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The medical term for toenail fungus is onychomycosis. Essentially, it is an infection under the surface of the toenail that is caused by a fungus. As the organisms multiply, the nail becomes darkened underneath and can cause a foul smell. Toenail fungus can affect a single toe or may spread to other toenails, the skin or even the fingernails. The infected nails become thick and difficult to trim, and can make it difficult to wear shoes. If it is not treated, it can impair the ability to walk.
Fungi are microscopic organisms that are typically found in the soil; they are especially prevalent in damp areas. People often go barefoot in areas where fungi are likely to be found, such as showers, swimming pools and locker rooms, which increases the risk of infection. An injury to the nail bed increases the risk of a fungal infection, and chronic diseases such as diabetes or circulatory problems may increase the risk. Excessive perspiration and a history of athletes foot also increase the risk of fungal nails.
If the infection is mild, home treatment with an over-the-counter medication may be sufficient. However, home treatment may not be successful in some cases, or the infection may reoccur, in which case, a podiatric consult is desirable. A podiatrist may recommend prescription oral anti-fungal medications or use a topical medication that is applied to the infected area. In some cases, the nail must be removed and the area of the nail bed debrided to remove infected tissues.
Certain strategies may decrease the risk of fungal nail infections. Keeping the feet clean and dry and inspecting them regularly are key (fungal nails often have no obvious symptoms until the nail becomes discolored). Proper hygiene by washing the feet with soap and water is helpful. Patients should wear shower shoes in public areas, and change shoes, socks or hosiery at least once a day. Shoes should fit properly and be made of materials that breathe. Home pedicure tools should be disinfected after use. Avoid polish on discolored nails.
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