• Also known as onychomycosis

• Fungal infection of the nails, nail bed, and often the surrounding tissue

• Cosmetically unsightly, but particular attention to prevention and prompt treatment should be paid by people with diabetes or immune disorders

• Thickened nails can cause pressure on the nail bed in side footwear and pinching of the skin of the toes, leading to potential secondary conditions

What causes it?

• Fungus gains entry, often by previous damage or trauma to the nail or nail bed
• Fungus thrives in warm, moist areas such as the bathroom shower, carpet, locker room floors, and swimming pool change rooms and deck areas
• It enters the body through open cracks or sores; it remains there to cause infection and spread if feet are not well washed and dried after exposure
• It can spread to other parts of the body
• People with diabetes and the elderly are particularly susceptible because their immune system is often compromised

Signs and Symptoms

• Cracking, yellow to brown discolouration, thickening, crumbling, spotting and streaking or loss of toenail

Prevention and Treatments

• Thorough washing with soap and drying of feet will help prevent infection and re-infection
• Good cleaning and sanitization practices on surfaces prone to hold the fungus; this will help prevent infection and re-infection
• Wear protective shoes in public areas with high risk of holding the fungal spores such as public showers, swimming pools, locker rooms, hotel bathrooms and carpets, etc.
• Avoid wearing toenail polish
• Wear clean, dry shoes, socks, panty hose, etc.; remember that old footwear items must either be sanitized or discarded following an infection or re-infection may occur; do not share footwear
• Advanced nail care using a specialized podiatric drill to grind and reduce thickened nails
• Anti-fungal medication
• Cushioning and shielding devices if nails present a problem rubbing or creating pressure in footwear
• For severe conditions, a simple in-office surgical technique may be performed to permanently remove the nail

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