Understanding It
What It Is
A fungal nail infection occurs when fungi invade the nail plate and the nail bed beneath it. The same organisms often responsible for tinea between the toes can spread to the nail.
Once established, the infection is difficult to clear because the nail plate has no blood supply, so treatments have to reach the fungus through the nail itself or grow out with it. Toenails grow slowly (a full toenail takes roughly nine to eighteen months to replace), so any treatment takes considerable time.
Importantly, only around half of thickened, discoloured nails turn out to be fungal. Trauma, psoriasis, nail bed damage and other conditions can look almost identical.
How does it usually present?
- Yellow, white or brown discolouration of the nail
- Thickening of the nail plate
- Crumbling or brittle nail edges
- Nail lifting away from the nail bed
- Debris building up under the nail
- Distorted nail shape
- Sometimes an odour
- Often starting at one edge or the tip and spreading back
It is usually painless, though thickened nails can become painful in shoes.
When to Act
When to Seek Help
See a podiatrist if nails are changing appearance, becoming thick or uncomfortable, or you are unsure what is causing it. Confirming the diagnosis matters, as treatment for fungal infection is prolonged and pointless if the cause is something else.
Seek prompt podiatry or medical care if you have:
- Diabetes, peripheral neuropathy or poor circulation along with any nail change — thickened nails can cause pressure damage and infection risk in these circumstances
- Redness, swelling, pain or discharge around the nail — possible bacterial infection
- A single nail changing rapidly, or a dark streak or pigmented band in the nail — this needs medical assessment, as rare but serious causes need to be excluded
Causes & Risk
What Causes It and Who Is at Risk
Fungi thrive in warm, moist, enclosed environments. Risk is higher with occlusive footwear worn for long periods, communal wet areas such as pools and change rooms, previous tinea, nail trauma, and shared nail clippers or salon instruments that are not properly sterilised.
Risk is considerably higher, and the condition more significant, in people with diabetes, poor circulation, or a suppressed immune system.
How We Help
How Our Team Can Help
Our podiatrists assess the nail, examine the surrounding skin for tinea, and consider whether the appearance is consistent with fungal infection or another cause. Where diagnosis is uncertain, a nail sample can be sent for laboratory testing before committing to lengthy treatment.
For extensive infection, oral antifungal medication prescribed by your GP is sometimes considered. That requires medical assessment including liver function, and we can refer you back to your GP to discuss it.
Ongoing nail care is often the most practical approach, particularly for older clients and those for whom systemic medication is unsuitable.
Starting Out
What to Expect at Your First Appointment
Your podiatrist will examine the nails and skin, ask about duration, footwear and previous treatments, and check circulation and sensation. They may reduce the nail thickness on the day, which many people find immediately more comfortable.
You will get a clear explanation of what is likely going on, realistic expectations about timeframes, and a management plan.
Ready to book?
Ready to get started?
Contact inOne Healthcare on 1300 765 456 or submit a referral online. Nail conditions are managed by our Podiatry team.
info@inonehealthcare.com.au
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