Fungal nails

Singapore's warm and humid climate provides an optimal environment for the development of fungal nail infections, with the toes being particularly susceptible to such conditions.

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Fungal nails are more commonly observed in toenails than the fingernails as the toes are usually confined in the warm and moist environment of shoes and covered footwear.

Other contributing factors that can greatly affect our skins’ environment and make it more susceptible to the growth of fungi include:

  • Walking barefoot
  • Excessive perspiration
  • Repetitive trauma to specific areas
  • Dry and cracked skin

Risk factors for fungal nails

There are many causes of fungal nail infections but certain risk factors can increase the chances of certain individuals developing this condition, such as:

  • Age, especially for individuals over 65 years old
  • Wearing artificial nails or pedicures
  • An injury on the nail or skin around the nail which may provide an entry point for fungi
  • Weakened immune or circulatory system
  • Walking barefoot in public places like pools or beaches
  • Poor foot hygiene
  • Wearing the same shoes daily, without allowing them to air out

Patients with chronic diseases, circulatory problems, or immune-deficiency conditions are also more prone to developing fungal nails and recurrent infections. If left unaddressed, fungal infections can cause toenails to become thickened and be difficult to trim, resulting in pain during walking. Patients may need to avoid footwear that feels tight around the toes and could experience discomfort or embarrassment when their feet are uncovered due to the unsightly appearance. Fungal infections can also spread easily to other toenails, fingernails, and even the skin around the nails.

Delay in seeking podiatric care can lead to significant or permanent damage, especially in patients with weakened immune systems, including those undergoing cancer therapy, individuals with rheumatological or neurological conditions, or diabetes. Underlying biomechanical conditions, such as hallux limitus, can also impact recovery rates or worsen fungal infections. In some cases, nail infections can be missed or ignored due to the absence of symptoms or pain. At-risk individuals should undergo routine nail and skin care from their podiatrist to ensure that any changes to the nails are promptly addressed upon discovery.

Complications of fungal nails

If left unaddressed, fungal nails can lead to complications such as persistent pain, difficulty walking, and the spread of the infection to other nails or even the skin. In individuals with weakened immune systems, the infection may become more severe and challenging to manage. It is crucial to note the risk factors in using multiple anti-fungal products or incorrect methods to manage a fungal toenail infection can cause the infection to spread or become more resistant to medication. This would subsequently make it harder to resolve.

How can fungal nails be managed?

Podiatrists specialise in diagnosing and managing lower limb conditions, including fungal nail infections. They conduct a thorough examination of the toenails and surrounding skin to determine the best course of action. Management options may include over-the-counter medications, topical creams, minor surgical procedures, or advanced therapy like the Photodynamic Antimicrobial Light Therapy (PACT) or also known as a low-dose laser therapy.

Photodynamic Antimicrobial Light Therapy (PACT)

This non-invasive procedure involves applying a special gel to the nail, sensitising the fungi to specific wavelengths of light. The focused light destroys the nail fungus spores without harming healthy cells. Before the therapy, podiatrists debride and file the nail to enhance the penetration of light, ensuring a higher success rate in eradicating the infection without invasive measures.

Early diagnosis and appropriate intervention by a podiatrist are crucial for effective management and preventing the progression of fungal nail infections. Regular podiatric care, proper foot hygiene, and prompt attention to any changes in the nails help individuals maintain healthy and fungus-free nails.

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Common Symptoms

Nail discolouration
Foul odour
Thickened nail
Crumbly nail
White markings on nail
Nail deformity

How It Looks Like

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What are the most common types of nail fungus?

Most cases of nail fungus are caused by a type of fungi called dermatophyte. Yeast and mould can be a cause of nail fungi too.

What is the most effective solution for nail fungus?

The type of fungal nail therapy that is used depends on the individual and their specific condition. Every fungal nail condition is different from patient to patient. What works for one person may not work for another. However, a podiatrist can determine the best options after an initial assessment. Effective fungal nail therapy usually incorporates a multi-faceted approach involving trimming of the affected regions of the nail, applying topical antifungal medication, undergoing low dose laser therapy, consuming oral antifungal medication, podiatric intervention aims to quickly and effectively remove nail-penetrating fungal spores.

How much does it cost to resolve fungal toenails in Singapore?

Fungal nail therapy can cost from as little as $15 for an over-the-counter tube of cream to hundreds of dollars for a multi-faceted medical approach that includes multiple sessions. The cost varies widely depending on the types of procedures used by different professionals.

What is the fastest home remedy for nail fungus?

Examples of common fungal nail home remedies include tea tree oil and vinegar. However, these remedies are often not as effective as they are unable to penetrate, and eliminate fungus that reside deep inside the nail. Furthermore, many home remedies are fungistatic, which simply keeps the fungus from growing but do not kill it. This is different from fungicidal therapy, which kills the fungus and eradicates the problem at its root for a successful recovery. Although home remedies can be helpful for mild cases of fungal nail infections, severe cases or cases that do not improve with home remedies should be seen by a podiatrist.

Will my nail fungus grow out?

Fungal nail that has invaded the nail plate is unlikely to go away on its own without any podiatric intervention. If you plan on using topical ointments and home remedies while the nail grows out, be aware that it can take up to 18 months for the nail fungus to clear up.

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Looking for a treatment for fungal nail. Googled and found East Coast Podiatry clinic. Was very happy to get immediate attention. The staff from the podiatrist to the nurses and receptionists are very polite and friendly. They were very detailed and clear with explaining the entire procedure to me. Overall i was very happy and comfortable and confident that i came to the right place for treatment.

Tan Dee

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