What are Fungal Nails?
Types of Fungal Nails
- Dermatophyte onychomycosis – the most common and is caused by Trichophyton species, often spreading from fungal skin
- Non-dermatophyte mould onychomycosis – caused by mould species and often due to nail trauma and hygiene issues
- Candida onychomycosis – caused by Candida species and typically starts from paronychia (inflamed sides of the nail)
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Causes of Fungal Nails
Fungal nail infections are opportunistic, so you have to give the fungi the right conditions to start an infection. There are multiple causes and risk factors of fungal nail infections, which are often difficult to determine.
Causes and risk factors of fungal nails include:
- Nail trauma: Stubbing your toes or dropping a heavy object on your toe could damage the nail and open a portal for fungus to enter.
- Inappropriate pedicure or nail-trimming techniques: Cutting your nails too short or repeatedly pushing the cuticles can create a portal of entry for the fungus.
- Prolonged use of nail polish: Overusing nail polish creates a dark and moist environment for fungus to thrive under the nail.
- Hot and humid conditions: The weather in Singapore is, unfortunately, a pleasant environment for nail fungus to strike.
- Poor foot hygiene: You are more likely to get infected if you do not wash your feet often.
- Compromised immune system: Medical conditions and treatments like diabetes or chemotherapy can make you more prone to fungal infections.
Signs and Symptoms of Fungal Nails
Fungal nails can present in various appearances. Signs and symptoms of fungal nails include:
- Discoloured nails (e.g. white, yellow, brown, or black)
- Brittle nails with powdery debris under them nails
- Separation or lifting of the nail from the nail bed
- Subungual hyperkeratosis (hard, thickened skin under the nail)
- Change in nail shape, often resulting in an ingrown toenail
- Foul odour
The appearance of fungal nails determines their severity:
- Distal subungual onychomycosis – mild-to-moderate severity; only the ends of the toenail are affected
- Total dystrophic onychomycosis – severe infection of the entire affected nail
- White superficial onychomycosis – white discolouration on the surface of the affected nail
Fungal Nail Treatment Options in Singapore
Nail fungal infections are stubborn and difficult to eradicate. Various home remedies often produce little to no improvements, leading to further spread and becoming severe. Therefore, managing them early to prevent further spread is essential.
Options for nail fungal treatment in Singapore include:
- Topical anti-fungal application: Such medications can help with very mild cases or as an adjunct to other therapies.
- PACT therapy: A light therapy, commonly known as “laser” therapy, to effectively treat mild-to-moderate cases.
- Oral anti-fungal medications: We usually recommend oral medicines for severe widespread cases, but they can cause a risk to liver functions.
- Nail avulsion and debridement: Severe cases may require total nail removal and nailbed clearance.
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Frequently Asked Questions
Why are fungal nail infections more common in Singapore?
Unfortunately, Singapore’s hot and humid climate is ideal for fungi to thrive. Hence it increases our risk of developing fungal nail infections. Also, if you have to wear enclosed shoes often or like to visit public pools and showers, which can increase the risk of fungal nail infections.
Can I get a fungal nail infection from pedicures or nail salons?
Yes, it is possible to contract a fungal nail infection from pedicures or nail salons, especially if they do not sterilize their tools and equipment. You can minimize the risks by visiting reputable practices and bringing your own equipment. You should also avoid aggressive pedicure services, such as pushing the cuticles, as such services can create a portal of entry for fungi.
How long does it take to recover from a fungal nail infection?
The total duration to manage a fungal nail depends on the extent of infection and the type of nail fungal treatment you require. For cases requiring PACT treatment, it can take between 3 to 6 weeks for a complete course. Otherwise, if you are taking topical or oral medications, it can take up to several months to complete. The fastest method is nail removal, but only severe cases require it. We recommend that you complete the entire course of nail fungal treatment given by your medical professional, whichever way you took, to ensure the best possible outcome.
Are there any home remedies for treating fungal nail infections?
You may have seen various home remedies recommendations on the web, such as tea tree oil or apple cider vinegar soaks. However, their effectiveness has yet to be proven, and many people see no improvement after trying them. Therefore, we still recommend seeking a podiatrist or healthcare professional for a proper diagnosis and management plan.
Can fungal nail infections recur after successful treatment?
Yes, fungal nail infections can certainly recur if you give them the opportunity to start an infection again. Therefore, prevention is essential to minimize the risk of reinfection. You should maintain proper foot hygiene, keep your feet clean and dry, change your socks daily if you wear shoes, and avoid walking barefoot in public areas. If you experience recurring fungal toenail infections, consult a podiatrist or a medical professional for advice and further evaluation.
How to Prevent Fungal Nail Infection in Singapore?
Fungal nails are easier to prevent than to treat. Therefore, you should remember the following tips:
- Ensure good foot hygiene by washing your feet with soap and water daily.
- Avoid unnecessary pedicures and nail polish if you do not need it.
- Avoid picking your nails or causing trauma to your nails.
- Clean and dry your enclosed shoes regularly.
- Change your socks daily or twice a day if you have sweaty feet.
- Apply foot powder if you have sweaty feet to help remove excessive moisture.
