Onychomycosis
Onychomycosis refers to fungal infection of the nails. Fungal infection of the nails caused by a subgroup of fungi called dermatophytes is known as Tinea unguium.
Nail infection commonly develops in individuals who have tinea pedis (athletes foot).
Spread occurs through contact with infected individuals, carpets or floors.
Fungal nail infection may look identical to psoriasis of the nails.
for this reason, a nail clipping for microscopy, culture and histology is sent off to the laboratory in order to confirm the diagnosis and choose the appropriate treatment. Recently, a new, more sensitive diagnostic test has been introduced requiring smaller amounts of sample. This looks at the DNA of the infecting organism and is referred to as a PCR test.
Fungal infection of the nails is not just a cosmetic problem. The nails are important structures in providing counterbalance and fine movements of the hands and feet are dependent on normal nails.
New Treatment of Fungal Nail infection
The NdYAG laser (Nordlys NdYAG laser made in Denmark shown on left) is the newest method of treating fungal nail infection. A laser beam is passed a few times over the nails, effectively killing fungus present in the nail. To ensure that all fungus is killed, all 10 nails are treated in one treatment session.
Even though the fungus is killed immediately, it can take a few months for the diseased nail to grow out and the for the nail to become clear. The new nail that grows out grows without the fungus, thus producing the clear nail.
Watch this you tube video to see how laser works for nail fungus (except you don’t have to go to San Francisco for treatment – we offer it right here at Westville Hospital)
LASER TREATMENT FAQS
How does laser treatment work for fungal infection
The laser is applied over each nail (on one foot or both), to cover the entire surface of the nails.
The fungus is heated by the laser and killed.
How long does each treatment take?
About 10 minutes for each foot.
How many treatments are required?
Usually 2 to 3 treatments are required for a satisfactory response. These are separated by intervals of 3 to 6 months.
Are the treatments painful?
Not usually. Often just a sensation of warmth during treatment.
Any special instructions after treatment?
Shoes can be disinfected with Formaldehyde, or by leaving them in the sun for a few hours. Report any recurrence immediately.
Other treatments for fungal nail infection:
Terbinafine (Lamisil)
Itraconazole (Sporanox)
Griseofulvin (Microcidal)
Amorolfine (topical application) (Loceryl)
The dose of the 4 oral medications is calculated according to whether the fingernails or the toe nails are involved and the age of the individual,
12 Tips for prevention of nail fungus
Wear open footwear (sandals) as much as possible
Wear cotton socks – they absorb sweat better than polyester or nylon.
If you have athletes foot (scaling, redness. white discolouration between the digits,) see your dermatologist or GP for treatment.
Dry feet thoroughly after washing (warmth and moisture are the best friends of fungi)
If family members have athletes foot, refer them to a doctor to have it treated.
If you have athletes foot or nail fungus, wear slops in the shower. Fungal infection is contagious.
Sterilise nail clippers before clipping non-infected nails.
Do not share nail clippers
Do not share socks/ shoes/ sandals/ towels.
Keep slops on in gymnasia, swimming pools, public bathing facilities and places of worship if barefoot.
If toe nails are thick, use appropriate nail clippers like the type shown on the right.
Remember that hotel carpets and showers may harbour fungus. – Wear your slops!
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Suite 202, Westville Hospital, 7 Spine Road (now Harry Gwala Road), Westville, 3630, South Africa
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