Archive for month: July, 2015

FOOT HEALTH REPORT
Presented by Mr Frank Dowling,Podiatrist

Case Study No.3 Fungal Toenail Infection.

Alana mac, a thirtysomething businesswoman from Maynooth, presented at my surgery in August complaining of thickened discoloured toenails on both feet. Several years ago she noticed that her big toenail on her left foot had become discoloured at the tip of the nail as time passed she discovered it had spread to other toe nails.

Many people come to my surgery with this lady’s problem it is a very common condition, the fungus concerned is a member of the dermatophyte family and lives in moist damp areas such as swimming pool changing rooms and hotel showers. It is easily picked up and spread from one person to another walking barefoot or something as easy as trying on another person’s shoes. The fungus usually presents on the foot and is known as “athletes foot” it can spread under the nail where it becomes very difficult to treat as the nail is made up of several layers on top of each other and the fungus exists between the layers and under the nail eventually taking hold in the nail bed.

When Alana came to the surgery I informed her of my opinion and we decided to take a sample of nail for testing, to rule out other conditions such as psoriasis or nail trauma ,this is a painless procedure and does not hurt at all. Three weeks later the sample of nail Tissue was cultured and proved positive for a fungal infection.

There are many treatments for nail fungus the most effective of which involve taking a course, usually 12 weeks, of an antifungal tablet, this treatment is the most effective but there are many side-effects of this therapy including nausea, upset stomach and headaches, in addition contraindications include anybody who is pregnant or breastfeeding or has a history of gastrointestinal
The problems such as reflux, stomach ulcers and digestive trouble. also available are a range of antifungal nail lacquers which can be applied directly to the affected area but these are far less effective as it is very difficult for them to penetrate through the nail according to some research less than 30% of people who applied the nail paint for three months noticed any difference. Although the nail paint is usually very well tolerated there have been reports that overuse can cause irritation around the nail.

It is important to remember that toenail fungus is generally confined to the toenails and in very rare cases is seen on the fingernails, although it is very unsightly it is not in anyway dangerous it will not cause any other sinister illnesses or lead to other health problems and in most cases is not painful nor make it uncomfortable to wear shoes which is why it is often ignored by a lot of people.

As with all unhealthy conditions prevention is better than the cure, the best way to avoid picking up a fungal infection is to wear flip-flops when bathing in public areas. By paying particular attention to the risks involved when away from home by using an antifungal spray such as” mycil”
keep in mind that the athletes foot fungus can live in footwear for months after last being worn. To ensure eradication of this bother some problem it is advised to apply an antifungal cream or spray directly to the foot daily for at least four weeks and in addition neutralise any fungal spores in footwear by spraying inside the shoes you are wearing that morning for a about a month, although there are products on the market which claim to eradicate the fungus with one treatment the problem is that the fungus lives in the shoes and there is a very high chance of reinfection.

Alanna decided she would try to get rid of the nail fungus by using an over the counter product. Latest developments in America using laser have proved to be quite successful and have little side-effects so perhaps this will be the treatment of choice in time to come.