If nail fungus infection makes you think twice about putting on open toe shoes or going barefoot you are not alone. Fungus nail infections (Onychomycosis) affect millions of people annually, and toenails are about 25 times more likely to be infected than fingernails.
The longest toe, either the first or the second bears the brunt of pressure and trauma from footwear and therefore it is particularly susceptible to invasion, although typically multiple nails get infected.
Proximal Subungual Onychomycosis (Nail Fungus)
Proximal subungual onychomycosis is a disease that is most frequently diagnosed in people with depressed or deficient immune system, and even more commonly in people with human immunodeficiency virus or HIV. It only rarely occurs in people with a good healthy immunity. Immunodepression can be caused by procedures like chemotherapy, or in people whose immune system is suppressed during a recovery from an autoimmune disease or an organ transplant.
The progression of the disease starts at the cuticle and grows out with the nail, and usually causes the nail to become disfigured just like other nail fungus infections. Since it starts at the cuticle and works its way up it is more likely to infect the nail bed early on which causes the nail bed to develop irregularities and bumps. This may cause the nail plate to become dislodged and fall off, exposing the nail bed to possible further infection.
Although majority of proximal subungual onychomycosis cases are caused by the same dermatophyte, Trichophyton ruburm, it can also be caused by a different dermatophyte, Trichophyton mentagrophytes as well as molds. Another defined symptom of proximal subungual onychomycosis is the skin around the nail which may become swollen, red and inflamed, and it may start to ooze pus. This is more frequently seen when the nail fungus infection is caused by molds than by dermatophytes.
Since antibiotics do not kill fungi they will not stop the infection. Only antifungal is required to eradicate molds, yeasts and dermatophytes. All available medications have potential for severe side effects and require costly and painful monthly blood tests.
Causes of nail fungus (Onychomycosis)
Fungi, including yeasts and molds, are the typical causes of nail infections. Most infections belong to a group of fungi called dermatophytes. The most usual fungi causing nail infections are Trichophyton rubrum, Trichophyton mentagrophytes, and Candida albicans.
These fungi live in the layer of dead skin around your nails, in the space under your nail and in the nail itself. Nail infection can cause a permanent deformity of the nail, which can impair your ability to wear shoes, walk and participate in sports and other activities.
Signs and Symptoms of Nail Fungus
Infected nails show one or more of the following signs:
- Yellow streaks in the skin under the nail, in the nail bed and on the underside of the nail.
- Buildup of bits and pieces of skin and nail fragments under the nail.
- Discolored and thickened nail that may separate from the skin under the nail.
- Brittle, broken and thickened nails.
- White spots or streaks on the nail surface.
- Soft and powdery nail surface appear as the infection worsens.
- Damaged, crumbly, and brown or gray nail surface with no separation of the nail from the underlying skin.
New Laser Treatments for Nail Fungus
New and nearly painless laser procedure is now available to treat fungal nails. Clinical trials have shown that laser procedure safely destroys the fungus in 70% to 90% of cases. This result is much better than the alternative medications.
Nail fungus laser procedure requires a small number of safe, quick treatments with little or no discomfort and it is performed as an outpatient service with no anesthesia. The laser light beam treats only the infected area and has no effect on the surrounding healthy tissue.
How Does Laser Work
Medical Laser beam is designed to safely penetrate your nail and destroy only the infection-causing pathogens embedded in and under your nail. Treated nail will not become instantly clear since it takes time for new nail to grow out again. This is a better result than any antifungal medicine, which you have to take for several months with some risks of side effects to the liver and other organs.
If your nail bed is healthy the nail plate should grow out in 6 to 12 months, with healthy new growth visible within the first three to six months. After several treatments the new and healthy nail will push the diseased nail plate out. BY cutting the nails as they grow you will remove the diseased nails in time.
What about the Results?
Failure to respond to standard therapy for Onychomycosis could be related to the presence of dormant Chlamydospores and Arthroconidia within the diseased nail plate, which are resistant to laser treatment. Laser light works through the nail to selectively photo-inactivate fungal pathogens to a depth just below the nail tissue surface, while it leaves the surrounding healthy tissue intact.
Advantages to Laser Treatment
- No side effects
- No harm to the nail or the skin
- Minimal pain so anesthesia is not needed
- Only 2 to 3 sessions are usually required
- Shoes can be worn immediately after treatment
Disadvantages to Laser Treatment
- Discomfort during the treatment
- Potential of infections and skin burns
- Requires meticulous hygiene after treatment
- Cost of the treatment