Types of Toenail Fungus

Wondering if that discolouration of your toenails could be a fungal infection?

Toenail fungus is a common and persistent problem that affects millions of people worldwide. It can cause pain, discomfort, and embarrassment, and if left untreated, can lead to more serious complications. There are several different types of toenail fungus, each with their own unique characteristics and symptoms. In this informative article, we will explore the different types of toenail fungus, their causes, and the most effective treatments available to help you find relief and restore the health of your nails. Whether you have recently noticed the signs of toenail fungus or have been struggling with it for some time, this article will provide you with the knowledge and insights you need to better understand the condition and take control of your treatment.

What is a Fungal Toenail Infection?

Toenail fungus is a common condition that affects many individuals globally, causing discomfort and embarrassment. It is a type of toenail infection that develops underneath the toenail, leading to discolouration, thickening, and brittleness of the nail. This condition can be persistent and difficult to treat if not detected early. Toenail fungus is prevalent in older adults, athletes, and those with weakened immune systems, and can also affect those with poor hygiene habits. There are a variety of different types on toenail fungus, however all fungi thrive in warm and moist environments, making toenails particularly vulnerable to infection.

Common Types of Toenail Fungus

Toenail fungus can present in different forms, depending on the type of fungus that causes it. The most common types of toenail fungus are Distal Subungual Onychomycosis, Superficial White Onychomycosis, Proximal Subungual Onychomycosis, Endonyx Onychomycosis, and Total Dystrophic Onychomycosis.

Fungal toenail infection treatment Sydney

Distal Subungual Onychomycosis

Distal Subungual Onychomycosis (DSO) is a fungal infection that commonly impacts nails, particularly toenails. The infection is mainly caused by a group of fungi known as dermatophytes, which thrive in warm and moist environments. DSO is often characterised by nail thickening and discolouration, as well as separation of the nail plate from the nail bed.

DSO is a chronic infection that can be challenging to treat and may last for years if left untreated. The infection typically starts at the distal end of the nail and slowly progresses towards the nail base. The nail may become discoloured, and it may also become brittle and crumbly.

DSO can be transmitted through direct contact with infected nail clippings, shoes, or socks. It is also more common in individuals with a weakened immune system or a history of nail trauma or frequent exposure to water.

Superficial White Onychomycosis

Superficial White Onychomycosis (SWO) is a fungal infection that impacts the nails. The condition is caused by different types of fungi and is characterised by white spots or streaks on the nails. The fungus grows on the nail surface and can appear similar to dry nails. The infection is generally painless but can cause the nail to become brittle and crumbly.

SWO is more prevalent in toenails than in fingernails and is often observed in individuals with weakened immune systems or those who frequently expose their feet to warm and moist environments. The fungus responsible for SWO can be transmitted from person to person or from one nail to another.

Proximal Subungual Onychomycosis

Proximal Subungual Onychomycosis (PSO), is a fungal infection that primarily affects the toenails. This condition is typically caused by dermatophytes, a type of fungi that thrive in warm and moist environments such as the inside of shoes or socks.

The infection starts at the base of the nail and gradually spreads towards the tip. As the condition progresses, the nail may become discoloured, thickened, and crumbly. PSO is more commonly seen in individuals with weakened immune systems, such as those with HIV/AIDS or diabetes, as well as in people who frequently expose their feet to warm and moist environments, such as athletes or those who wear closed-toe shoes for extended periods.

Early detection and treatment are crucial in preventing the infection from spreading and causing further damage to the nail and surrounding tissue.

Endonyx Onychomycosis

Endonyx Onychomycosis is a type of fungal infection that affects the nails. Unlike other types of onychomycosis, endonyx onychomycosis primarily affects the nail bed, which is the tissue underneath the nail. This type of infection can cause the nail to thicken and become discoloured, often turning white or yellowish in colour.

Endonyx onychomycosis is caused by a variety of fungi, including dermatophytes and yeasts. It can be difficult to diagnose, as the nail may not show any visible signs of infection. In some cases, a fungal culture may be necessary to confirm the diagnosis.

Total Dystrophic Onychomycosis

Total Dystrophic Onychomycosis is an “end-stage” fungal infection in which there is total destruction of the nail plate. This type of fungal infection can affect both the toenails and fingernails and is characterised by thick, discoloured, and brittle nails that may crumble or separate from the nail bed. It can be the result any of the fungal infections caused by dermatophytes or yeast-like fungi.

People with compromised immune systems, diabetes, or peripheral vascular disease are more susceptible to developing total dystrophic onychomycosis. It can also occur due to poor foot hygiene, wearing tight shoes, or walking barefoot in public places.

Knowing the type of toenail fungus you have is important for proper diagnosis and treatment. Understanding the different characteristics and symptoms of each type can help you identify the condition and seek appropriate medical attention. In the next section, we will explore the symptoms of toenail fungus in more detail.

Signs and Symptoms

The signs and symptoms of toenail fungus can vary depending on the severity of the infection. However, the most common signs and symptoms of a fungal infection include:

  • Change in the colour of the toenail. The nail may become discoloured and develop white, yellow, or brown spots. The nail may also become darker and appear black in severe cases.
  • Thickening of the nail. The infected nail may become thicker than usual and can be difficult to cut with a nail clipper.
  • Brittleness of the nail. The infected nail may become dry and brittle, making it more likely to crack or break.
  • Changes to the shape of the nail may also occur as the infection progresses. The nail may become distorted and appear curved or twisted.

Other symptoms of toenail fungus as it progresses include:

  • A foul odour
  • Pain or discomfort in the affected area
  • Separation of the nail from the nail bed

It is important to note that not all cases of toenail fungus cause symptoms, especially in the early stages of the infection.

If you suspect you may have toenail fungus, it is important to seek medical attention promptly to receive an accurate diagnosis and appropriate treatment. Early detection and treatment can help prevent the infection from spreading and causing further damage to the nail and surrounding tissue.

Causes and Risk Factors

Fungi thrive in warm, dark, moist environments, so people who frequently expose their feet to such conditions are at a higher risk of developing toenail fungus. Additionally, older individuals are more prone to this condition, as toenails become thicker and more brittle with age, making them more susceptible to fungal infections.

Toenail fungus can be caused by various factors, including:

  • Nail trauma
  • Sharing nail care equipment
  • Poor hygiene
  • Wearing ill-fitting shoes
  • Having a weakened immune system
  • Male gender
  • Diabetes
  • Peripheral artery disease
  • Certain medications, such as those used to treat cancer and autoimmune disorders, can also weaken the immune system
  • Athlete’s foot (tinea pedis)

It is important to note that toenail fungus is not always caused by poor hygiene or lifestyle habits. It can also occur due to genetics or a family history of fungal infections. People with a family history of toenail fungus should be extra vigilant about taking preventive measures to reduce their risk of developing this condition.

Prevention and Treatment

To prevent toenail fungus, it is important to maintain good foot hygiene. This includes keeping feet clean and dry, wearing breathable and properly fitting shoes, and avoiding sharing shoes or nail clippers with others.

If you suspect that you have toenail fungus, it is important to seek treatment from a podiatrist. Topical antifungal medications, such as creams or ointments, can be effective in treating mild cases of toenail fungus. However, more severe cases may require oral antifungal medications, which are typically prescribed by a doctor.

It is important to note that treating toenail fungus can be a lengthy process, and it may take several months for the infection to clear up completely. In addition to medications, there are also alternative treatments, such as laser therapy, that may be quicker and more effective in treating toenail fungus.

Overall, prevention and early treatment are key in managing toenail fungus. By practicing good foot hygiene and seeking prompt medical attention when needed, you can help prevent the spread of the infection and promote healing.

When to See a Podiatrist

In most cases, minor fungal toenail infections can be treated effectively with over-the-counter medications, providing that the appropriate medication is purchased for the specific infective organism. However, if the condition is severe or if home remedies are not effective, it may be necessary to seek medical attention from a podiatrist. If the suspected infection is black, and you have noticed it is starting to involve the skin surrounding the nail plate, seek medical attention immediately.

A podiatrist can diagnose toenail fungus by examining the affected nail, and if required, taking a sample for laboratory analysis. They can also recommend the most effective treatment options based on the severity of the condition and the patient’s medical history.

It’s important to seek medical attention if the toenail fungus is causing pain or discomfort, if the infection is spreading to other nails or skin, or if there are signs of an underlying medical condition, such as diabetes or a weakened immune system.

In addition, individuals who have a history of toenail fungus or other foot infections should consider seeing a podiatrist regularly for preventive care and early detection of any potential problems.

Overall, if home remedies or over-the-counter treatments are not providing relief or if there are any concerns about the condition, it’s best to schedule an appointment with a podiatrist for further evaluation and treatment.

Summary

To summarise, toenail fungus is a common condition that can affect individuals of all ages and backgrounds. There are several types of toenail fungus, each with their own distinct features and symptoms. These include:

  • Distal Subungual Onychomycosis
  • Superficial White Onychomycosis
  • Proximal Subungual Onychomycosis
  • Endonyx Onychmycosis
  • Total Dystrophic Onychomycosis

While toenail fungus can be unsightly and uncomfortable, there are several ways to prevent and treat the condition, including maintaining proper foot hygiene, wearing proper footwear, and seeking medical attention if necessary. With proper care and attention, individuals can effectively manage toenail fungus and prevent its recurrence. It’s essential to stay informed about the causes, symptoms, and treatment options available to make informed decisions regarding your health. Remember to always consult with a qualified medical professional  such as a podiatrist, if you suspect you have toenail fungus or notice changes within your toenails.

Daniel Graham
Podiatrist Sydney

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