Nail Fungus

Not a good look on the nails.


Augh! Toenail fungus. For many, the presence of thickened, discolored nails poses no serious health consequence. But it sure puts a damper on sandal season. If celebrity influencers were able to spin that discoloration into something of an organic, neutral, textured look, we might even ignore those little fungal squatters on our nail beds. That is, until they rip out the walls and flooring.


For diabetics and those who have a compromised immune system, the presence of onychomycosis is not simply unsightly. Toenail fungus may serve as a gateway for opportunistic infections invasion. Fungal infections of our toes and feet puts us at more than two times higher risk for cellulitis of the leg. Often, eradication of the fungal infection is more challenging than fighting the bacterial skin infection. Fungi are incredibly hardy. Effective management of toenail fungus usually requires months of treatment. Even after successful initial treatment, relapse and reinfections are not uncommon (with reported recurrence rate ranging 6.5%-53%). 


There are common sense efforts to minimize recurrence but they require vigilance and perseverance. For example, any sign of foot fungus should be promptly treated, as fungal infections of the skin can serve as a reservoir for infection of the nail (and vice versa). All fungi-bearing feet within a household are fair game for prompt treatment. Did you get foot fungus or toenail fungus while sporting those Jimmy Choos around town? Sorry, you should probably chuck them, or at the very least, disinfect them (terbinafine, UV light) and replace the soles. Go a little nuts when laundering because dermatophytes have been shown to survive in socks even after they have been washed, especially when using cold water. For diabetics and immunocompromised patients, it’s not unreasonable to be a little neurotic at the first sign of toenail fungus. The earlier we alert our doctor to discuss a treatment strategy, the better the chance of getting rid of the stubborn fungi. 


Controlling toenail fungus recurrence is no small feat. No matter how much #fungimanipedi is trending, the organic, textured nail bed courtesy of dermatophytes should never be a thing.