Onychomycosis

Fungi are plant organisms, without chlorophyll, found in the environment around us. There are about 100,000 species of fungi, of which only 100 are capable of causing disease in man.

Fungi live in our body in balance. This means that under normal conditions they do not cause infections. Certain environmental conditions or the person himself can cause a fungal infection to develop.

The onychomycosis is an infection of the nail caused by fungi and is a very common disease. Between 40% -50% of podiatry consultations occur for this cause, which shows its high incidence in the population. Unlike athlete’s foot, onychomycosis is more common in middle-aged and elderly people, favored by age-related circulatory disorders of the fingers and nail shape disorders that can be acquired throughout life .

Why is it produced?

Onychomycosis is caused by a fungal infection that affects the nail. This nail disease can be caused by different types of fungi, which can be grouped into two large groups. These two large groups are: dermatophytes and yeasts.

Dermatophyte fungi : those that most frequently affect the nail are (from highest to lowest incidence):

• T. Rubrum.
• T. Mentagrophytes
• E. Floccosum

Yeasts : among yeasts, without a doubt, “Candida Albicans” is the fungus that most affects the nails, but it must be taken into account that when the nail infection is caused by it, it is almost always due to conditions immunodeficiency, that is, when the body has low defenses. Also, Candida Albicans is more frequent in people who carry out certain types of activities that favor foot moisture, such as athletes, cooks, formworkers, firefighters, gardeners, etc.

The areas where a mycosis is most frequently located are:

• Between the toes.
• The sole of the foot.
• The English.
• The ones.
• Hair.

Fungi are spread by direct contact of our feet with spores scattered on the ground. The places where you normally walk barefoot are risk areas for contagion. For example:

• Swimming pools.
• Showers
• Saunas
• Gyms
• Beaches.
• Etc.

Once the nail has been affected by the fungus, it is altered in shape and growth. Normally the nail turns yellow, thickens and grows slowly. The fungi feed on the keratin in the nail and gradually destroy it, but the nail residues remain compacted on themselves and the nail ends up being an accumulation of waste from the metabolism of the fungi. As the nail grows from its portion closest to the root of it, it is affected by the action of fungi and the result over time is a thickened, yellowish nail with a floury texture.

Nail fungal infections (onychomycosis) are sometimes spread by fungi that live on our skin, and are favored by certain conditions. The foot is an area of ​​the body that more easily suffers from fungal infections (caused by fungi). The skin of the foot is often damaged by external agents such as overly aggressive soaps or cosmetics, inadequate footwear or socks (which keep the foot moist), which produces a decrease in the natural protection of the skin called the acid mantle. The acid mantle of the skin is made up of a thin protective layer that is constantly being renewed. This layer prevents the development of fungi.

When excessive sweat from the skin cannot evaporate due to poor footwear or the use of synthetic fiber socks, the acid mantle of the skin is destroyed by its action and leaves a free way for fungal invasion.
High temperature is another factor that facilitates the growth of fungi and this condition is highly favored in the feet due to the use of footwear.

The circulatory problems of the legs affect the feet more harshly, which is logically where the blood reaches the most difficulty. Likewise, the fingers are in this case the most affected and therefore the toenails are poorly nourished and begin to thicken. The thickening of the nail favors its detachment from the nail bed, a circumstance that is used by fungi to entrench themselves in this area and initiate the invasion of the rest of the nail.

Symptoms of onychomycosis

The nail can be affected in different ways, but there are common signs that can alert us to it:

• Thickening of the nail.
• Color changes. The nail appears yellow, black-brownish.
• Alteration of the normal growth of the nail.
• Redness and swelling of the tissues around the nail.
• The nail falls apart when cut.
• Accumulation of remains of skin and nail under it.
• Bad smell from the nail when cutting it.
• Presence of fluid or exudate under the nail.

How is it diagnosed?

Onychomycosis is a disease that is difficult to diagnose with the naked eye, so that only with the clinical appearance of the lesion we cannot be sure that such an infection exists. This difficulty lies in the existence of other nail diseases that closely resemble onychomycosis, such as onychogryphosis or psoriasis .

For the correct diagnosis of onychomycosis, cultures of the affected nails are used. The method of identifying the fungus consists of culturing the infected material (nail plate, nail powder) in suitable culture media, such as agar or Sabouraud.

Once the growth of the fungus has been obtained, several techniques are used to identify it, such as the study of the macroscopic characteristics of the colony (shape, arrangement, etc.), the analysis of the growth rate and also the study with a microscope.

It is also possible to observe the fungi directly through the microscope, which facilitates a quick diagnosis but does not allow to identify the genus and the species.

Treatment of onychomycosis

If you suspect that you have foot fungus, you should quickly see your doctor or podiatrist for treatment. Fungi are treated with medicines called antifungals. There is a wide range of them. Nail polishes, lotions or creams are also used to treat onychomycosis. You should not use drugs without first consulting a professional.

Your podiatrist can properly trim and trim your fungal infected toenail, speeding up healing and preventing spreading from nearby nails. The fungi must be treated and cured as soon as possible. This will prevent its extension to the rest of the foot, which will delay and hinder its healing.

How to avoid it?

There are a number of measures to prevent fungal foot infection:

• Do not go barefoot in beaches, swimming pools, gyms, saunas or common showers. Nor do it for rugs or carpets at home or in hotels.
• Use footwear that allows the correct perspiration of the foot and appropriate to the season of the year in which we find ourselves.
• Change shoes every day.
• Wear natural fiber socks, mainly wool, thread or cotton, which allow the foot to breathe and at the same time keep it dry.
• Wash feet daily and change socks every day.
• If there is increased sweating, wash your feet twice a day.
• Control foot sweating with antiperspirants that prevent continuous moisture from the foot.
• Use neutral soaps that do not injure the skin.
• Apply moisturizing and protective creams of the acid mantle.
• Dry your feet after bathing with a cotton towel and with special care between the toes.
• Do not leave your feet submerged in water for more than 10 minutes.