Nail fungus (onychomycosis) is caused by three main classes of fungal organisms: dermatophytes, yeasts, and nondermatophyte molds. All three classes cause the very similar symptoms or appearances in nails. Dermatophytes are, by far, the most common causes of nail fungus in Minnesota. Yeasts cause 8% of cases, and nondermatophyte molds cause 2% of onychomycosis cases.
There are many subtypes of nail fungus. These subtypes of onychomycosis can be identified based on where the infection appears to be located relative to the structure of the nail.
- Distal lateral subungual type is the most common form of onychomycosis. The fungus generally spreads from the skin and invades the underside of the nail where the nail meets the nail bed. Inflammation in these areas of the nail causes the symptoms of nail fungus.
- White superficial type is a rare infection caused by the fungi directly invading the surface of the nail plate and secondarily infecting the nail bed.
- Proximal subungual type is the least common subtype, the fungi invade the cuticle (the skin around the nail) and the nail fold and then penetrate the nail plate. It is least common in healthy people, but is found more commonly when the person is immunocompromised.
- Endonyx type is the fungi reach the nail via the skin. Instead of infecting the nail bed, however, the fungi immediately invade the nail plate.
- Candidal (yeast) infection type is a little different from onychomycosis related to other fungal infections. This is a species invasion of the fingernails which usually occurs in persons who frequently immerse their hands in water. It normally requires prior damage of the nail by infection or trauma. The hair stylists, cleaning workers and nail techs in Minnesota are often diagnosed with this type of fungus.
- Dystrophic onychomycosis is the term used to describe the most advanced form of any of the above subtypes, and it involves the entire nail unit. Dystrophic onychomycosis may cause permanent scarring of the nail matrix.
If you have a suppressed immune system due to medications, diabetes or other conditions such as, AIDS, leukemia or have had an organ transplant, you are at more serious risk for an infection that can spread beyond your toe nails.
A person with diabetes can have issues with their blood circulation and nerve supply to their feet. They are also at greater risk for getting a bacterial skin infection called cellulitis. With diabetes any minor injury to the feet or a fungal infection, can be serious and potentially lead to major health issues and extensive medical treatment.
Following are some of the risks and complications associated with them. The list illustrates why early and effective treatment is so important.
- Deformity. The deformities could be in the form of ridges in the nail as it grows out or a bend in the middle of the nail that is not going away.
- Pain. The deformities lead to ingrown toenails that cause pain and nail fold infection (paronychia).
- Emotionally distressing. Almost half of people with nail fungus said the condition had negatively affected their self-image.
- A spreading of the fungual infection. Without treatment, your fungal nail infection is likely to spread to other nails—and to other people in your household.
Cellulitis with a bacterial infection. Fungal nail infections leave skins more susceptible to bacterial infections – cellulitis, the immunosuppressed patients are more vulnerable.