Nail fungus – answers to the 10 most frequently asked questions

Nail fungus is one of the most common nail disorders, affecting people of all ages. Although often perceived as a purely beauty issue, nail fungus can also be painful and can have serious health implications, especially for those with weakened immune systems.

In this post, we answer the ten most common questions asked in connection with nail fungus:

Nail fungus (onychomycosis) is an infection of the nail plate – usually with dermatophytes, more rarely with yeast or mould fungi. In most cases, the fungus penetrates the nail plate from distal to proximal – i.e. from the outside inwards. If there are already cavities under the toenail, the fungal pathogens have an especially easy time of it.

2. How can you discover nail fungus?

In most cases, discolouration of the toenails – more white or yellowish depending on the pathogen – can be seen under or on the nail plate. Without treatment, the nail is increasingly destroyed, and detachment from the nail bed is also possible. In the final stage, everyone is familiar with the crumbly, yellow-brownish or black discoloured nail plates, which resemble a woody surface. This often disrupts nail growth – toenails tend to grow thicker rather than longer, or not at all.

3. Is a medical examination necessary?

Since a bacterial infection can show similar visual symptoms, a medical examination should definitely be carried out. Skin diseases that have no infectious cause, such as psoriasis, can also cause nail discolouration. With the help of a fungal culture, the pathogen can be precisely determined by the doctor. Important! Patients must not have applied any anti-fungal medication for several weeks before the test. It is also crucial that the nail sample is taken from the right place.

The most important risk groups for which nail fungus is particularly common include athletes, diabetics, older people and patients with angiopathies (= diseases of the blood vessels). Wearing unsuitable shoes (wrong fit, safety shoes) over a long period of time can also permanently damage the nail and increase the risk of nail fungus. Likewise, recurring fungal skin infections can contribute to the formation of nail fungus.

5. How can nail fungus be treated effectively?

The most effective treatment can always be determined by the visual findings and the pathogen detection. Regardless of which treatment the podiatrist decides on, the top priority is to remove all the affected nail material. This should be done at short treatment intervals so that the antimycotic preparations used can work better. Treatment can only have the desired effect if the patient also actively participates, i.e. consistently applies the prescribed remedies. A particularly existing skin fungus should not be neglected. Often, this is not treated and, under unfavourable conditions, the yet healthy nail can become infected again with the same pathogens. Hygiene of shoes and socks also plays an important role. Breathable socks and shoes or wearing toe socks are recommended. An absolute no-go: wearing shoes without socks.

Systemic means then, ‘affecting the entire organism.’ Systemic treatment refers to the use of medications thanks to which the active ingredient spreads throughout the body. This is always considered if more than 50 per cent of a toenail or more than three toenails are affected. In addition, there are patients for whom local therapy is not possible due to a lack of mobility. Systemic treatment is clearly a medical matter. A combination of systemic and local treatment is also possible.

7. How long does nail fungus treatment usually take?

Nail fungus treatment requires a lot of patience. As a rule, it takes as long as the toenail needs to renew itself completely. You can expect it to take about a year.

8. What methods can be used to avoid infection in practice (cross-contamination)?

To avoid the risk of infection in the podiatry practice, all surfaces that have been contaminated must undergo accurate wipe disinfection. The instruments are disinfected and sterilised, and disposable materials are disposed of immediately. It is practical to wear disposable aprons during treatment to be able to dispose of the accumulated nail material as safely as possible. The practitioner should protect themselves by wearing a mask and gloves. During mechanical filing, a suction device with the highest suction power should be used. Healthy toenails are protected by covering them, while infected toenails are disinfected and treated last to minimise the risk of infection. It is extremely important to work without injury, because even the smallest injuries or cracks can create new entry points for the fungal pathogens!

The best prevention is to have well-circulated, nourished feet that do not tend to sweat. Shoes that allow the feet to ‘breathe’, air, light and sun whenever possible are the perfect conditions for keeping feet fungus-free. Insufficient or excessive foot hygiene has a negative effect on the skin and nails and creates suitable conditions for fungal infections. If there is an injury to the nail – the typical entry point for fungal pathogens – then it is worth disinfecting daily, avoiding any particular pressure and, if necessary, visiting a podiatry practice to establish the cause.

10. Which preparations are recommended for co-treatment by the patient?

Preparations with spirulina algae, used daily, have no side effects and are highly effective for localised therapy. Proven products include peclavus PODOmed Spirulina Lotion (skin fungus) and peclavus PODOmed AntiMYX-Protectorstift (nail fungus). Medical nail polishes such as Batrafen or Loceryl are also often found in application. However, the main thing is to process the nail so that the fungus no longer feels comfortable. With you, the cause research is an important pillar. If the conditions on and around the foot stay the same, then the best anti-fungal agent can't work.

You can read more about nail fungus here.

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