What Is The Outlook For Someone With Toenail Fungus
While toenail fungus is common, its usually not harmful. Symptoms mostly affect the look of your toenail.
Toenail fungus may spread to the skin between your toes or other areas of your body. When getting dressed, put your socks on first to reduce the chance of spread.
Treating toenail fungus takes a long time, and it doesnt always work. Even then, toenail fungus often returns. Discuss the pros and cons of treating toenail fungus with your provider to determine whats best for you.
Practicing good hygiene and foot care reduces the chance toenail fungus will come back. If you have diabetes, getting regular foot exams may help you address foot problems before they get serious.
The Way It Spreads Throughout The Body:
With psoriasis, the good news is that it is not communicable. This can work in your favour if you are vigilant as the speed of spreading isnt that fast. However, fungi are communicable, and they can spread faster. In the previous point, we stated that the symptoms exclusively start with the nails, well they dont stop with them. As time goes by, victims of Nail fungus might notice that their skin between the toes starts to become infected as well.
What Treatments Are Available
Mild nail disease which isn’t causing discomfort does not need any treatment. If the nail disease is severe and causing problems then your doctor may refer you to see a skin specialist for advice and treatment. Unfortunately treatment of psoriatic nail disease is difficult and not always successful.
Treatments for nail psoriasis include:
- Treatments applied to the nail, which include steroids, salicylic acid, calcipotriol or tazarotene. Local treatments applied to the nail are often not very effective but are worth trying. If the nail is lifting off then strong steroid scalp application can be trickled under the nail.
- Antifungal treatment – this may be required for fungal nail infection if this is also present.
- A steroid injected into the nail – this may be effective for some types of nail psoriasis but it is painful.
- Light therapy – psoralen plus ultraviolet light A treatment is effective for some types of nail psoriasis but not for pitting of the nail.
- Removing an affected nail – this can be done by applying a special type of ointment and then covering the nail for seven days. Otherwise the nail can be surgically removed using local anaesthetic.
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Symptoms Of Toenail Psoriasis To Watch For
Symptoms of psoriatic nail disease vary according to the severity of the condition. These symptoms may include:
- Pitting of the nail, causing the appearance of tiny craters
- Small white spots on the nail known as leukonychia
- Splinter hemorrhages: these small bleeding spots under the nail are often visible as dark lines that run parallel to the direction of the nails growth and resemble wooden splinters under the nail
- The oil drop sign, a red, orange, or brown discoloration of the nail bed, named for its resemblance to a drop of oil under the nail
- The whitish, half-moon-shaped area of the nail known as the lunula may develop red spots
When toenail psoriasis becomes more severe, the nail may begin to separate from the nail bed, a condition known as onycholysis.
Subungual hyperkeratosis, a thickening of the nail bed, may also occur. If this happens, a chalky material will begin to accumulate under the nail, further contributing to onycholysis.
The nail may eventually separate entirely from the nail bed, or it may crumble away. This condition has a very similar appearance to fungal nails. Your doctor should biopsy your nail first before any treatment to confirm if your nail is infected with fungus or if it is psoriatic nail changes.
Types Of Toenail Fungal Infections
Toenail infections affect about 14 percent of the population at any given time, according to a study published in June 2014 in PloS Pathogens. The most common symptoms of a toenail fungal infection include discoloration of the nail, debris under the nail, irregularity of the white part of the nail, nail thickening, and pain, says Sheth.
Toenail fungal infections can usually be categorized into one of the following five subtypes:
Distal Subungual Onychomycosis This is the most common form of toenail fungal infection, usually occurring in the portion of the nail closer to the tip and on the underside of the nail. The nail may become thick, yellow, or brittle.
Endonyx Onychomycosis People who have endonyx onychomycosis have fungus growing between the layers of the toenails. With this type of fungus, toenails usually have a milky white color and may be pitted or split. They usually dont thicken or separate from the nail bed.
Proximal White Subungual Onychomycosis This is a relatively uncommon form of toenail fungus, seen most often in people with weakened immune systems due to conditions such as HIV. The fungus enters the toenail through the cuticle and affects the part of the nail closer to the base, turning it a whitish color.
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Nail Color And Structure Changes
Keratin is a protein that promotes the development of the skin and nails. Nail psoriasis sometimes causes too much keratin to grow under the nail. This overgrowth is called subungual hyperkeratosis.
People with hyperkeratosis may notice a white, chalky substance under the nail. When this occurs in the toenails, the pressure of shoes pushing down on the nails might cause pain.
What Can You Do To Help Improve Psoriatic Nail Disease
- Keep your fingernails and toenails as short as possible – long or loose nails are more likely to catch and can cause more damage to the skin underneath the nail.
- Keep your nails dry.
- Protect your nails by wearing gloves when doing any manual work.
- Avoid a manicure of the base of the nail. This may cause an infection.
- Avoid false nails as they may damage the cuticle and make it difficult to apply treatments to the nail.
- Nail varnish can be used to cover up pitting. Nail varnish remover containing acetone should not be used, as it can cause damage to the nail.
- If you have painful toenail psoriasis then you should see a person who is qualified to diagnose and treat foot disorders .
Note: if you have psoriatic nail disease and develop pain or swelling in one or more of your joints or if you develop pain in your heel then you should see your doctor as soon as possible. You may be developing psoriatic arthritis. It is important that you are seen by a doctor specialising in joint diseases early. It has been shown that the sooner this condition is treated, the less likely you are to suffer permanent damage to your joints.
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Symptoms For Nail Fungus
The fungus affects toenails more than fingernails. Toenails have more chances of coming in contact with fungus while walking barefoot. If an infected person has walked in a public place, they can spread the infection to others. The following symptoms will help you diagnose finger fungus correctly.
Nail color changes to grey, green or brown depending on the sub species of fungus causing. It begins as a spot and then spreads to your entire nails. Such hyperpigmentation is not observed in nail psoriasis.
Nails become more brittle, crumbled and patches may develop. It easily spreads throughout as your nail grows.
Nail fungus can also spread to other uninfected nails and the surrounding skin.
Diagnosing: Another Method Of Determining
It so happens that psoriasis can be accompanied by a fungal infection due to disruptions in immunity, metabolism, and other changes. In those cases, additional diagnostic methods might be needed.
Microscopic examination of a piece of the affected nail is needed to determine the pathogenic fungal flora that accompanies psoriasis.
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Have A Specialist Diagnose Psoriasis Vs Fungus
Psoriasis and fungal infections on fingernails and toenails have very similar symptoms. Only a medical examination and testing of the nail can determine if its a psoriasis or a fungal infection. A self-diagnosis of the condition is not always accurate or recommended method to determine treatment.
Knowing the difference between both conditions will allow the proper medical treatment to prevent symptoms from worsening. Because a fungal infection is contagious, it is important to treat and cure the infection.
Additionally, it is possible for a person with psoriasis to also have a fungal infection on nails. Because psoriasis is an autoimmune disease, it makes them more susceptible to skin and nail infections. This is another reason it complicates the very nature of self-diagnosing the condition.
The Detroit area hand specialist Dr. Ali can examine, test, diagnose and treat fingernail and toenail abnormalities and medical conditions. Proper diagnosis and medical treatment of psoriasis and fungal infections of the nails can prevent symptoms and damage from spreading or progressing. Identifying the condition quickly in order to treat the symptoms and underlying cause will help you get back to having healthy, pain-free nails.
What Is Nail Psoriasis
Etymologically, psoriasis comes from the Greek psora, which means itching. The dead cells that are in the epidermis, which is the outer layer of the skin, are replaced by new cells. This process takes place approximately every 30 days.
However, when this renewal accelerates more than the average, then what is called psoriasis occurs. This disease causes redness on the skin or scales. These usually cause pain and itching, which can often affect the nails.
Psoriasis of the nails is defined by various abnormalities that occur on the nails of the hands and feet. Most of the time, there are small depressions that look like thimble holes, detachments or crumbling, discoloration, thickening or streaking on the nails.
On the other hand, psoriasis lesions on the nails are normally more common on the hands than on the feet. However, very often, these are the only signs of psoriasis in a person affected by this disease.
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Increased Chances Of Athlete’s Foot
If the nail fungus spreads to the skin on your feet it is called Athlete’s foot. Symptoms include itchy and dry skin between the toes or on your soles, cracking, and peeling of the skin.
People suffering from athletes feet have high chances of developing nail fungus. As the name suggests, athletes are at high risk of contracting the disease. However, it can infect anyone if preventive measures are not taken timely.
Top Detroit Area Hand Specialist
If you are suffering from an injury or pain in your fingernails, wrist, elbow or arm, contact board certified Detroit area hand specialist Doctor Rehman for a comprehensive evaluation and consultation. As with most medical conditions, early detection, awareness, and a prevention or treatment plan is the most effective way to combat the effects of conditions like psoriasis and fungal infection of the fingernails and toenails.
HAnd specialist Doctor Rehman will assess your individual situation, and prescribe the treatments that are best for your condition.
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What Is Psoriatic Nail Disease
Psoriatic nail disease is a type of psoriasis. It is not caused by infection and you cannot pass it on to anyone else.
Psoriasis is a common skin condition that usually causes patches of red, scaly skin but sometimes only affects the nails. There is also a form of arthritis that is linked to psoriasis, called psoriatic arthritis. Psoriatic nail disease is particularly common if you have psoriatic arthritis. You can read more about these conditions in the separate leaflets called Psoriasis and Psoriatic Arthritis.
When Should I Call The Doctor
In rare cases, toenail fungus can cause an infection called cellulitis. Without prompt treatment, cellulitis may pose a serious danger to your health.
You should seek treatment guidance from a trusted healthcare provider if you have:
- Circulation problems.
- Redness, pain or pus near the toenail.
- Weakened immune system.
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What Else Could It Be
infections of the nail can occur at the same time as psoriatic nail disease and can sometimes look like psoriatic nail disease. Fungal nail infections also cause thickening of the nails. It is important to get the correct treatment as some treatments for fungal nail diseases can aggravate psoriasis.
Onycholysis is the loosening or separation of the nail from the skin underneath it. Treatment depends on the cause. Apart from psoriasis it has many other causes – for example:
- Trauma to the nail bed – for example, by repeated tapping of the fingernails on a keyboard or by pressure from shoes in long-distance runners and walkers.
- Allergy to nail glue .
- Infections, such as fungal infections, bacterial infections, or the cold sore virus .
- Many medicines – for example, some forms of chemotherapy for cancer, and tetracycline and fluoroquinolone antibiotics.
- Other diseases, such as diabetes or thyroid disease.
In most of these situations the onycholysis is not permanent and the nail will grow out normally once the cause has been removed or treated.
Prevention Of Nail Psoriasis
Good nail care is the best way to treat nail psoriasis. Try these prevention tips:
- Keep your nails trimmed short.
- Use a nail file to keep nail edges smooth.
- Wear gloves to clean and do other work with your hands.
- Moisturize your nails and cuticles every day and after they’ve been in contact with water.
- Wear comfortable shoes with enough room for your toes.
If you’re unhappy with the way your nails look, try nail varnish or artificial nails. They can also protect your nails from more damage. Some people are sensitive to the chemicals in varnish and nail adhesive. Talk to your doctor about whether these are right for you.
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What Tests Might I Have For Toenail Fungus
Your provider will probably take a small sample from underneath your nail to further analyze it. Viewing the cells under a microscope can confirm a toenail fungus diagnosis. If the initial test is negative, a scraping can be sent to see if the fungus grows out in a culture. It also helps your provider identify the type of fungus.
When Should Someone Seek Medical Care For Nail Psoriasis
If there are changes in the nails such as discoloration or pits or if the nails seem infected or are painful, see a doctor.
At present, psoriatic nail disease does not have a cure. The goal of treatment is to improve the function and appearance of psoriatic nails. If the nails have a fungal infection, a doctor will prescribe an antifungal medication.
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Psoriasis Can Affect Both Fingernails And Toenails
The percentage of those with psoriasis who have nail involvement is thought to be up to 50%. In psoriatic arthritis this may rise to 80%. For some unknown reason fingernails are more often involved than toenails. For many people, nail psoriasis is often mild and causes few problems.
The nails are part of the skin, so it is perhaps not surprising that a skin disease such as psoriasis can affect the nails. No one knows why some people get nail involvement and others dont. Nails grow from the nail root , which is just under the cuticle. In people who develop nail psoriasis it is involvement of the nail root that causes pitting and ridging of the nails.
Onycholysis , subungual hyperkeratosis and splinter haemorrhages are all caused by disease of the nail bed. These conditions are explained in the next section.
The nail is made of modified skin and, once it has grown, it can only be altered by filing or clipping. Treatments are usually directed at the nail bed that supports the nail or the nail folds that tuck around the edges. Soothing these tissues can result in better nail growth with fewer features of psoriasis.
What changes can occur with nail psoriasis?
These are the most common changes in nail psoriasis:
Some nail changes are caused by using systemic retinoid medication, which can help the skin but may result in format ion of very thin nails which do not appear normal. These nail changes can take several months to grow out only after retinoids are stopped.
Treatment For Nail Psoriasis And Nail Fungus
There are a few treatments for nail fungus like laser treatment which is efficient but quite expensive. The guarantee that it may not reoccur with a laser treatment is uncertain as various studies based on this are still in progress. Pills are available for treatment of this condition but it needs to be taken over a very long period and like all pills it has the risk of side effects when taken for too long. Lamisil is one such pill that is used for treatment of nail fungus.
Ointments are available which are preferably used owing to the low cost and the easy use. It is essential not to use a single ointment continuously as this may cause the fungus to become resistant to the medicine. By using multiple effective ointments, the risk of resistance is eliminated. Most antifungal ointments contain an enhancer which aids the medicine in penetrating through the nail to contact the skin that is affected. For instance, antifungal medicine Fungicillin contains Keratrate which helps in reaching the infected area. In the absence of such enhancers, the ointment may not act on the affected area and will instead only be absorbed by the surrounding skin which will finally have no effect on the infected nail.
While fungus can be treated, nail psoriasis has no particular treatment. Treatments are available to only improve appearance of the nail by using certain ointments that contain vitamin A and vitamin D or by injecting the nail bed with steroids.
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