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TOENAIL INFECTION
- Nails are made of keratin, the same protein as horses’ hooves
- It takes 12 –18 months for a toenail to grow from root to tip
- If you are right-handed, the nails on your right hand grow faster than on your left, but toenails grow at the same rate on each foot
- Nails grow faster in summer than winter
TOENAIL PROBLEMS have strange medical words.
Onychogryphosis is the thickened, hard toenails that old people often have
onychomycosis is fungal nail infection
Thickened, ugly nails are common – up to 10% of the population have infected toenails – but can be very upsetting. Over 500 people were questioned about their nail fungus condition in a US Hospital in Massachusettes. The people who were questioned were embarassed about it, they had loss of confidence and self-esteem, and even had depression and social isolation. Fortunately, there are now some fairly effective treatments available.
Causes of thickened toenails
Physical damage to your toenail may cause it to be thick until the damaged area grows out. This is why thickening of the big toenails is common in young men, particularly football players. Old people also often have thickened, hard toenails, probably because of the damage they have sustained over the years, and because their nails grow more slowly, it takes longer to repair the damage.
Fungal infection can make your nails thick. The commonest infection is with Trichophyton rubrum, the same fungus that causes athlete’s foot. Occasionally, other types of fungus, such as yeasts, are responsible, and people who have been abroad may have some quite exotic fungi.
Psoriasis, a skin condition, can make nails thick, with tiny pits on their surface.
How a fungal infection occurs
It is easy to pick up fungi – they are particularly common on the floors of communal showers and changing rooms – and many of us probably already have fungi on our skin. They cause problems only when conditions are ripe for them to thrive, which means warmth and moisture. When human beings started wearing enclosed shoes, which trap sweat and heat, we created ideal conditions for fungi.
The fungi shelter under the tip of the nail and start to get a hold.
This is particularly likely to happen if:
- the end of the nail has been damaged (for example, by ill-fitting shoes) and is already slightly separated from its toe
- you have a condition such as diabetes or an immune deficiency
- you are elderly
- the fungus is already multiplying between the toes (athlete’s foot).
The nail fungus very gradually spreads towards the base of the nail and down the sides, loosening the nail from the underlying toe and filling the separated area with crumbly, yellowish-white gunk. The nail itself becomes thicker and yellowish brown in colour. This can take months or years.
Sometimes the infection starts at the base of the nail, giving a whitish area near the half moon, or it may just affect the surface of the middle of the nail, where it will appear as a white patch.
What you can do
Be patient. For any treatment to be successful, one of the most important elements is patience. You will have to use the treatment for at least 3 months, and some treatments take even longer to work. Nails grow from the base to the tip, as anyone who has used nail varnish knows. Because it can take 18 months for a nail to be replaced completely by a new one, it may be a long time before you see a result.
Care for your feet sensibly by following these rules.
- Give your feet plenty of air, because warmth and sweat encourage the fungi; so follow the advice given for sweaty feet. When you are at home, go barefoot whenever possible, and if you don’t want to expose your toenails, search for some strappy sandals that cover the toes.
- Choose shoes that give your toes plenty of room.
- Dry your feet very thoroughly after washing, using a tissue to dab underneath the end of the nail to make it as dry as possible.
- It is tempting to use nail varnish to disguise the nail, but nails need to breathe so use it for short periods only, removing it as soon as possible.
Treat athlete’s foot promptly. If you ever develop athlete’s foot in the future, treat it so it does not spread to the nails.
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