There is a trend I have noticed in the community pharmacy for the past few months. This is the frequency of prescriptions being written for fungal toenail infections. This got me wondering and thinking how common fungal toenail infections actually are. According to a study in a Journal of European Academy of Dermatology and Venerology, about 6.4% of the Canadian population are affected my this disease and the senior population are more affected. Some underlying medical conditions can also predispose people to getting fungal toenail infections such as: peripheral vascular insufficiency, excessive sweating, diabetes, HIV or patients on immunosuppressive therapies.
How do toenails get infected?
Fungal infections are common in parts of the body that are warm, moist and dark from prolonged coverings such as folds and creases. If you walk bare-footed in a gym or a public swimming pool, you might pick up some fungi on your toes. Now if you don't allow your feet to dry completely and go ahead to wear your socks and covered shoes, the fungi will migrate into your nail bed and begin to grow and settle in there because it is warm and moist. In the winter, you might not notice since you wear boots all the time. However during the summer season most people want to wear sandals and would like to show off beautiful toenails so they come running to the clinic to find a cure.
Treatment options
Onychomychosis (fungal toenail infection) is characterized by discolored, thick and brittle appearance. Although treatment is not always required, it may be a cosmetic concern. In more severe cases, toenails may become distorted, cracked or loosened away from the nail bed. In terms of treatment, it generally takes a long time (up to 1 year) for it to be totally cleared out. Technically it requires the old infected nail to grow out, without re-infecting the new growth. It is also important to treat any accompanying athlete's foot (fungal infection between the toes) to prevent re-infection and re-occurence.
The goal of treatment is to eradicate the fungi, improve appearance, prevent spread and recurrences and prevent secondary bacterial infection. Depending on the severity of the infection, the doctor may decide to just ask you to watch and monitor for worsening signs and symptoms or the doctor may prescribe a topical medicine to put on the nails daily or lastly the doctor may prescribe oral prescription medications.
Over-the-counter anti-fungal creams such as clotrimazole, miconazole, cannot penetrate the cuticles and thus cannot eradicate fungi in the nails, however these creams can help clear the fungi in the surrounding areas of the toe and prevent re-ocurrence or re-invasion of the nails.
Prevention tips:
-Keep your feet cool and dry
-Trim your nails often and do not share nail clippers
-Wear flip flops when in a gym or public swimming pool
-Wear 100% cotton socks and change them every day
-Wear shoes that are not too tight to allow the feet to breathe
-Manage underlying chronic health conditions such as diabetes mellitus or peripheral vascular disease.
Therefore, to prepare for next summer, start following the above prevention tips and keep at it all through the winter to get your summer-ready toenails come next year. Summer body loading... hoping next year will be a better one to enjoy the season without public health pandemic restrictions.
Disclaimer: all health information provided on this platform represent my opinion only and are for educational purposes only. Reading my blog is not intended to be a substitute for a visit to your local pharmacist, physician, dietitian, and other healthcare providers. Be sure to seek proper care from your nutritionist, family doctors or specialists when needed.
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