Keeping feet free of fungal infections

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

After introducing tinea fungal infections last week, this week we will deal with preventive measures you can use to avoid the infection, as well as learning more about fungal nail infections.

How to prevent tinea infection?

Keeping your skin clean and dry is your best defense. However, you are also less likely to get a tinea infection if you do the following: * When you are at home, take your shoes off and expose your feet to the air. * Change your socks and underwear every day, especially in warm weather. * Dry your feet carefully, especially between the toes, after using a locker room or public shower. * Avoid walking barefoot in public areas. Instead, wear flip- flops or sandals. * Don't wear thick clothing for long periods of time in warm weather. It will make you sweat more. * Throw out old gym shoes, and never wear other people's shoes. * Check your pets for areas of hair loss. Ask your veterinarian to check them too. It is important to check pets carefully, because if they caused your fungal infection you may get it from them again, even after treatment.

Tinea infections and irritated skin take time to heal, but usually don't leave scars after the fungus is gone. Sometimes, people don't even know they have a fungal infection and get better without any treatment.

Anyone can get a fungal nail infection. These infections are more common in adults. Children hardly ever get fungal nail infections, but it can happen.

A fingernail or toenail infection that is caused by a fungus is called onychomycosis. Toenails are more likely to become infected than fingernails. The infection can make your nails thick and discolored. You may also have pain in your toes or fingertips.

Tinea unguium may affect one or more toenails and/or fingernails, and most often involves the big or the little toenail. It can occur in one or several different patterns: * A white or yellowish opaque streak on one side of the nail. * Scaling under the nail. * The end of the nail lifts up, and the free edge often crumbles. * Flaky white patches and pits on the top of the nail. * Yellow spots in the half-moon of the nail. * Complete destruction of the nail.

Tinea unguium often results from untreated Tinea pedis (feet) or Tinea manuum (hand). It may follow an injury to the nail.

Candida infection of the nail plate generally results from paronychia and starts near the nail fold (the cuticle). The nail fold will become swollen and red, and lift off the nail plate. White, yellow, green or black marks will appear on the nearby nail and spread. The nail may lift off its bed and will be tender if you press on it.

Clippings should be taken from the crumbling tissue at the end of the infected nail. The discolored surface of the nails can be scraped off and the debris can be scooped out from under the nail. Previous treatment can reduce the chance of growing the fungus successfully in culture, so it is best to take the clippings before any treatment is started.

Next week we will look at how to treat fungal infections.