is the best prevention and, if infection occurs, is an effective therapy.

Besides keeping the groin area clean and dry, a variety of effective topical creams are available. Your physician can help you select the most appropriate agent.

Complications
Patients with diseases such as diabetes are at risk for fungal infections. Patients who have some interference with immune responses, including patients with acquired immunodeficiency syndrome (AIDS), transplant recipients, patients on cancer chemotherapy, and patients receiving steroids, need to be unusually scrupulous about their personal hygiene to reduce the possibility of fungal infection. Avoid sharing nail-cutting instruments to prevent the passing of infection.

Notify Our Office If ...

• You develop itching of the feet and/or toes.
• You develop irregular marks on fingernails or toenails.
• You develop an itch in the groin area.