Toenail fungal infections occur when fungi called dermatophytes invade the space under the toenail, usually entering the toe through a tiny cut, abrasion, blister or other very small opening in the skin around the nail. Once the fungi become lodged beneath the nail, they're protected by the hard nail and can be very difficult to treat without medical intervention. Because circulation to the nail bed is often diminished, it's much more difficult for the body's immune system to effectively fight toenail fungal infections, which means the fungi can grow rapidly and become rooted in the deeper layers of tissue.
Typically, the first sign of a fungal infection in the toenail is a discoloration or darkening or the nail. Over time, the nail will become thickened, ragged and brittle, sometimes peeling or chipping off in layers. Without care, the nail area will eventually become quite sore, especially when pressure is applied to the toe and when wearing shoes, and the infection can spread to other toes. Toenail fungus infections are more common among people with circulation problems including those with diabetes and among people with immune system disorders. Having a family history of toenail fungal infections also increases the risk of infection.
Because of its located beneath the protective barrier of the nail, toenail fungus can be very difficult to treat without skilled medical care. Over-the-counter products rarely provide long-term relief, and, because they can mask symptoms, they can allow the infection to worsen. While the usual approach to treating a toenail infection is to remove all or part of the nail in order for topical medications to reach the deeper layers of tissue, today many toenail fungal infections can be treated with lasers. During treatment, a special device delivers laser energy painlessly to the deep areas of tissue where fungal bodies are rooted. The focused heat destroys the fungi while leaving surrounding tissue unharmed. Treatment takes about 15 minutes, and up to four nails can be treated in a single session.
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