Onychomycosis or tinea unguium is a fungal infection that affects nails, especially toenails. It is one of India’s most common nail infections affecting the male population more than females. According to a 2021 study by researcher Shivani Tyagi published in the International Journal of Research in Medical Sciences, the incidence of this infection varies from 0.5 – 12 per cent in India and around 5 per cent globally.
“In 2022, whenever I walked for long distances, my toes ached. When I inspected them, they appeared curved to me,” says 58-year-old Kabeer Munshi, Bengaluru. He did not give it much thought, and applied petroleum jelly and soaked his toes in water. “After one or two months I noticed that my other toenails also started deforming and breaking, there was redness around the nails,” he recalls. He was eventually diagnosed with onychomycosis and prescribed medication.
“It took me a few months to heal completely, and it happened due to my diabetes and habit of walking barefoot in the garden,” says Munshi.
Causes and risk factors
“Onychomycosis is primarily caused by dermatophyte fungi, such as Trichophyton rubrum and Trichophyton mentagrophytes,” says Pakistan-based, Dr Ahmad Chaudhry, a board-certified dermatologist at Scandinavian Biolabs. However, it can also be caused by non-dermatophyte moulds and yeasts, such as Candida species. “The infection occurs when these fungi find their way into the nail bed, often through tiny cuts or separations between the nail and nail bed,” says Dr Chaudhry.
Dr Aruna Raghunathan, dermatologist and founder of Elixir: The derma clinic, Delhi, says, “It is frequently observed in the elderly, those with diabetes or immunocompromised people.” It can also occur in healthy individuals who wear tight footwear, maintain unhygienic nail practices, or receive frequent pedicures. The 2021 study also reveals that individuals who have suffered nail trauma, engage in chronic smoking, participate in intense sports, take communal baths, are exposed to occupational hazards, or work in wet environments, are at a higher risk of developing it.
Onychomycosis is usually chronic as it develops gradually over weeks and months. “Due to its slow development, it is generally hard to detect it early on,” says Dr Raghunathan.
Symptoms
Experts provide symptoms to look out for:
- Discoloration of the nail (white, yellow, or brown)
- Thickening and brittleness of the nail
- Nail deformity or distortion
- Separation of the nail from the nail bed
- Accumulation of debris under the nail
- Foul odour
Prevention
It is a tough fungus to beat, say experts, but with some nail-biting determination, one can kick onychomycosis to the curb. Experts provide precautionary measures to prevent the infection:
- Keep your nails clean and dry.
- Avoid walking barefoot in public areas, especially in damp environments such as swimming pools and locker rooms.
- Wear moisture-wicking socks and breathable shoes.
- Change your socks and shoes regularly, especially if you have sweaty feet.
- Trim your nails straight across, avoiding ingrown nails, and file down any sharp edges.
- Avoid sharing nail clippers, files, or other personal items with others.
- Disinfect your nail tools regularly.
- If you have a fungal skin infection like athlete’s foot, treat it promptly to prevent its spread to the nails.
- Opt for hygienic places and do not play with the cuticle or nail too much, while getting a pedicure done.
Read more: Paronychia: a pain in the nail
Beyond manicures: the role of cuticle care
Treatment
“Nail lacquer is used to treat onychomycosis as it contains antifungal agents that can help treat the infection,” says Dr Raghunathan. It is applied directly onto the affected nail, forming a protective layer and releasing the antifungal medication over time. This allows the medication to penetrate the nail and reach the site of the infection. Thus, forming a protective layer and slowly releasing forming a protective layer and slowly releasing it works to eliminate the fungus. “Usually, the treatment goes on from 2 – 6 months and for toenail, up to 12 months,” she adds.
