The south-west monsoon, which is the first of two annual wet seasons in Singapore and typically lasts from June to September, significantly affects the feet. During this period, Singapore’s weather is characterised by rain and humidity, creating optimal conditions for fungus to spread in the skin and toenails. Undetected to the naked eye, fungal spores are opportunistic in nature and latch onto any possible host. They thrive in moist environments, causing itchiness, flaking, red spots, and dryness to the skin of the foot.
When a fungal skin infection worsens, it can lead to a more severe condition called foot rot (tinea pedis). This is a bacterial infection that develops on top of the fungal infection, often causing bleeding, pus, open wounds, and pain. If ignored or incorrectly managed, foot rot can become a medical emergency. Moreover, it is contagious and can be transmitted to close contacts.
Fungal nail and skin infections are closely related. If you have a chronic fungal skin infection, you’re more likely to also have a fungal nail infection (onychomycosis) or vice versa. Initially, superficial fungus appears as white or yellowish discolouration on the nail’s surface. However, over time, the fungus can invade the nail bed, causing the nails to become thick, crumbly, and lifted. The nail may appear dark yellow, brown, greenish, or white.
Once nail fungus invades the nail bed, it can be difficult to manage and eliminate. Therefore, leaving the fungus unaddressed can allow it to spread to all 10 toenails and to others through direct contact.
Self-Monitoring and Prevention
Prevention is crucial in maintaining healthy feet. To start, always ensure your feet are dry, especially between the toes. Additionally, regularly rotate your footwear to allow proper aeration and help prevent fungal growth. It’s important to wear socks with closed footwear and change them at least once or twice daily to keep moisture levels in check. Avoid sharing nail clippers, files, polish, or other products with others to prevent the spread of infections.
As for salon pedicures, be cautious to minimise the risk of cross-contamination, which can occur if the instruments are not properly sterilised. To ensure the instruments used on your feet are clean and safe, consider bringing your own tools to the salon. Most importantly, pay close attention to the state of your feet and nails by checking them daily. If you notice any changes or discoloration in your nails or skin, it could be a sign of a fungal infection.
Realities of Retail Antifungal Products
While prevention is key, sometimes infections do occur despite best efforts. When this happens, many patients turn to common home remedies such as tea tree oil and apple cider vinegar to eliminate nail fungus. Unfortunately, these products often do not contain strong antifungal ingredients, which leads to temporary improvement but a high chance of recurrence.
In addition to home remedies, some patients try over the counter (OTC) antifungal products for relief. For mild or superficial nail fungus, these products can be somewhat effective. They come in various forms such as ointments, creams, and drops. However, they require consistent and diligent application for at least six to 18 months to see results. Despite their use, these treatments often have minimal or no effect on severe infections, as the fungus may have invaded the deeper layers of the nail plate, nail bed, or even the nail matrix.
Therefore, while the above-mentioned options might offer some relief for mild cases, they are often not strong enough to fully eradicate stubborn nail fungus. For severe infections, professional treatment is necessary.
Clinical Intervention Options for Nail Fungus
In Singapore’s climate, managing fungal nails can be challenging, but prompt intervention helps. Chronic infections often need treatments like oral antifungals, such as terbinafine and itraconazole, to promote healthy nail growth. A three-month course is typically required, but these potent drugs might cause liver toxicity. To mitigate this risk, monthly blood tests are necessary. Additionally, oral antifungals can interact with antidepressants and beta-blockers, making them contraindicated for some patients.
Given these challenges, advancements in medical technology have introduced effective alternatives like laser and light therapies. These methods avoid the drawbacks of oral drugs and offer faster results. One advanced treatment is Photodynamic Antimicrobial Therapy (PACT), which uses a photosensitising gel and specific light wavelengths to destroy fungus. Multiple sessions are needed, with possible top-ups. For severe infections, total nail avulsion, a surgical option, may be necessary. This involves removing the entire nail plate to allow a healthy nail to grow. Healing takes one to two weeks, followed by PACT therapy to ensure complete fungal elimination.
Choose East Coast Podiatry for Nail Fungus Treatment
Here at East Coast Podiatry, our experienced podiatrists use modern treatments and technologies to effectively manage and treat nail fungus. Whether through advanced therapies like PACT or surgical options, our goal is to offer comprehensive care tailored to your needs. Patients hoping to be free of stubborn fungal infections should dedicate full compliance to the therapy once it has started to ensure success. In Singapore’s tropical climate, eradicating fungus is often not 100 per cent, and without proper clinical care, there is a high possibility of re-infection. Timely podiatric care is key to preventing the spread of fungus from toenail to toenail. Schedule an appointment with one of our podiatrists today to take the first step towards healthier nails.
