The Ugly Thick Toenail
Part two – Preventative Measures
Little critters called dermatophytes are responsible for causing the nasty fungal toenail infections. These dermatophyes are located in our surroundings everywhere.
The most common sites are areas used by the general public such as health clubs, locker rooms, swimming pool areas and any other places where there is shared traffic.
Fungal infections in the general population. Millions of people have these infections. So the unaffected person is more likely to come in contact with the infection when using shared facilities.
Protect your feet to avoid contact with any area which could be a potential for infection. Wear protective footwear or sandals all the time. It ls difficult to know the maintenance procedures at any facility. It is difficult to know what sanitary measures are taken
It is always a good practice to inspect your feet daily and this is even more important for those individuals with diabetes or circulation problems. Most nail conditions begin with an infection of the skin called tinea pedis for more generally called athletes’ foot
Often a skin infection precedes the nail infection and most nail infections are much slower. The initial signs are discoloration and later progressing to irregular deformed and sometimes ingrown nails. These thick fungal nails are often painful as well. This can be a problem for Diabetics who have lost feeling in their feet.
Check the way instruments are handled if you have your nails done by a pedicurist. It is Ok to ask your professional how the instruments are handled. Ask your podiatric physician if they sterilize instruments in the autoclave.
Begin treatment early when there is any evidence of skin infection. Don’t wait until the infection has spread to the nails. At the earliest sign of athletes foot start an over-the-counter antifungal agent. If the infection does not respond seek early medical treatment. There are many agents now available by prescription.
Preventing the skin infection is a good defense against it spreading to the nails which are more difficult to treat. Nail injuries should be addressed to avoid future problems.
Cleanse your feet daily use soap and water be careful to wash and dry between toes
Change socks daily or even twice a day. It is advisable to put fresh socks on after a workout. There are studies now showing the little sneaky dermatophytes can hide in socks. They can also survive in the washing machine depending on on temperatures used to wash the socks. Higher Temperatures will kill the infecting critters. Maybe this is why everyone says to wear white socks. The whites are usually washed in higher temperatures.
Rotate your shoes daily . Shoes create a moist environments where fungus will grow. It is advisable to change shoes at least once a day especially if you are a high risk diabetic. In this case, a planned shoe change can also be a time to inspect the feet.
Ultraviolet shoe devices have been shown to eliminate the fungal elements that live in shoes. This shoe tree device can be plugged in an placed in whichever shoes last worn. Eventually, there will be a rotation through all shoes worn. It is not practical for patients to purchase an entire new shoe wardrobe
There are Home remedies for care of a skin and nails which are too numerous to mention. The use of tea tree cleansing
products are one such home remedy.
Be aware of for other individuals within the same household that have athletes feet or mycotic nails can be the source of infection for you. Consideration should be given to treat all persons in same household to reduce the chance of reinfection.
Get an evaluation early at the first sign of an infection. Ask your podiatric specialist about new agents recently approved by the FDA are now available by prescription.
Efinaconazole 10% (JUBLIA) is a 10% topical solution now being used for fungual nails.
Part III will list the most common questions patients ask their podiatrist.
