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The
most common cause of yellowed, thick and/or deformed toenails is
a fungal infection of the toenail. The fungus that infects the nail,
most commonly, is the same fungus that causes athlete's foot. It
tends to be slowly progressive, damaging the nail to a greater and
greater degree over time. The infection usually starts at the tip
of the nail and works its way back. It usually is not painful and
often not noticed until it has gotten well established. A single
toenail or any number of nails can be affected. It can also occur
on just one foot. Over time, the nail becomes thickened, crumbly,
and distorted in appearance. Sweaty feet contribute to the initial
infection process and contribute to its spread. The fungus prefers
an environment that is moist, dark and warm, which is why it affects
the toenails much more often than fingernails. It does not spread
through the blood stream. The infection limits itself to the nails
and skin. It is often found in association with areas of dry scaly
skin on the bottom of the foot or between the toes. The dry scaling
skin is frequently found to be chronic athlete's foot. It is not
highly contagious, and family members are almost as likely to contract
it from some other source as they are from the family member who
has the infection. Keeping common showering areas clean is recommended,
and sharing shoes should be avoided.
Not all thickened or yellowed
toenails are caused by a fungal infection. Injury to a toenail can
cause the toenail to grow in a thickened or malformed fashion, due
to damage to the nail root. In these instances, treatment with anti-fungal
medications will not correct the malformed nail. Other causes of
thickened toenails are small bone spurs that can form under the
toenail, and psoriasis.
It is best to treat the
condition as soon as it is noticed. In early cases, over the counter
medications may be sufficient. In more advanced cases, prescription
medication may be needed. There are effective topical and oral medications
available for the treatment of fungal toenails. On occasion, your
doctor may recommend removing the toenail.
It is also important to treat any concomitant athlete's foot that
may be present. If sweaty feet are a problem, changing shoes and
socks during the day is recommended. There are topical medications
available that help to reduce sweating of the feet.
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