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Fungal nail infections

Yellow, black and white toenails could be sign that you’re suffering from a fungal nail infection. A condition that can incite much distress in its patients, what actually causes it and what is the best fungal nail treatment and Athlete’s foot cure around?

We asked GP, Dove DermaSeries and Dr Anita Sturnham and podiatrist Margaret Dabbs to separate the foot fact from the fiction for a go-to action plan to enact before slipping on your flip flops. From prevention to treatment of a toenail infection, plus some interesting bits of information proving that you’re not alone, foot confidence could just be the swipe of a computer mouse away.

What are the causes of a fungal nail infection and Athlete’s foot?

“Onychomycosis is the medical name for a fungal nail infection,” says Dr Sturnham. “Most fungal nail infections are caused by dermatophyte fungi which is the same fungi that also causes Athlete's foot.

“Athlete's foot is a fungal skin infection that affects the skin between the toes. It can easily spread to the toenails. Quite often people with toenail infections will have Athlete’s foot too.

“Factors that increase the risk of nail infections are:

1) Nail damage or biting;

2) Wearing damp, sweaty shoes such as trainers;

3) Medical conditions such as diabetes, psoriasis, or a weakened immune system;

4) Smoking;

5) Trauma to the nail - for example, from running or poorly fitted footwear.”

How common are fungal nail infections?

“They are common and affect up to 1 in 10 of the UK population. Around half of all nail problems seen in GP surgeries are related to fungus.

“It seems to affect men more than women and is more common as you get older. It is more common in toenails than fingernails,” Dr Sturnham explains.

What are the symptoms of a fungal nail infection?

“The most common sign of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green,” says Dr Sturnham.

“A fungal nail infection is usually painless but in some cases the infection can cause the nails to become so thickened and deformed that the nail becomes painful, often due to rubbing against footwear. If you have pain in the affected toenail, it can eventually make walking and wearing shoes difficult. As the infection progresses, you may experience other symptoms, such as the nail becoming brittle, with pieces of nail breaking off and coming away from the toe or finger completely.

“If left untreated, the skin around the nail can sometimes become inflamed and painful. White or yellow patches may also be visible on the nailbed, or you may have scaly skin next to the nail,” she adds.

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How can you treat a fungal nail infection?

“Treatment is not always needed for mild fungal nail infections,” explains Dr Sturnham.

“If you notice any unusual nail changes, go and check with your GP if you aren't sure of the cause. Your GP may send a clipping of your nail for laboratory testing to discover the exact cause of the infection and rule out other conditions. They will then discuss appropriate treatments with you.

“Fungal nail infections can be treated and usually cured, but some treatments can take several months to work. Antifungal medicines include nail paints such as Curanail, £19.99 that can be purchased over-the-counter without prescription. Daktacort Cream, £5.39 is available over-the-counter for Athlete’s foot.

“Antifungal tablets are usually effective but they may cause side-effects. These are prescription only treatments and you need to discuss this with your GP before deciding which treatment to use.

“Surgery to remove the nail may be recommended in very severe or painful cases. Laser treatment, where a high energy laser is used to destroy the fungus, is also an option,” she adds.

According to foot expert and podiatrist Margaret Dabbs, “The Margaret Dabbs laser is a series of 4 treatments that work by photo coagulation to destroy fungal that is thriving. The treatment is carried out at 14 day intervals and is pain free. The results are evident fairly quickly and improve the look of the nail.” The treatment costs from £175 per treatment per nail from the Marylebone clinic and Sole Spa at Liberty.The Margaret Dabbs Foot Hygiene Cream, £18 is also brilliant at helping to prevent fungal nail and skin conditions,” recommends Margaret.

How can I prevent a fungal nail infection?

“It is frequently said that prevention is better than cure and this is very true,” says Dr Sturnham. “Here are some tips to help you avoid these fungal infections.”

1) The first and obvious one is good daily foot hygiene. The feet should be washed in warm soapy water, then rinsed before drying carefully, paying particular attention to the skin between and beneath the toes.

2) Dusting afterwards with a medicated talc containing a mild anti-fungal agent is beneficial and ensures that you do not cause resistance to the stronger agents which may be needed for an infection at a later date.

3) Wear footwear made of natural materials as far as possible as these allow the feet to ‘breathe.’ Socks of wool or cotton and real leather shoes are advised for people who are prone to this problem.

4) Never wear anyone else’s footwear.

5) Do not go barefooted in public areas such as swimming pools and changing rooms.

6) If you notice Athlete’s foot, treat this early with over-the-counter treatments to avoid spreading to the nails.

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