Its that time of year where we are beginning to think about summer, wearing sandals and flip-flops or going bare foot on the beach. But not everyone has ‘pretty’ feet. In fact, many people have toenails which they would prefer to keep undercover.
So, what causes grotty nails? Nails can become damaged by trauma, friction from wearing ill-fitting footwear is a common trigger. If this is the case, then there is no cure, apart from waiting for the damaged nail to grow out or covering the nails with a polish to disguise any imperfections.
Grotty nails could also be caused by fungal infections. Sounds horrible doesn’t it? In fact, fungal nails appear to be more common than one may think.
Onychomycosis is the medical name for a fungal nail infection. They are common and affect up to one in ten of UK population. Around half of all nail problems seen in GP surgeries are related to fungus.
It seems to affect men more than women and is more common as you get older. It is more common in toenails than fingernails
The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.
A fungal nail infection is usually painless but in some cases the infection can cause the nails to become so thickened and deformed that the nail becomes painful, often due to rubbing against footwear.
If you have pain in the affected toenail, it can eventually make walking and wearing shoes difficult.
As the infection progresses you may experience other symptoms, such as the nail becoming brittle, with pieces of nail breaking off and coming away from the toe or finger completely.
If left untreated, the skin around the nail can sometimes become inflamed and painful. White or yellow patches may also be visible on the nailbed, or you may have scaly skin next to the nail.
What causes a fungal nail infection?
Most fungal nail infections are caused by dermatophyte fungi, which is the same fungi that also causes athlete’s foot.
Athlete’s foot is a fungal skin infection that affects the skin between the toes. It can easily spread to the toenails.Quite often people with toenail infections will have athletes foot too.
Factors that increase the risk of nail infections are:
1: nail damage or biting
2: wearing damp, sweaty shoes such as trainers
3: medical conditions such as diabetes, psoriasis, or a weakened immune system
4: smoking
5: trauma to the nail – for example, running or poorly fitted footwear
Treating a fungal nail infection
Treatment is not always always needed for mild fungal nail infections.
If you notice any unusual nail changes go and check with your GP if you aren’t sure of the cause. Your GP may send a clipping of your nail for laboratory testing to discover the exact cause of the infection and rule out other conditions. They will then discuss appropriate treatments with you.
Fungal nail infections can be treated and usually cured, but some treatments can take several months to work. Antifungal medicines include nail paints such as Curanail that can be purchased over the counter without prescription. Daktacort cream is available over the counter for Athletes foot.
Antifungal tablets are usually effective but they may cause side effects. These are prescription only treatments and you need to discuss this with your GP before deciding which treatment to use.
Surgery to remove the nail may be recommended in very severe or painful cases.
Laser treatment, where a high energy laser is used to destroy the fungus, is also an option. I treat many people at my clinic Nuriss Skincare and Wellness Centre on Wimpole Street in London.
How to prevent it:
It is frequently said that prevention is better than cure and this is very true. Here are some tips to help you avoid these fungal infections. The first and obvious one is good daily foot hygiene. The feet should be washed in warm soapy water, then rinsed before drying carefully, paying particular attention to the skin between and beneath the toes. Dusting afterwards with a medicated talc containing a mild anti-fungal agent is beneficial and ensures that you do not cause resistance to the stronger agents which may be needed for an infection at a later date.
Wear Footwear made of natural materials as far as possible as these allow the feet to “breathe”. Socks of wool or cotton and real leather shoes are advised for people who are prone to this problem.
Never wear anyone else’s footwear.
Do not go barefooted in public areas such as swimming pools and changing rooms.
If you notice athletes foot, treat this early with over the counter treatments to avoid spreading to the nails.
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