Fungal infections can cause a toenail to fall off, though this occurs in advanced cases. The presence of fungus can significantly compromise the nail’s integrity over time. Understanding how these infections develop and impact the nail structure, along with available treatments and preventative measures, can help manage and avoid such severe outcomes. This article explores toenail fungus damage, how to identify an infection, and steps for treatment and prevention.
How Toenail Fungus Affects Nail Structure
Toenail fungus begins by invading the nail bed and plate. The most common culprits are dermatophytes, a type of mold that feeds on keratin, the primary protein making up our nails. As these fungi consume keratin, they gradually weaken the nail’s structural composition. This degradation changes the nail’s appearance and strength.
The fungal invasion causes the nail to thicken, become brittle, and sometimes crumble at the edges. Over time, the growing fungal mass can lift the nail plate from its underlying nail bed, a condition called onycholysis. While onycholysis is a frequent symptom, complete detachment of the toenail is an advanced stage that signifies extensive damage.
Identifying a Fungal Infection
Recognizing a toenail fungal infection involves observing changes in the nail. Discoloration is a common sign, where the nail may turn white, yellow, brown, or green. The affected nail becomes thicker than healthy nails, making it difficult to trim.
The nail’s texture can also change, becoming brittle, ragged, or crumbly, with pieces potentially breaking off. The nail’s shape may distort, or it might begin to separate from the nail bed. While discomfort is not always present in early stages, pain or inflammation around or under the nail can develop as the infection progresses.
Treatment Options for Fungal Nails
Addressing toenail fungal infections requires professional medical intervention, as over-the-counter remedies are effective only for mild cases. Medical treatments range from topical applications to oral medications, laser therapy, and, in severe situations, surgical removal. Consulting a healthcare provider is important for an accurate diagnosis and a tailored treatment plan.
Topical antifungal medications, such as medicated nail polishes or creams, are applied directly to the affected nail and are suitable for early or superficial infections. These treatments require consistent application for several months to show improvement. For more pervasive or stubborn infections, oral antifungal medications like terbinafine, itraconazole, or fluconazole may be prescribed. These pills are taken for several months and are more effective at reaching the fungus within the nail structure, though they can have side effects and may require liver function monitoring.
Laser therapy is another option that uses focused light beams to target and eliminate the fungus within the nail bed. This non-invasive procedure aims to disrupt fungal growth with minimal side effects, but multiple sessions are necessary, and results can vary. Surgical removal of part or all of the nail may be considered for severe, painful, or recurrent infections that do not respond to other treatments. This procedure is performed under local anesthetic and can be combined with other antifungal treatments to promote healthy nail regrowth.
Steps to Prevent Fungal Nail Infections
Preventing toenail fungal infections involves consistent hygiene practices and careful attention to foot care. Keeping feet clean and thoroughly dry, especially between the toes, helps create an environment less conducive to fungal growth. Moisture provides an ideal breeding ground for fungi, so drying feet completely after bathing or swimming is important.
Choosing appropriate footwear is another effective preventative measure. Wear breathable shoes made of materials like leather or mesh, and regularly change socks, particularly if they become damp, to help keep feet dry. Avoid walking barefoot in communal damp areas, such as public showers, locker rooms, and swimming pools, to prevent exposure to fungi. Regularly trim toenails straight across and keep them short, which reduces areas where fungi can accumulate. Disinfect nail clippers after each use and avoid sharing nail grooming tools to prevent the spread of fungal spores.