In the months from October to April, also known as the 'wet season', Darwin experiences extreme heat and an increase in humidity.
Fungi thrive in warm and humid environments, such as toenails due to our feet being in socks and shoes most of the day. Fungal nail infections, or onychomycosis, are caused by various microorganisms with dermatophytes being the most common.
The pathology of fungal nail infections involves several key stages:
Entry and Establishment
- Fungal spores gain entry through tiny cuts or separations between the nail and nail bed.
- Warm and damp conditions, such as damp socks or public swimming pools, create an ideal environment for fungal growth.
Invasion of the Nail Plate
- Once inside, the fungi start to invade the nail plate composed of keratin.
- Dermatophytes release enzymes that break down the keratin, allowing them to penetrate and establish within the nail.
- As the infection progresses, the nail starts to discolour, typically presenting as yellowish or brownish stains on the nail.
- The fungi cause the nail to become thickened, brittle, and change in shape.
Nail Bed Involvement
- For advanced nail infections, it can extend to the nail bed which is the soft tissue underneath the nail.
- Sometimes there is inflammation and pain while the nail separates from the nail bed.
Spread to Surrounding Nails
- If left untreated, fungal nail infections can spread to adjacent nails.
- The cycle may continue, contributing to the persistence and recurrence of the infection.
Chronic Infection and Complications
- In some cases, onychomycosis can become a chronic condition, causing discomfort and affecting the quality of life.
- Individuals with compromised immune systems such as diabetics, are at a higher risk of complications from fungal nail infections.
Diagnosis and Treatment Challenges
- Diagnosing fungal nail infections may require microscopic examination of nail clippings or culture tests to identify the causative fungi.
- Treatment challenges arise due to the slow growth of nails and the resilience of fungi, often necessitating prolonged therapeutic interventions.
Understanding the pathology of fungal nail infections is crucial for developing effective treatment strategies. Addressing these infections often involves a combination of topical or oral antifungal medications, laser treatments, or, in severe cases, surgical interventions. Early detection and intervention play a significant role in preventing the progression of onychomycosis and reducing the risk of complications.
Stay tuned to Part 2 of this topic which will explore the various treatment options in managing onychomycosis and how you can prevent it. Meanwhile, learn more about fungal nail laser treatment here.