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Onychomycosis or what we commonly called a toenail fungus affects 12% of the worldwide population, 20% of the population over 60 years of age and 50% of the people over 70. Males are affected twice as much as females. Diabetics are affected three times more than nondiabetics. Toenail fungus is a fungal infection that gets under the toenails. It causes the nails to thicken and become discolored. They often crumble. The fungus that causes toenail fungus multiplies in warm, moist and dark places like the inside of our shoes. It usually starts in one toenail but it can subsequently spread to all ten toenails. Fungus in the toenails usually starts with a small white or yellow spot on the toenail and gradually spreads underneath the nail and into the growth area or the matrix. Once it spreads underneath the whole nail it is much harder to treat. Woman who wear nail polish can actually make the toenail environment more susceptible to getting fungus. Nail polish also does not let one see the color of the nail plate itself so fungus can grow. When toenail polish is removed and a small spot of fungus is noted treatment at this point is very successful. When one waits until all ten toenails are affective have a lower success rate.
The fungi that cause most of the toenail infections include Trichophyton rubrum and Trichophyton mentagrophytes. These are the same organisms that cause athlete's foot and in many cases uncontrolled athlete's foot when we are younger can affect the toenail. Athlete's foot is much easier to treat with just topical medications because the skin which is made of keratin is soft. Once the fungus gets into the toenail, which by the way is made of keratin, it becomes harder because the nail is made of hard keratin and harder to penetrate.
Risk factors for getting onychomycosis include increasing age, being a male, diabetes, hyperhidrosis, peripheral vascular disease, immunodeficiency, Athlete's foot and poor hygiene.
Normal nails grow at the rate of 0.1 mm per day or 3 mm a month. This means it takes the toenails approximately 1 year to grow Any of the treatments that we utilize do not show results for 4-6 months. Good care of nails is the way to keep the fungus out. This includes keeping the nail clean and dry, using a nail file to keep the ends of the nails shaped and free of high points, keeping your toenails rounded, not removing the cuticle because it protects your body from infections and avoid cutting deep into the nail fold areas when trimming your nails. If you see any changes in your nail which include color, swelling or have pain seek medical care sooner than later.
Treatment for fungus toenails has changed over the last 10-15 years and now consists of basically six options.
The first option is to not treat your toenails and let the fungus continue and possibly spread.
The second option is to treat them topically. There are 100's of different medications to treat fungus toenails. These include homeopathic treatments such as Vic's Vaporub, tea tree oil, beer, vinegar and even urine. These modalities are 2% successful if even that. Recently we have been mixing urea cream with any antifungal agent and applying it to the nail. (more)