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Fungal and discoloured toenails

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What is a fungal toenail?

Fungal toe nails are nails that have become infected by fungus. They can be caused by the same micro-organisms that cause athlete’s foot. They use the keratin in your nails as a food source and cause discolouration, thickening and damage.

Often the discolouration is white, yellow or brown. Black nails are usually caused by trauma (stubbing or dropping something on your toe) but if you haven’t damaged your toe and your nail becomes black or or dark in colour, seek advice from a Podiatrist, GP or Dermatologist as it should be looked at.

Anyone can get a fungal nail infection. They can be associated with previous trauma, but this can be microtrauma which you were not aware of, leading to nail damage and an entry portal for the fungus. Damaged or dehydrated nails, or poor foot hygiene may also increase risk of developing a fungal nail infection, and they can be associated with a number of medical conditions such as diabetes, and the ageing process.

How can I help myself?

Fungal toenails are particularly hard to treat and even if you can eradicate all of the active fungus, the nails can still appear thickened, deformed or discoloured.

You can try some over the counter treatments if you think you have a fungal nail, but ideally you should get the checked by a Podiatrist or another medical professional to confirm the likely diagnosis and they may offer testing of the nail too.

Self treatment usually involves a liquid or paint which is applied to the nails. Treatments can vary in strength and effectiveness and also the way they work can vary too. They can work if it is a superficial infection but you may have to file the nail surface and apply medicated nail varnish or cream regularly and consistently. This treatment requires dedication for a minimum of nine months we usually find, and treatment is often unsuccessful, particularly for more stubborn infections.

There are many myths about fungal infections. One common one is that tea tree oil, or Vick vaporub will kill fungal nail infections which has not been confirmed with any research we have seen. We will be launching a video and blog post soon about some of the common misconceptions and with more information about self treatment of fungal nail infections.

When to see a Podiatrist?

Podiatrists can offer advice on possible diagnosis and treatment.

They may recommend getting the nail tested to confirm that it is fungal. There are in clinic testing kits available, but testing may also require further cultures to identify the microbes and then a suitable course of action can be taken. This is definitely important if you are considering taking tablets to try and treat the fungal nails but is not as important if you are just looking for advice or more conservative or cosmetic treatments.

If the nails are very thickened, you may require your podiatrist to thin the nails for you using gentle scalpel debridement, a nail file or electric burr.

There are also gentle micro-drilling treatments such as Clearanail which can be effective. These make tiny holes in the nail plate to allow a topical medicament to be administered by you on a daily basis. Laser therapy options are also growing in Popularity. See if any of your local Podiatrists are offering this in the directory. All treatments can vary in effectiveness and even if the fungus can be irradiated, the nails may still appear thickened, discoloured or damaged unfortunately.

If the nail is very thickened and painful, then you may wish to consider a surgical nail removal. This is a minor operation and then you need to apply a daily treatment as the new nail grows back, alternatively you could opt to have the nail bed treated with a chemical to stop the nail growing back at all. A podiatrist will be able to carry out these procedures for you under local anaesthetic and will be able to discuss the risks and benefits of each.

Many patient’s are very happy with the appearance of fungal toe nails after a Podiatrists treatment even when the fungus has not been eradicated, because the nails are usually made thinner and neater which is more cosmetically pleasing and can stop them catching on socks or footwear.

Often, fungal nail infections are symptom free. They will only leave the nail slightly discoloured, thickened or brittle. Nail fungus is extremely difficult to totally resolve but treatment should be tried to prevent the infection from becoming a significant problem later on.

It is also worth addressing any fungal infections of the skin at the same time, such as athletes foot.

Fungal and discoloured toenails
Fungal and discoloured toenails