Onychomycosis (Fungal nail infection)

There are over a thousand entities in dermatology; it is difficult to understand all in just a few pages. We are going to describe a few common skin problems. This is purely educational; if you have a skin disease, please consult your dermatologist.

Fungal nail infection (Onychomycosis) affects either the finger or toenails, and together they account for 50% of all nail diseases. 30% of superficial fungal skin disease sufferers will also suffer from onychomycosis. Only 2-3% of toddlers may have onychomycosis, but this figure rises to about 90% in the elderly. Those who work with enclosing boot wears such as chefs, cleaners and firemen may get it more often than the general population.

In the early stage, the symptoms are minimal. Most people notice their nails turn a greyish yellow colour. The nails may thicken and become brittle. Some go to see a dermatologist mainly for cosmetic reason. When the symptoms are neglected, the nail may cause pain and paraesthesia over time, causing discomfort in walking. In severe cases, the nail bed and plate may become distorted.

The mainstay treatment is oral antifungal medicine. Fungal nail paint has a disappointingly low cure rate, and is not advised. Sometimes, it may be necessary to clip the nail and send for laboratory confirmation before treatment. Finger nail will need an oral course of 6 weeks, and toenail will require 12 weeks treatment. This is already a big improvement compared to older treatment regimes which require 6 months or more.

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