Elizabeth is an experienced freelance writer, specializing in health & wellness, education & learning, family life & parenting, and women's issues. She's been published on Huffington Post, and was a regular contributor to Love Live Health and Daily Home Remedy. Elizabeth is a retired primary school principal and education consultant, with a continuing passion for education and learning. She's familiar with writing newsletters, reports to stakeholders, financial reports, business plans and evaluation reports.
Dr. Kyoung Min Han is a podiatrist (foot and ankle specialist) practicing in Southern California. Dr. Han completed her undergraduate education at the University of California, San Diego, and went on to the New York College of Podiatric Medicine to pursue her medical training. She returned to her native Southern California to complete a three-year foot and ankle surgical residency, followed by subspecialty training in a sports medicine fellowship.
For some people, a fungal infection of the nails can be difficult to cure and the first round of medication might not work. The nail infection can’t be considered cured until a new nail that’s free from infection has grown in. Although this indicates that the nail is no longer infected, it’s possible for the fungal infection to return. In severe cases, there may be permanent damage to your nail, and it may have to be removed.
If the diagnosis is uncertain, direct microscopy of a potassium hydroxide preparation of a skin scraping (known as a KOH test) can confirm the diagnosis of athlete's foot and help rule out other possible causes, such as candidiasis, pitted keratolysis, erythrasma, contact dermatitis, eczema, or psoriasis. Dermatophytes known to cause athlete's foot will demonstrate multiple septate branching hyphae on microscopy.
Other causative pathogens include Candida and nondermatophytic molds, in particular members of the mold genus Scytalidium (name recently changed to Neoscytalidium), Scopulariopsis, and Aspergillus. Candida species mainly cause fingernail onychomycosis in people whose hands are often submerged in water. Scytalidium mainly affects people in the tropics, though it persists if they later move to areas of temperate climate.
Candida albicans is a common yeast that grows inside the human body. In healthy people, other bacteria and immune cells keep this yeast under control so it doesn’t cause any problems, but in some people candida can become overgrown and cause infections in various areas. One of the ways candida shows up is through the skin where it can cause noticeable reactions or infections. Other ways are on the mouth, vagina and anus.
If you have diabetes or a weakened immune system, treatment is especially important. After getting a fungal nail infection, people who have diabetes have an increased risk of developing sores that do not heal. Sores that do not heal can lead to a serious health problem. It’s important to see a dermatologist (or other doctor) at the first sign of a nail problem. A dermatologist can tell you whether you have a nail infection or something else.