Nail fungus

"Nail fungus (onychomycosis) is the most common disease of nails, about 20-30% of people over 40 years old are affected. Toenails and fingernails affected by a fungus can be recognized by the fact that they thicken, deform and discolor. The sooner a nail fungus is treated, the sooner it can be removed. In our practice, we are equipped to deal with any nail fungus."

C. Bettina Rümmelein, M.D., Specialist in Dermatology & Venereology
C. Bettina Rümmelein, M.D., Specialist in Dermatology & Venereology
Symptoms

Nail fungus symptoms

The first symptoms of nail fungus can appear at almost any age. However, with age the frequency of nail diseases increases, so that from the age of 65 about 50% of people are affected.

Toenails affected by the fungus lose their shine, show a whitish to yellowish discoloration and thicken and deform. This can lead to increased brittleness of the nail bed, and in the case of severe infestation, this can result in the loss of parts of the nail or the entire nail (called onycholysis).

Although the infection is considered harmless to general health, it can lead to bacterial infections of the adjacent nail edge in people with a severely weakened immune system. Due to the thickening of the diseased nails, it becomes increasingly difficult to wear normal shoes. Nail fungus is therefore not only an aesthetic problem, even if some people are embarrassed by the fungal nail.

If you discover discoloration on your nails or the nails thicken, please consult a dermatologist in time.

Causes

Nail fungus causes

A nail disease such as nail fungus can be transmitted through shared objects (smear infection) or in rare cases through direct human contact (contact infection). The most common pathogen of a nail fungus infection are the so-called dermatophytes. These feed on keratin, which makes up the horny substance of our nails. The loss of keratin causes discoloration, thickening and deformation of the nails. Less common pathogens are molds or yeasts.

The development of nail fungus can be influenced by various risk factors. Known factors are for example nail injuries caused by sports or tight shoes, athlete's foot, hyperhidrosis, old age, diabetes, weak immune system and peripheral vascular diseases.

Treatment

Nail fungus treatment

Nail fungus treatment may sound straightforward and like a short process, but it requires a lot of persistence and patience, especially in advanced cases. An effective treatment program consists of several different treatment approaches, including regular laser treatments (Nd:YAG laser), antifungal agents, podological treatments (painless removal of the diseased part of the nail), disinfection of shoes and application of special products for nail reconstruction.

Drug treatment for nail fungus

  • In case of nail fungus infestation of less than 50% of the nail, local treatment in the form of nail polish, which is applied directly to the affected areas, is usually sufficient. Antifungal agents in the nail polish prevent the spread of infection and also reduce the risk of infection.

Laser treatments for nail fungus

  • If more than 50% of the nail is affected or topical and systematic treatments do not respond, laser treatment is recommended.
    In our practice, we offer a treatment program that includes various treatment approaches.
    In addition, home remedies such as apple cider vinegar or tea tree oil can help in the treatment of nail fungus. These natural remedies have antimicrobial properties and in combination with other treatment methods can support healing. It is important to note that the use of home remedies alone is often not enough to completely combat the fungus.
Frequently asked questions

Nail fungus Frequently asked questions

How can I recognize nail fungus?

Nail fungus, also known as onychomycosis, is characterized by visible changes to the nails. These can lead to a thickening, yellowish, white or brownish discoloration of the nail. It can also include discoloration with irregular edges, crumbling or peeling of the nail and white patches or streaks on the nail surface. Accompanying itching or occasional pain in the area of the nail indicates that the nail bed is already affected.

Is the treatment painful?

The treatment of nail fungus is usually painless. It includes the application of local fungicides in the form of special nail varnishes or creams, the use of oral antifungals in tablet form and, in most cases, treatment using a nail fungus laser (1064nm Nd:YAG). The use of the laser can help to destroy the fungus and revitalize the nail. Pain usually only occurs if the nail is already severely damaged or if an infection has occurred. The exact therapy depends on the severity of the nail fungus. The treating doctor will recommend the best option.

How can I prevent this from happening in future?

To prevent nail fungus in the future, please note the following: - Take good care of your feet and nails, and avoid injuries (tight shoes, nail salon, etc.) - Wear breathable shoes and change socks regularly. - Avoid walking barefoot in public areas and use flip-flops in communal showers. - Cut your nails straight and not too short. - Avoid nail polish if you already have an infection. - At the first sign of an infection, consult a dermatologist immediately.

What happens if I don't get treatment?

If you leave a fungal nail infection untreated, the condition of the nail can worsen. The nail can become thicker, more brittle and deformed, which can lead to pain and discomfort. There is also the possibility of infection in the nail bed area. The more time passes and the nail fungus progresses, the longer the duration of treatment will be. In some cases, the nail may fall off or have to be removed. It is therefore advisable to consult a dermatologist at an early stage in order to receive appropriate treatment and prevent possible complications.
Further information

Further information

Publications
Laser treatment of nail deformities - a case report: spontaneous regression of pincer nails during nail fungus laser treatment.
Müller, A. / SZD 5/2020: 13-14
Publications
Laser treatment for onychomycosis.
Rümmelein, B. / SZD 5/2017
Article
Laser treatment for nail fungus: Very effective!
Dr. med. C. Bettina Rümmelein
Article
Athlete's foot forever?
Dr. med. C. Bettina Rümmelein

Further information

Publications
Laser treatment of nail deformities - a case report: spontaneous regression of pincer nails during nail fungus laser treatment.
Müller, A. / SZD 5/2020: 13-14
Publications
Laser treatment for onychomycosis.
Rümmelein, B. / SZD 5/2017
Article
Laser treatment for nail fungus: Very effective!
Dr. med. C. Bettina Rümmelein
Article
Athlete's foot forever?
Dr. med. C. Bettina Rümmelein