People who never dare to show their feet in summer have this unspeakable secret (it’s not athlete’s foot, it’s contagious)

In the hot summer, when others wear light sandals and open-toe slippers to enjoy the coolness, there is a group of people who dare not expose their feet.

The reason why they choose to hide their feet is not because of athlete's foot or foot odor, but because there is a problem that is more unbearable than athlete's foot and foot odor - gray! nails! nails!

Onychomycosis, a disease that sounds like something people would rather avoid, greatly affects our appearance. I believe many people are suffering from it, and even many pedicure shops on the street are trying to practice medicine in violation of regulations and advertise that they can treat onychomycosis.

Today, we are going to remove onychomycosis and try to give everyone beautiful toenails.

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The truth about onychomycosis

There are two big misunderstandings about onychomycosis. One misunderstanding is that graying of the nails is onychomycosis; the other misunderstanding is that onychomycosis is just a change in the nails. In fact, onychomycosis is not what many people imagine.

The formal medical name for onychomycosis is "onychomycosis". As the name suggests, it is a nail disease that occurs after fungus infects the fingernails or toenails.

The fungi that cause onychomycosis generally prefer warm, humid, sweaty, and airtight environments. Therefore, in the summer, sweating and warming up toes are more likely to be colonized by fungi and cause infection.

The true face of onychomycosis is not as simple as turning gray. In detail, onychomycosis often manifests itself in nail discoloration (some white, some yellow), nail thickening (or increased keratin under the nail), nail separation (that is, the nail and toe do not fit well), nail plate cracking (that is, nail plate cracking), etc. In severe cases, there is also damage to the nail plate, like a crushed sesame cake.

The following pictures are typical examples of onychomycosis. You are welcome to check which ones apply to you.

Figure 1. Onychomycosis of different severity (organized from reference materials)

However, sometimes, onychomycosis is not very typical and may be confused with other similar nail diseases. For example, when the shoes do not fit well, high heels are worn for a long time, or when running and climbing are frequent, the toenails will also undergo corresponding changes due to repeated mechanical action, especially the tendency to thicken and turn yellow. At this time, do not easily diagnose it as onychomycosis.

In addition, onychomycosis has some characteristics, such as:

Onychomycosis mainly affects adults and is much less common in children.

Onychomycosis is chronic, appears gradually and gets worse gradually;

Onychomycosis usually persists for a long time and rarely heals on its own (the exception is when children have onychomycosis and the lesions are relatively mild);

Onychomycosis is basically painless and causes no itching (except when it causes paronychia or cellulitis).

Onychomycosis may gradually spread to the surrounding nails and is often accompanied by athlete's foot (scientific name: tinea pedis).

If you want to further determine whether it is onychomycosis, the safest way is to ask our dermatologist for help. The doctor can help confirm the diagnosis through "eagle eyes and golden eyes", dermoscopy, microscope examination and other means to minimize the risk of misdiagnosis and mistreatment.

How did onychomycosis come about?

Some people may be curious about why onychomycosis occurs out of nowhere.

The essence of this question is actually thinking about how onychomycosis is transmitted.

First of all, we need to know that the fungus that causes onychomycosis feeds on keratin. The source of keratin includes both the nail and the surface of the skin, but the keratin of the nail is very dense and hard, which is equivalent to the bones we chew.

Based on this, it is not difficult to know that fungi can have several infection pathways:

· Path 1: There is fungus on one's skin, which accidentally infects one's toenails. A common situation is that one has athlete's foot, and the fungus on the foot infects the adjacent nails.

· Route 2: If you have onychomycosis, you can infect two others. Although this is a widely circulated advertising slogan, it is not groundless.

· Route 3: Direct contact with someone else's lesions, including their feet or toenails. This can also be transmitted, but the probability of the drug being less effective.

· Route 4: Indirect contact with fungus-contaminated items, such as shared slippers and nail clippers. Another indirect route of infection is walking barefoot in public areas, such as the floors of public bathrooms and swimming pools.

Therefore, if onychomycosis comes to you, it must be because someone opened the door for you. This door is either "direct contact" or "indirect contact". In short, onychomycosis does not come out of nothing.

Onychomycosis prefers these people

Although onychomycosis is contagious and the diseased nails themselves are contagious, not everyone will get onychomycosis. It is not like chickenpox or hand, foot and mouth disease, which are highly contagious and susceptible to infection by the general population, but rather it has a specific preference group.

So, who are the "unlucky ones"? We have sorted out the following groups of people who are more likely to get onychomycosis:

Elderly population: Big data shows that as the elderly population increases, the prevalence of onychomycosis will also increase;

· Skin diseases: especially those with athlete's foot, psoriasis, or hyperhidrosis, are more likely to be infected with onychomycosis;

Skin damage: When the skin or nails are damaged, fungi are more likely to take advantage of it. Even people who often do manicures have a greater risk of infection than ordinary people.

Poor hygiene habits: such as wearing shoes that are not breathable, not liking to wash feet, not cleaning nails properly, and often soaking nails in water;

· Having certain chronic diseases: the classic disease is diabetes, which can easily affect the immune system, reduce resistance to fungi, and therefore make it more susceptible to infection;

· Use of immunosuppressive drugs: such as oral hormones, which generally reduce the body's immune response and increase the risk of infection.

However, nothing is absolute. The above only talks about the population that is relatively susceptible to onychomycosis, and it is a matter of probability. If you want to stay away from onychomycosis, you still have to take the initiative.

How to stay away from it? Let’s read on.

Stay away from onychomycosis, here are the secrets

As an infectious skin disease, to stay away from onychomycosis, we have three key points:

Point 1: Control the source of infection

Point 2: Cut off the transmission route

Key point 3: Treat vulnerable groups

Below, we have used a table to sort out the things that can be done in each link, all of which can help us stay away from annoying onychomycosis step by step.

Table 1. Summary of tips to avoid onychomycosis

The above measures can not only reduce the risk of infection, but even if you have onychomycosis, taking relevant protective measures can also reduce the risk of recurrence, aggravation and transmission to others.

Well, today's "hands-on" popular science about "onychomycosis" ends here. Although onychomycosis is quite stubborn, it is believed that this unspeakable secret can be better controlled through scientific treatment and targeted daily protection.
I hope everyone can confidently wear sandals and slippers, show their toenails, and enjoy the coolness and comfort of summer!

References

[1] Jin Park, Jae-Hui Nam, Ji Hyun Lee, et al. Korean guideline for the diagnosis and treatment of onychomycosis: Purpose and process of algorithm guideline development. JMI. 2018, 23(2): 33-44.

[2] Onychomycosis epidemiology, clinical features, and diagnosis. UpToDate. https://www.uptodate.com/contents/zh-Hans/onychomycosis-epidemiology-clinical-features-and-diagnosis

[3] Toenail Fungus. Cleveland clinic. https://my.clevelandclinic.org/health/diseases/11303-toenail-fungus

Planning and production

Author: Tang Jiaoqing, MD, attending physician of dermatology

Review | Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital

Planning丨Zhong Yanping

Editor: Zhong Yanping

Proofread by Xu Lailinlin