Okay, first things first—Sun Tzu probably didn’t have fungal toenails in mind when he wrote “The Art of War.” He may have had them, we suppose, although that particular detail is lost to history.
And second, we know the idea of thinking about your toenail fungus any more than you already do doesn’t seem all that appealing. Most people who have the condition try to conceal its presence—from others, and also from themselves.
But the basic advice of “know thine enemy” actually applies quite well here! If you don’t understand anything about toenail fungus, how are you going to prevent or treat it successfully? Simply put, you aren’t.
So, let’s get further acquainted with these pesky fungi.
Who Are They?
The fungi that cause fungal toenails are from a category of organisms known as dermatophytes. If you’ve ever had athlete’s foot, ringworm, jock itch, or any other fungal skin infection, these are also caused by the same types of fungi.
The overarching medical term for dermatophyte infections is tinea. For example, athlete’s foot is also known scientifically as tinea pedis, and fungal toenails are also called tinea unguium (although the term onychomycosis is more commonly used as well).
What Do They Want?
The short answer is that they want keratin.
Keratin is a fibrous structural protein that makes up a good percentage of the defensive outer layers of human and animal bodies. It’s extremely abundant in nails, the outer layers of skin, and hair—not to mention hoofs, claws, and horns if you happen to be a member of a species that has them.
Dermatophytes essentially “colonize” these outer layers of hardened, dead tissue and break down the keratin to obtain the nutrients they need to survive.
When Do They Want It?
Now, of course!
How Do They Get In?
Some of this will be review for those of you who read last month’s blog, Fungal Toenails: What Not To Do. If you haven’t checked it out yet, make sure you give it a read after you’ve finished this month’s installment.
Basically, the fungi need two things: access to your feet and a way under the nail.
For the former, it’s important to know that fungi especially thrive in environments that are warm, moist, and ideally dark—and that they can spread through both direct and indirect contact. That means the fungi can get to your feet through:
- Walking barefoot in a public location (pool decks, locker rooms, etc.)
- Wearing sweaty, damp shoes and socks
- Sharing infected towels or linens with someone else
- Sharing foot care tools that haven’t been properly sanitized
- Transferring from one part of your body (e.g., ringworm) to the nail area through contact
- Going to an unsanitary spa or salon
As for the latter, they really don’t need much of a gap to get underneath. There may be microscopic cuts or separations between the nail and nail bed you can’t even see or feel, and that’s all they need. However, you might make the opening much more inviting by cutting your nails too short or stubbing your toe.
What Makes Fungal Toenails Different From Other Tinea Infections?
Unfortunately, fungal toenails are much more frustrating to treat than most other infections caused by dermatophytes. Why? It’s all about the nail.
First, the nail offers a basically limitless supply of keratin. While some fungal skin infections can be somewhat self-limiting—that is, they may go away on their own if you simply keep up with regular hygiene—fungal toenails do not go away without treatment.
Second, the nail itself offers substantial protection for the fungi. Because fungal skin infections like athlete’s foot and ringworm are so exposed, they can usually be cleared up after a couple of weeks of over-the-counter topical treatments. Not so for fungal toenails, which almost always require intervention from a physician, and may require oral medications or other treatments.
Third, since nails are not living tissue and grow slowly, any damage to the nail caused by the fungus will remain until it grows out naturally or is cosmetically remodeled. Whereas your skin completely replaces itself roughly once per month, it may take six months to a year (or more) for your damaged toenail to fully grow out naturally, even if the fungi are long gone.
How Can I Prevent Fungal Toenails?
Re-read the “How Do They Get In” section, or last month’s blog, and you’ll be most of the way there. Simply knowing what not to do is a large percentage of the battle.
If you want to be more proactive, you can also incorporate these strategies into your routine:
- Rotate pairs of shoes each day so they can dry out
- Treat your shoes with antifungal sprays or powders each day to prevent unwelcome fungal colonization
- Treat skin infections immediately, before they have a chance to spread
What Should I Do If I Get Fungal Toenails Anyway?
You may have lost the battle, my friend. But with our help, you will not lose the war.
Fungal toenails may be far more stubborn than a typical dermatophyte / tinea infection, but with discipline and help from a good podiatrist, you absolutely can have clear, healthy toenails again.
And the timing is perfect! Right now, temperatures are starting to cool off and sandal season is past its peak. If you start treatment now, you’ll have a great chance of having clear, healthy-looking nails by the time the mercury starts spiking again by the start of next summer!
Don’t wait any longer to get the treatment you deserve for your fungal nails. Now that you understand them, we hope you realize how important it is to get rid of them—and how to keep them away for good.
To schedule an appointment with the Capital Podiatry Associates, please contact our office today at (703) 560-3773. You can also fill out our online contact form to have a staff member reach out to you.