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Children and Nail Fungus Infections

Children and Nail Fungus Infections

Although it is far less likely than not that a child will contract a nail fungus infection, it does happen. Onychomycosis, or nail fungus, is more commonly an adult disease, but as children spend a great deal of time getting into things they shouldn’t and playing in the dirt, they have as much potential as anyone else to attract the fungus that causes the infection.

For kids, the infection is more of a social affliction than anything. Other children may see the infected nail and want to avoid the person with the nail fungus because they think they’ll get sick. This can be really rough on a child’s self esteem.

And as the nail fungus infection develops, the nail can become painful and even possibly fall off. So treating the infection, or better yet avoiding the infection entirely is the best solution.

The infection tends to show up as whitish or yellowish spots on the nail, then gradually grows to cover the nail surface entirely so that the nail is opaque. The nail will then become thicker and more brittle, possibly flaking or crumbling at the edges. Depending on the type of infection, the nail can disengage from the nail bed and fall off, which can be very painful.

How Can I Prevent My Child From Becoming Infected?

Start by teaching your children good hygiene. Make them wash their hands when they come inside after playing. This will quickly remove any spores they may have picked up outside. Get a soft nail-brush and show them how to scrub underneath their nails as well, as that can be a very common area that nail fungus attack.

Keep your children’s nails trimmed close to the tips of their fingers and toes, as the less exposed nail there is, the less surface is available to the spores to invade.

Put antifungal powder in their shoes overnight so they don’t risk infection from wearing shoes all the time. Wash their socks in bleach to kill off anything that might be lurking in the fibers.

If you do end up with a child contracting a fungal nail infection, simple methods of controlling the disease are:

•           Rubbing Tea Tree Oil on the infected nail and surrounding skin

•           Soaking the infected nail in a solution of vinegar and water twice a day

•           Clean underneath the nails to remove the dirt and then wipe with rubbing alcohol to kill the fungus.

If these solutions don’t have an effect, you can speak with your child’s doctor about other available treatments. Some of these, particularly the oral antifungal medications, do carry the risk of liver damage, so be careful which option you choose, and make sure your child’s health is up to the treatment.

What are the symptoms of a Nail fungus and how can I tell if I have a Nail Fungus Infection?

What are the symptoms of a Nail fungus and

how can I tell if I have a Nail Fungus Infection?

You’d think these would be fairly straightforward questions that ought to illicit simple answers. Unfortunately not only is this not true, but it is confusing enough that sometimes doctors misdiagnose nail fungus (or onychomycosis). Knowing the symptoms will assist you in helping your doctor to order the appropriate diagnostic tests so that you end up with the correct solution to your problem.

There are two basic causes of nail infections. Bacterial and fungal. Onychomiycosis, or fungal nail infection, is usually caused by a dermatophyte called Trichophyton rubrum. If not, it is caused by Candida albicans, a yeast growth (also a fungus). As nail infections differ in variety and in cause, the correct cure must be applied. A fungal infection should be treated with an anti-fungal whereas a bacterial infection should be treated with an antibiotic.

Onychomycosis affects the nail bed (skin underneath the nail) nail plate (the hard surface that we refer to as the nail) or the skin around the nail. About one third of skin infections and half of nail infections are caused by Onychomycosis. The visual signs are the abnormalities caused by the nail fungus. A white or yellowish crust appears on top of or embedded in the nail. This is the actual fungus growth. Sometimes it appears as streaks that follow the line of the nail against the infected digit (finger or toe) and sometimes it appears at the cuticle (soft area at the base of the nail).  As the fungus spreads, it covers the entire surface of the nail, turning it to a milky white or yellow. Frequently it causes the nail to become ridged and deformed. This is a result of the dermaptophytes emitting destructive waste product as a result of consuming keratin. If the fungus gets underneath the nail plate, it can cause the nail bed to become irregular. This causes the nail plate to release from the bumpy nail bed and the nail becomes loose and can fall off.

If the nail fungus infection becomes severe, or if it contains Candida, the area around the nail can become swollen and sensitive to the touch. The skin may express (think ooze) pus and be very uncomfortable, even painful. These are common signs of infection. The pus is a result of white blood cells rushing to the area to fight off the infection. This is your body trying to do its job and tell you and your doctor that something is wrong.

It is most common for pus to be present in the case of bacterial infections. Thus your doctor should check for this before looking for fungal infections. To add to the confusion, there are diseases that mimic a nail fungus, including hallopeau acrodermatitis, lichen planus, nail bed psoriasis (which can occur in conjunction with fungal infection of the nail), nail bed melanoma, Reiter syndrome, yellow nail syndrome, onycholysis, and paronychia. Because of this factor, more than one test may be necessary to determine the correct course of treatment.

Different forms of onychomycosis will require different samples from the affected area. In some cases the nail can be sampled from the end or the top can be scraped for a sample, in others, the nail will need to be removed entirely. Whereas this can be a bit scary, it is also to your advantage as it then exposes the nail bed so that it can be treated.

The most typical tests performed on a nail culture to look for onychomycosis are a potassium hydroxide wash, which allows for the sample to be put under a microscope and searched for evidence of fungal growth, or a fungal culture, where the sample piece of nail is put in an environment (usually a petri dish) where it has the necessary components to thrive and create new growth, thus showing what kind of fungal infection it is. In the unlikely event that neither of these tests show positive for onychomycosis, the remaining nail sample can be pulverized and sent to a pathology lab for analysis or submitted for a bacterial culture if it is determined that the infection is bacterial instead of fungal.

Determining what kind of infection you have and what to do about it are very important when dealing with a nail infection of any kind. Having the infected area looked at by a physician, preferably a dermatologist, is the best way to deal with these diseases as they can help to rule out and diagnose serious problems as well as knowing what to do about the infection in the first place.


Leukonychia

Leukonychia

Leukonychia is a nail condition. It manifests as the nail changing color either partially or fully. This disease can be caused by systemic problems or most commonly, it is a genetic disorder. The nail appears to have the standard shape and appearance, except for the fact that the nail turns white. This is caused by the presence of “parakeatotic cells”. These cells have an undeveloped and bulky nucleus, which contain ‘keratohyalins’. This cell variation causes the nail to reflect light and makes the nail appear opaque white.

Types of Leukonychia

True Leukonychia:

This type of Leukonychia is broken into two variations, total leukonychia and partial leukonychia. The difference seems to lie in the nail being either fully white, or only two thirds discolored as it takes a while for the maturation of the keratin to occur and change.

  • Total Leukonychia is an autosomal dominant condition. Other circumstances that may cause total leukonychia to occur are;
    • Leprosy
    • Typhoid
    • Cytotoxic drugs
    • Nail Biting
    • Partial Leukonychia is viewed as a phase of total leukonychia. The most common causes of partial leukonychia are:
      • Metastatic carcinoma
      • Tuberculosis
      • Leprosy

There are three different variants of partial leukonychia.

  • Transverse leukonychia – This causes the nail plate to be multi colored in its opacity. It is seen mostly in women’s fingernails. Possible causes are:
    • Acute respiratory infections
    • High fever
    • Malaria
    • Leprosy
  • Punctuate leukonychia – This is the most common form and can happen to anyone. The telltale symptom is that the nail appears to have tiny opaque spots which fade with time.
  • Longitudinal leukonychia – A small white line under the nail plate

Pseudo Leukonychia

This occurs when a discoloration in the nail appears due to a change in the nail bed. Pseudo leukonychia has three different forms:

  • Terry’s nails – This affects the majority of the nail and makes it multi-colored. The majority of the nail is white, the rest, pink or brown.
  • Muhrecke’s nails – The nail appears to have several white transverse bands
  • Half and half nails – This is seen as a larger part of the nail being dull white and the rest being brownish in color.

Treatment

Increasing the quantity of grains, vegetables and nuts and even taking a zinc supplement (as zinc deficiency is a cause of leukonychia) is a good preventative and treatment, as is keeping affected nails out of harms way when using chemicals of any kind as they can further damage the nail.

Are There Any Over the Counter Nail Fungus Treatments That Actually Prove Effective?

Are There Any Over the Counter Nail Fungus

Treatments That Actually Prove Effective?

As microorganisms go, fungi seem to be one of the strongest strains. It is much harder to kill them than bacteria and viruses. Dermatophyte, molds and yeasts can invade your nails and burrow deep into the nail itself, creating quite the armor of keratin for this marauding nail fungus. This makes treating onychomycoses much more difficult as even powerful antimycotic medications are not always entirely effective. So this begs the question of whether any of the available over-the-counter nail fungus treatments are effective and worth your time and money.

It is an unfortunate but true fact that very few topical treatments, whether prescription or over-the-counter, effectively treat and cure nail fungus infections.

Amorolfine

A very popular over-the-counter topical onychomycosis drug that has been proven to be effective in clinical trials is amorolfine. This topical drug is available without a prescription in a handful of countries such as the United Kingdom and New Zealand. It’s marketing name is Loceryl. Amorolfine comes as a nail lacquer and is painted on the nail like a polish. This leaves the medicine free to penetrate the nail after it has dried and allows it to work over time, just as the nail fungus does. It is active up to a week, then may need to be re-applied.

Amorolfine works by inhibiting the cell membrane of the fungus. It is only effective on distal (or lateral) subungual onychomycosis. This leaves out proximal subungual onychomycosis and superficial white onychomycosis. Knowing which type of onychomycosis you have contracted is important if you wish to choose this over-the-counter method.

Amorolfine is not available in the United States as an over-the-counter remedy, which is inconsistent with other countries’ policies. There are a few side effects but they are mild and rarely occur with proper usage. A burning sensation while applying the lacquer for the first time has been reported, but it goes away quickly. As online pharmacies become more popular, it may be possible to obtain amorolfine in the U.S. via these services who sell it over-the-counter. However cost may be an issue as Loceryl (the commercial name for amorolfine) can cost around $100.00 – $150.00 for a single 5 ml tube.

There are several over-the-counter anti-fungals that are very successful at treating skin fungus problems but are not successful nail fungus treatments.

Lamisil is a decent oral onychomycosis treatment when it is prescribed in tablet form. However it also has an over-the-counter form of a topical cream, which has not proven effective at treating nail fungus.

Lotrimin (also known as clotrimazole) is very effective at treating athelete’s foot and jock itch but has not tested or been shown as a good nail fungus treatment.

Tolnaftate (or Tinactin) is the third over-the-counter product that although it is an excellent skin fungus treatment, does little or nothing for nail fungus.

A more promising solution in terms of over-the-counter medications is an anti-fungal nail liquid of undecylenic acid. Two different papers, one published in 1965 and the other published in 2008 examined the use of undecylenic acid in treating onychomycosis. The 2008 study shows a positive effect, however in these tests the undecylenic acid was combined with cyanoacylate and hydroquinone. There is no definite proof of undecylenic acid being effective on its own.

In the realm of alternative medicine, Tea Tree Oil, (Melaleuca alternifolia) has been shown to have some positive effect on nail fungus. As it is a naturally occurring fungicide and insect repellant, applying a 100% concentration of the oil to the infected area has been reported by small studies to be able to cure 20% of the cases followed. In two-thirds of the patients followed, using Tea Tree Oil caused an improvement in the appearance of the nail fungus infection. Another study compared the twice daily application of 100% Tea Tree Oil and a 1% solution of clotrimazole. The Tea Tree Oil appeared to be slightly more effective at clearing up the nail fungus problem.

Topical products or removing the nail

All of these topical products are applied and have been tested in cases where there has not been surgery to remove the nail before applying the product. It is possible that removing the nail before treatment, via surgical, mechanical or chemical method, may improve the chances of an over-the-counter nail treatment clearing up a nail fungus as this allows the medicine to get directly to the source of the infection. If you are considering surgery or any other form of nail removal as part of your onychomycosis treatment, please ask your surgeon or doctor for information about follow up nail fungus treatments.

If you do not wish to go the surgery route to solve your onychomycosis issues but do wish to cure your nail fungus, the best chance of success still lies with taking oral antifungal agents, which are currently only available with a doctor’s prescription.

What Are The Most Effective Treatments for Nail Fungus Infections?

What Are The Most Effective Treatments

for Nail Fungus Infections?

Figuring out which treatment will work best for you is part of the process of curing your nail fungus infection. There are many options out there and whether this is a long term infection or a very bad infection, it can be eliminated. However this will require patience. It can take months to clear up a nail fungus infection.

Good things to know about treating nail fungus infections

  • Getting rid of a nail fungus infection requires a lengthy treatment, no matter which option you choose.
  • Fingernails tend to clear up faster than toenails. If you have an infected fingernail it is likely that your treatment course will be faster.
  • With some medications, there is a risk of liver damage although this is not common. Your doctor may recommend a blood test to see if your liver is healthy enough to support your treatment
  • The most common method of prescription treatment is an oral medication (pills). Other options include topical treatments that you apply directly to the nail. A more mild case of nail fungus infection may be treated with a nail varnish or Tea Tree Oil.
  • With a severe or reoccurring infection, your doctor may recommend removing part, or the entire nail. This is usually left as a last resort.
  • If your nail fungus infection is mild and doesn’t bother you, it may be best to leave it alone.

Many things can be done to keep a nail fungus infection from reoccurring. To learn more, read “How To Keep From Getting a Fungal Nail Infection”

Available Treatments for Fungal Nail Infections

How to find the best treatment? Here is a list of the currently available treatments for nail fungus infections, divided into three categories to help you determine what might work best for you.

It is always best to consult with your health care provider to determine the best course of action. You can also use current medical research to learn about treatment options.

Most likely to be effective and least harmful:

Itraconazole Pills (commercial name, Sporanox): This is an antifungal oral medication. It treats nail infections caused by fungus.

Terbinafine Pills (commercial name Lamisil): This is an antifungal oral medication. It treats nail infections caused by fungus

Likely to be effective but possibly more harmful:

Fluconazole Pills (commercial name Diflucan): This is an antifungal oral medication. It is used to treat infections caused by fungus but fluconazole is not commonly given for nail infections.

Ciclopirox lacquer: An excellent choice if you wish to avoid taking pills to clear up your nail fungus infection, especially if your case is mild. This antifungal nail polish is applied directly to the affected area. The commercial name for ciclopirox is Penlac Nail Lacquer.

Needs further research:

Griseofulvin Pills (commercial name Grifulvin V): Griesofulvin is actually an antibiotic. It isn’t as effective as other medications in clearing up a nail fungus infection.

Ketoconazole Pills (commercial name Nizoral): Ketoconazole is an antifungal oral medication that is rarely used because it can cause damage to the liver.

Terbinafine Cream or Spray: Terbinafine also comes as a topical cream and a topical spray. Its commercial name is Lamisil

Removing a portion of or all of your nail: This is usually done for very severe nail fungus infections or when people experience reoccurring symptoms. This is a treatment that doctors tend to suggest when all else has failed.

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