Onychomycosis is a fungal infection of the nails. It does not usually cause discomfort, but it alters the aesthetics of the affected nails and, if it is not treated in time, it can become chronic and extend. Learn to prevent it.

Onychomycosis is an infection caused by a fungus that affects the fingernails, mainly toenails. The disease usually begins in one of the big toes, but it can infect other nails on the same foot over time. It is common for people with onychomycosis to suffer from athlete’s foot simultaneously, which is also caused by fungi, but in this case, it would only affect the skin.

It is a common infection that can affect between 4% and 18% of the population. Its prevalence increases with age, and there are also more cases in some specific groups, such as athletes, livestock farmers, or diabetics.

People become aware of the infection when they observe changes in the color or shape of the nail. As it is not a disease that causes great initial discomfort, people who do not consult the doctor soon, which makes the infection completely invade the nail and is more challenging to solve.

The most common is that onychomycosis remains as an aesthetic alteration of the nail, but on some occasions, it produces chronic pain that is difficult to solve. Therefore, it is best to diagnose the infection as soon as possible and treat it. Today there are several treatment options, although oral antifungal drugs remain the primary option for treating onychomycosis.

Dermatophyte fungi of the type cause onychomycosis. These fungi are capable of invading keratinized skin structures such as hair and nails. The fungus that causes onychomycosis in most cases is Trichophyton rubrum. Other fungi that can cause this infection are Trichophyton mentagrophytes or even Candida albicans (not a dermatophyte fungus).

These fungi are transmitted by direct contact and live with us without causing infection until certain factors favor it. Some of the risk factors for developing onychomycosis are:

• The aging. Over the years, we accumulate more fungi that colonize the foot, and our body’s defenses are weaker.
• Keep the foot moist, as with swimmers and athletes.
• Having ringworm on the foot or athlete’s foot.
• Suffering from other skin diseases, such as psoriasis.
• Diabetes, which negatively affects the immune defenses of our body.
• Having relatives with onychomycosis, both because it may indicate a certain genetic predisposition and because of the possible transmission of the fungus.
• Immunosuppression, caused by chemotherapy, HIV, or biological drugs.

Symptoms of onychomycosis

The onychomycosis rarely causes discomfort to people who suffer. Sometimes it can give some mild pain, which can become chronic if the affectation is extensive. Also, it is a gateway for various germs that can cause other infections such as cellulitis.

The main problem, however, is aesthetics. Onychomycosis symptoms are precisely the alterations that the affected nails present, which change color and shape, taking on an unpleasant appearance. According to the type of alterations, they can be divided into several groups:

• Distal subungual: This is the most common type of involvement of the big toe. The free edge of the nail begins to yellow and thicken. The surface becomes rougher and can become fragmented.
• Proximal subungual: the root of the nail is damaged first, where it grows. Yellowish or whitish areas are seen moving towards the free end. It is a rare type of onychomycosis that is seen more often in people with AIDS.
• Simple white: in this case, the infection begins with a whitening of the nail surface. They appear first as small dots that later merge and form larger areas.
• Melanonychia: this term means ‘pigmented nail’ or ‘brown nail.’ It is a sporadic form of melanonychia caused by fungi other than the Trichophyton genus. Sometimes the nail becomes so dark that it is necessary to make a differential diagnosis with melanoma and subungual hemorrhage.
• Onychodystrophy: it is in most cases the final stage of all variants of nail infection. This is the name given to the nail’s total deformation, which becomes very thickened, curved, and quickly falls apart into fragments.