2 Foot Productions

Basic Foot Care for Nurses and Carers across Australia

Fungal Toenails What are fungal toenails? What causes fungal toenails? Where will you find fungal toenails? What happens if you dont attend to fungal toenails? What can you do to help?

What are fungal toenails?

A common problem seen in toenails is a fungal infection. The fungus penetrates the nail plate and multiplies – damaging the nail. The nail will commonly look yellow or brown, can thicken and crumble and may smell bad. Often a thick or deformed nail will be mistaken for a fungal toenail. The only way to positively identify a fungal nail infection is to get a sample tested.

What causes fungal toenails?

As mentioned earlier regarding tinea, fungus loves the feet. It is warm and moist and there is plenty of “food” available. Fungal nails aren’t necessarily a sign of poor hygiene, even the most conscientious foot carers can end up with a fungal infection of a toenail.

Where will you find fungal toenails?

Any toenail can be affected.

What happens if you don’t attend to fungal toenails?

The difficulty with fungal toenails is knowing when to treat and when not to.

Sometimes, careful monitoring and good foot hygiene is all that will be required.

Sometimes it will be important to start on oral medication as soon as possible.

Fungal toenails can lead to infection in the skin underneath and around the nail. They will also lead to an increased risk of an ingrown toenail.

A fungal toenail on a foot with poor circulation can carry a real risk of ulceration.

Something else to consider is that people are often quite embarrassed by unsightly toenails.

What can you do to help?

Careful monitoring is always important.

A small amount of discolouration in one, two or even a few toenails may not warrant treatment. However, extensive toenail involvement, pain, secondary infections or concern about other potential complications should warrant treatment.

The decision about when to treat and how to treat should be made in conjunction with a doctor or podiatrist.

Basic prevention and treatment includes particular attention to foot hygiene – careful washing and drying of the feet. All footwear and laundry items should be kept clean and changed regularly. All washing should be done on a hot wash. There are anti fungal washing detergents available.

A step up from this includes the use of topical agents. If you are going to put an anti fungal on a toenail you should use a paint. They are designed to penetrate the nail better. Creams, powders and sprays are not appropriate if you want to try and resolve a nail infection.

There are several types of anti –fungal nail paints available over the counter from your local pharmacy. They range in price from a few dollars to around $100.

Some nail paints are to be used daily. To use these kinds of paints – have the nail short and clean. Apply the paint up to twice daily as directed. Expect to be using the paints for quite a long time. Treatment success using nail paints varies widely, but think months and months and months as a guide. Never apply a topical anti fungal paint to an open wound.

A newer type of anti fungal paint is Loceryl – this paint is applied once a week. Speak to your pharmacist or doctor when it comes to deciding which one you will try.

There are many herbal and natural style products on the market claiming to cure all sorts of fungal infections. It is entirely possible that they are worth a try, but never expect a quick cure. Always remember to get advice from your pharmacist or GP if you are considering the use of any tablet therapy.

And that leads us into the last and best treatment option for fungal toenails. Oral medication is available and if you really want to get rid of a fungal nail infection, it must be considered. A treatment course will last around three months, maybe a bit more. This is a decision for the doctor to make. You will need to report any troublesome toenails to the doctor for a thorough review.

Just to recap the main points for treating fungal nails - the different levels of treatment for fungal toenails include:

1. Paying particular attention to foot hygiene and careful monitoring
2. The use of a topical anti fungal treatment
3. The use of oral anti fungal medication
4. For all steps – plenty of patience is needed.