All About Fungal Infections

Posted by on Feb 24, 2017 in Uncategorized | Comments Off on All About Fungal Infections

Skin Conditions- Fungal Infections Foot and Nail Advanced Podiatry Cortland,Ohio

 

Why is healthy skin important?

Healthy skin increases comfort dramatically as it stretches to absorb shock when we stand or walk. It also acts as a defensive barrier against infections. Healthy skin also looks good, especially when wearing sandals or backless shoes.

Are your feet a breeding ground for fungus?

Fungus is a primitive plant-like organism that commonly attaches to skin or nails when conditions are right for its growth, like a weed in the garden. Fungus needs darkness, moisture (usually sweating), and heat to live on a healthy individual’s skin or nails.  People with lowered resistance due to illnesses, such as diabetes, or people having problems with poor circulation can easily acquire fungal infections, even in perfect conditions.

Fungus is everywhere around us, mildly contagious and seldom related to personal hygiene. Though the feet are sweating fungus makes the skin dry, scaly and leathery as it holds onto the dead skin that normally sloughs off when we bathe. It also steals the natural oil the skin uses to keep it soft and supple. Eventually the skin becomes so dry it may crack open which may lead to infection, especially in diabetic patients.  Moisturizers alone do not work, as there is already enough moisture.  It takes two to three months of treatment with medications for the fungus-infested skin to grow out and be replaced with new healthy skin.

Can fungus affect your toe nails?

Fungus can also affect the nails making them discolored, dry, brittle, thick, and even deformed. Often the great toe, little toe or a long toe are most affected if the foot is working improperly leading to repetitive micro trauma to those nails an average of 5,000 steps per day in shoes.

The fungus is opportunistic, meaning that while the body is repairing the damage from the nail micro trauma the fungus starts under the nail tip, spreads beneath, intertwines with and eventually reaches the root of the nail. It is much more difficult to treat nail fungus because the fungus beneath the nail on the nail bed is protected by the nail making it hard for antifungal creams to reach and kill it, especially if it has spread to the root of the nail below the skin at the base of the nail. Antifungal pills may kill the fungus from the inside at the root, but it takes at least a year for the diseased nail to grow out as the fungus also slows the growth of the nail. In addition, the micro trauma must be eliminated or the long-term success is poor.

How are fungal infections treated?

The treatment regimen is easy, but the key to successful treatment is getting into a new daily routine and keeping the needed “tools” out in plain view as a daily reminder. The simple treatment regimen without the medication must continue after the skin returns to normal or the recurrence rate is high.

To rid the fungus we need to control the environment in which it lives. Since we cannot control the darkness because we wear shoes, we must control the moisture, or sweating, and heat produced by the feet. Going barefoot or wearing sandals are ineffective in controlling sweating because our bare skin still sweats when in contact with any material. Wearing natural socks, such as cotton or wool, and natural shoes, such as good leather and canvas, controls sweating and heat. Natural materials absorb moisture to help keep the skin dry and allow air to circulate, which cools and dries the skin. Cotton also acts as a natural inhibitor to the fungus.  Synthetic materials, such as nylon hose, socks or shoes, increase heat and sweating. They do not absorb moisture nor allow air circulate which results in the feet setting in a heated pool of its own moisture ̶̶ the perfect environment for fungal growth.

  • Common Antiperspirant, such as Arrid XXtra Dry, helps control sweating as we have the same sweat glands on the bottom of our feet as under our arms, only many more. We recommend the spray because it easily reaches between the toes. Apply every day after you shower and a second application later if felt needed. Stronger antiperspirants, such as B+ Drier or Certain Dri, may also be needed. Apply before any creams, if prescribed by the doctor, as the creams will block the antiperspirant.
  • Absorbing powders, such as Zeasorb or Zeasorb AF (with antifungal agent), will be needed to keep the skin dry if the fungus is between the toes (Presents as white, moist and sometimes split skin) or you work in a hot or wet environment.
  • A skin file, Ped Egg or pumice stone used quickly for only three or four swipes on any thickened skin every day while showering removes the fungus-infested layer of dead skin and allows the antifungal cream to better penetrate the affected skin until the skin has returned to its normal look and feel. Rinse and keep the Skin File in the shower as a daily reminder.
  • An Antifungal Cream for your skin, such as Laminsil AT, is to be applied ̶ preferably after showering for easier application using less cream̶ from the tips of the toes to the knee every day for two weeks to kill the fungus that has spread up the leg as you put socks and pants on. Thereafter, apply above your sock line for eight to ten weeks so it does not spread back up the leg. Continue to use once or twice a month on the normal skin to prevent recurrence if you also have remaining fungus in the nails until that condition has cleared. Only a small amount is needed but work it in well. Remember to use the antiperspirant first.

The doctor may also prescribe an exfoliating/ moisturizing cream, such as Cetaphil, to help dissolve the thick, dead skin. It too should be applied preferable after shower with the antifungal cream̶ mixing both together as you apply.

If the standard treatment is ineffective or the condition is more severe, the doctor may prescribe a stronger antiperspirant, antifungal cream and/or exfoliator, or even antifungal pills.

What treatment options are available for fungal nails?

The doctor may also prescribe a clear antifungal nail oil for fungal nails that is about 80-90% effective depending on the severity of the infection. This will need to be applied twice every day with a light coat on the nails and all surrounding skin. (More is not better!) This needs to be applied until the new nail grows out clear. This may take about one year if the entire nail is affected, and even longer if the root is involved, as it will slow the growth of the nail. Oil application before a quick shower is best as it also keeps away water which the fungus needs to live. A daily routine increases the success rate dramatically!

The doctor may also prescribe an oral nail antifungal medication that needs to be taken every day for three months, which is about 70% effective. There are some possible side effects that may affect your liver, so your blood may need to be taken and evaluated after you start the medication. Rash, cold and flu-like side effects are usually reversible if the medication is stopped immediately!

Nail polish and Fungal Nails

Nail polish should not be applied as it traps moisture, which allows the fungus to quickly re-grow. If polish must be used do not keep it on the nails for more than two to three days.

Prevention with Orthotics

Wearing orthotics, which realign the foot, can help to prevent the repetitive nail micro trauma in closed-toe shoes. This is often necessary to increase the long-term success rate of the nail fungus treatment regimen, especially when the great and little toes are most affected by the fungus.

If you suspect you have a fungal infection, contact one of our convenient foot care clinics to meet a doctor today. Let’s get your feet back to being at optimal health.