Common Nail Disorders: Nail Fungus

Onychomycosis/tinea unguium or nail fungus could be indicative of other medical problems or it could have caused complications. Fungus can become systemic (spread throughout the body).People with compromised immune systems (Lupus, HIV, etc) with invasive fungal infection have higher risk of complications and death.

In about one out of two dozen cases, the fungus migrates to other parts of the body, like the hands, back and legs, said Dr. Boni E. Elewski, a professor of dermatology at the University of Alabama at Birmingham who specializes in nail disorders.  For people who have nerve damage and poor circulation -- someone with diabetic neuropathy, for example -- this can have serious consequences. “Podiatrists frequently cite this as a cause of diabetic amputations,” Dr. Elewski said. “The fungus paves the way for bacteria, and it can definitely be a problem.” 

It’s not at all uncommon for patients with toenail fungus to also succumb to athlete’s foot, jock itch, and ringworm. “If your immune system isn’t functioning at its very strongest, the fungus will work against you to open the body up to other attacks,”  Dr. Nadia Levy explains. "The longer you wait, the harder it is to treat"

Dermatologists estimate these fungal infections account for 50% of all nail disorders they treat. Recent studies suggest that as much as 13% of the U.S. population has a fungal infection of one or more nails. As the fungal infection advances, the separated nail appears yellow and opaque, then appears crumbled and can brown.

Aging is the most common risk factor for onychomycosis due to diminished blood circulation, longer exposure to fungi, and nails which grow more slowly and thicken, increasing susceptibility to infection. Nail fungus tends to affect men more often than women, and is associated with a family history of this infection.

Onycholysis is NOT Fungus
Onycholysis refers to the detachment of the nail from the nail bed, usually starting at the tip and/or sides and is often caused by an internal disorder, trauma, infection, or certain drug treatments.

If addressed quickly, this common nail disorder poses no danger to clients. In general, clients should clip the affected portion of the nail and keep the nails short, keep the nail bed dry, avoid exposure to contact irritants, and wear gloves for wet work. The portion of nail that has separated will not reattach to the nail bed, so you will have to wait until the nail is fully regrown for the condition to be completely gone.  It is not recommended that the client have enhancements put on the nail until the onycholysis is gone.

Because the nail is lifted off the nail bed, creating a nice warm "pocket", onycholysis can allow fungus to more easily take root on a nail so it is important to keep an eye on the nail while the onycholysis is growing out.

As a nail technician, know that if you get a client with a nail fungus you must refer them to a doctor for treatment. Giving advice regarding nail fungus could be considered practicing medicine without a license.



References:
http://www.aafp.org/afp/2001/0215/p663.html
http://well.blogs.nytimes.com/2013/10/11/ask-well-leaving-nail-fungus-untreated/?_r=0
http://healingfeet.com/toes-2/danger-leaving-toenail-fungus-untreated#sthash.kT74aPa4.dpuf
http://www.nailsmag.com/article/92526/under-the-microscope-onycholysis
https://en.wikipedia.org/wiki/Onychomycosis