Fungal Toenails (Brisbane)

What does this mean?

Fungal Toenail.

A fungus is a micro-organism a bit like a bacteria although from a completely different family. Fungal infection on mucous membranes is called thrush, on the skin it is tinea or athletes foot and can also infect fingernails and toenails.  The nail becomes discoloured and loses its solid nature leading to it crumbling and looking ?  All nails are in fact already dead. Indeed the only living part of a nail is below the skin at the base of the nail.  This is important because it means that nails do not have any ability to fight off an infection.  The only protection from being infected by fungal spores, which are everywhere ?all the time, is the shiny surface of the nail.  When this is intact, the fungal spores can't settle in and grow but just fall off.  Think of it like a concrete footpath?no cracks means no weeds.  If the path is cracked no matter how clean you keep the environment, weeds will grow.

Fungal nails are not a reflection on your personal hygiene. Fungal nails don't need to be painful ?because the nail is not alive, it has no feeling.  If the nail is painful, it is almost certain to be a growth under the nail edge called onychophosis.  This can be easily and painlessly removed by a podiatrist.

Fungal spores get in when the nail surface is damaged.  Perhaps the nail was scuffed by a tight fitting shoe, scored while you were using a nail tool or damaged by some other kind of trauma.  Leaving toenail polish on for an extended period is also an excellent way to develop the infection as it can ?the fungus into place and traps moisture within the nail, creating perfect breeding conditions.  Be particularly wary about communal bottles of nail polish in pedicure salons. Only an autoclave will kill off fungal spores and these cost up to $10 000. Consider whether the local pedicure salon has invested in one of these.  Also, wonder whether the customer before you might have wanted their toenails painted to hide an ugly fungus ?will their tools be used on you? Ask questions about how the salon disinfects their tools and foot basins etc between customers before you try them out. As podiatrists, we see hundreds of people each year damaged by nail salons and each one will take up to a year of regular podiatric treatment to restore nail health.

Quite often, doctors will send you for a nail scraping and culture.  Very, frequently, this test will come back with a false negative ?meaning the test does not find fungus when it is clinically apparent that it is there. This occurs partly because the scraping is normally taken from the piece of nail that looks the worst. At this place, the spores have settled in and grown fungus which has aten?all of the nutrients within reach, resulting in the disorderly nail you see.  Because fungi can roam to search out more food, they then die.  The appropriate place from which to take  scraping from is where the bad nail meets the good.  This is painful when done by a novice and again, is best gently performed by your  podiatrist.

If you have got a fungal toenail, you have literally millions of fungi reproducing and spreading the infection throughout the nail.  It won't spread to your other toenails unless they too are damaged or you use the same nail tools on a good toe after using it on the infected nail. The podiatrist Brisbane will remove the affected nail to decrease this pool of infective spores.  This is not painful as the affected nail is no longer attached to the nail bed. The skin under the old nail will be thickened and coated with debris that the infection has produced.  This layer needs to be eliminated regularly during treatment as the regrowing, healthy nail can stick to it and an unattached nail will be sure to become reinfected. This is why fungal infections, when not treated properly, will continue indefinitely. It is also why there is always a fair chance of curing an infected nail with proper attention, even if it has been present for years.  The podiatrist will prescribe a fungal nail treatment paint for the nail that impairs the reproduction of the spores.

An oral medication is available through your doctor that is very effective in curing fungal nails, although it can be harsh on the liver.  In the tablet form it is very effective, although some physical care of the nail by a podiatrist during treatment will improve the chances of success. Again, this is because the plaque of debris that gathers under an unattached nail will stop the new nail from sticking to the nail bed. When thinking about taking Lamisil, extra consideration is required if you have known liver problems, drink (or have drunk) large quantities of alcohol or take any other drugs that rely on the liver to metabolise them. We recommend that you ask these questions of your Doctor prior to starting treatment so that you can consider the options and the potential consequences fully.