To make a toenail dead skin cells are packed tightly together by specialized cells at the root of the nail. As more and more dead cells are added at the root, those that have already been piled up are pushed outward, toward the tip of the finger or toe. This produces a very hard plate to protect the tips of the fingers and toes - a plate that has no sensitive nerve endings, no blood supply, and no immunity to infection. It is essentially dead tissue. The same features, unfortunately, make nail susceptible to colonization by certain fungi that can thrive off the keratin in the packed skin cells. Once a fungus gets well established, it appears to make the toenail dead indeed - the nail typically turns yellow, brown, or black, gets very thick, and starts to simply crumble away like rotten wood. What is happening is that the fungus is working its way between the packed layers of cells, separating them and breaking down the keratin, the substance that makes nails so hard. Though the fungus rarely invades tissue deeply (fungi generally do not invade healthy living tissue), it can spread to other nails or along the surface of the skin where, as in the toenail dead skin cells are present in abundance. Fungal infections of skin on the feet are very common and can spread to the toenails, just as a fungus can spread from the nails to the skin. Once a fungal infection is established and progressing, it can be very difficult to treat, especially in the nails. Successful treatment of a fungal nail infection hinges on getting the medication to the fungus. Again, the nail's protective features make it difficult to achieve this because any applied treatment tends not to penetrate the nail to kill the fungus. People have come up with various strategies to get around this problem. Soaking the feet in dilute solutions of chlorine bleach, vinegar, or hydrogen peroxide not only acts on any fungus it contacts, but also soften up the toenails. If you then use a file across the top surface of the toenail dead crumbly infected nail will be filed away and a lower layer will be exposed. Treatment can then be applied, and the process repeated daily until the nail infection is gone. Though topical antifungals are not usually very good at penetrating nail, some of the newer natural remedies claim to do a better job. In addition, one topical prescription drug is now available, along with several oral antifungal medications. Be aware, however, that these prescription drugs are expensive and have the potential for unpleasant side effects. |
