Removing The Infected Nail
A podiatrist a foot doctor may recommend removing the infected toenail entirely. In the absolute worst-case scenarios, removing the toenail may not be enough instead, it may require amputating the toe.
While removing the infected nail is certainly an effective option, it is one that leaves people with diabetes feeling like they cannot wear open-toed shoes or sandals due to shame, embarrassment, or discomfort.
A Pharmacist Can Help With Fungal Nail Infections
Speak to a pharmacist if the look of your nail bothers you or it’s painful.
They may suggest:
- antifungal nail cream it can take up to 12 months to cure the infection and does not always work
- nail-softening cream it’s used for 2 weeks to soften the nail so the infected part can be scraped off
The infection is cured when you see healthy nail growing back at the base.
Diabetic Wound Care And Onychomycosis
Did you know that certain foot problems are often early signs of diabetes? If you have diabetes, you may suffer from sores that dont heal, numbness, weakness, burning or coldness, blisters, dry skin, itching and other disorders of the feet. If left untreated, you are at risk of infection and other severe foot problems.
Diabetic foot problems are one of the leading causes of amputations of the lower limbs. A damaged nervous system is often to blame. Weakened nervous systems arent able to effectively convey messages from the feet and this causes numbness. Normal sweat secretion and oil production in the feet are also impaired causing abnormal pressure and skin issues that often result in sores. Unfortunately, the disease often renders the body unable to effectively fight off infections. And these open sores, or ulcers, on the bottom of the feet lead to bacterial infection, which can lead to amputation in severe cases. But the good news is, research shows that most diabetic foot ulcers are preventable with regulated blood sugar control and regular foot care.
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The Link Between Diabetes And Nail Fungus
Checking your feet every day is crucial if you have diabetes. As you may well know, your podiatrist and primary care physician encourage you to report any new sores or unusual defects on your feet as they can lead to major foot complications like foot and ankle ulcers. Your feet may not have much sensation due to diabetic neuropathy, so you might not know of a wound or injury unless you take a look.
At our Dallas, Texas, office, board-certified podiatrist Dr. Francine Rhinehart encourages all her diabetic patients to make regular visits for diabetic foot care and maintenance. What you might not expect is to find toenail fungus, a common complication of diabetes that also happens to be one of the most common issues podiatrists treat.
Risks Of Yellow Nails
The thickening that comes along with yellow nails can make it harder and more painful for you to walk. Thickened nails are also sharper than usual. They can dig into the skin of your foot.
If you do get a cut on your foot, nerve damage from diabetes may make it hard for you to feel the injury. Bacteria can find their way into the open sore, causing infection. If you dont feel the injury and dont treat the infection, it could damage your foot so much that you need to have it amputated.
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What Does Diabetes Do To Your Toes
Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcots foot. Charcots foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a rocker bottom.
Recommended Nail Fungus Treatment For Diabetic Patients:
The solution to a problem-free nail for diabetics is early detection for any signs of a nail fungal infection. Its important that onychomycosis is treated right away so as to avoid the dangerous complications that may arise after. Essentially, the treatment of nail fungus for diabetic patients is similar to non-diabetic patients, with the consideration that the fungal infection is in its early stages. At the moment, several treatments and procedures are available to the public. Here are your available options as a diabetic patient:
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What Is Tinea Unguium
When a dermatophyte causes toenail fungus, the condition is called tinea unguium. A dermatophyte is a mold that needs a protein called keratin to grow. Keratin is the main structural material of your nails that makes them hard. Dermatophytes cause 90% of toenail fungal infections. Tinea unguium is also known as onychomycosis.
What Does A Diabetic Toe Nail Look Like
What to Look For in Diabetic Toenails. The first toenail change youll notice in diabetic patients is likely to be discoloration. Most have some yellowing of the nails, though the shade and involvement can vary. Discoloring may start at the distal edge , and run all the way to the root of the nail bed.
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Pincer Or Trumpet Nail
An extreme curvature that increases distally, like a trumpet or cone formation. As the nail rolls or curls inward, it can cause skin breakdown and ulceration, and be extremely painful for the patient . Once again, ill-fitting shoes can add to the problem, as well as bone spurs and fungal infections. Some patients also have a hereditary predisposition toward nails that curl in this formation.
Should Diabetics Cut Their Own Toenails
Myth: People with diabetes cant cut their own toenails Not true: the general advice on toenail cutting applies to everyone. If you have diabetes you should keep your nails healthy by cutting them to the shape of the end of your toes. Dont cut them straight across, curved down the sides, or too short.
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Neuropathy And Poor Circulation: A Bad Combination For Those With Diabetes
Those with diabetes often have neuropathy or nerve damage. This condition causes loss of sensation in the extremities like the legs and especially the feet. With reduced sensation in the feet, a small injury like a bruise, cut or puncture can quickly worsen into a serious problem before you feel or notice it.
Another problem for those with diabetes is poor circulation. Diabetes causes excess sugar complexes and plaque in the blood as well as inflammation, so the blood vessels narrow and the blood flow decreases. These factors combine to cause poor circulation in the extremities, especially the feet and legs, which can hinder healing.
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Diabetes And Foot Problems
For people with diabetes, having too much glucose in their blood for a long time can cause some serious complications, including foot problems. you might like Diabetes can cause two problems that can affect your feet: Diabetic neuropathy. Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called “sensory diabetic neuropathy.” If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of the foot may not function properly, because the nerves that make the muscles work are damaged. This could cause the foot to not align properly and create too much pressure in one area of the foot. It is estimated that up to 10% of people with diabetes will develop foot ulcers. Foot ulcers occur because of nerve damage and peripheral vascular disease. Peripheral vascular disease. Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called “peripheral vascular disease.” Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart. If you have an infection that will not heal because of poor blood flow, you are at risk for developing ulcers or gangrene .Continue reading > >
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Its important to maintain a healthy body weight. You should also make sure that you drink plenty of water, and limit your intake of sugary drinks. In addition, make sure that you get regular exercise. You should also avoid alcoholic beverages. Lastly, you should avoid alcohol. These beverages contain high amounts of sugar. If you dont drink enough, youre not doing anything to prevent diabetes. Besides, drinking alcohol can be harmful to your health.
The most important thing to do is to follow the recommended diet. Eat more healthy foods that have low amounts of fat and high amounts of fiber. The best way to lose weight is to lose 7 percent of your body weight. If youre overweight, you should try to lose 14 pounds to reduce your risk of developing type 2 diabetes. However, you should not attempt to lose weight while pregnant. Talk to your doctor about what kind of weight is safe for you.
Besides high blood glucose, diabetes can also affect the nerves and skin. It may affect your sexual response and your nervous system. It can also affect your fertility. Women with diabetes are more likely to miscarry or have a baby with a birth defect. It can cause a person to have difficulty hearing and sleep. If the condition is left untreated, it can lead to type 1 diabetes and can even lead to amputation.
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How Can Ingrown Toenails Be Treated
In mild cases, ingrown toenails may be treated with a 15-20-minute soak in warm water. Dry cotton can be placed under the corner of the nail. Talk to your doctor if you are experiencing increasing pain, swelling, and drainage of the area. Minor surgery can be performed to remove the part of the nail that is poking into the skin.
Treating Nail Fungus When Diabetic
Q1. What can be done about nail fungus with a diabetic? I am 36. I’ve been a diabetic for over 12 years . My left foot has always been prone to athlete’s foot and now my nails are turning black. The nail on my left big toe is totally blackened. I’ve cut the nail down to the cuticle. Is this safe? My doctor said, “Get rid of the nail, get rid of the fungus.” So, I got rid of the nail . What advice can you offer? Should I have the entire nail removed?
It seems that you and your doctor have taken the surgeon’s approach to toenail infection!
Removing the toenail completely is not recommended for individuals who have diabetes, since the risk of complications due to poor wound healing and infection is high. I would highly recommend that you go to your doctor or a podiatrist to manage the trimming and, if necessary, the removal of the nail. Reasons for removal include the following reasons: if leaving the toenail will cause further complication, if trimming does not achieve the desired result, and/or if you are not eligible for antifungal agents.
Since you have recurring athlete’s foot, you might also consider the following guidelines:
Q2. I have type 2 diabetes. I have fungus on two of my toes. I was told by the doctor that he could remove my toenails permanently. I don’t know if this would be the best solution. What do you think?
Q3. I have diabetes. Is it safe to get a pedicure?
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Patients With Diabetes: Take Toenail Fungus Seriously
Fungal toenaildisease spreads slowly and usually goes unnoticed, but, once it becomesapparent, it means it has become deeply embedded inside the toenail.
At Paul S. DeMarco, DPM, weadvise our patients with diabetestobe extra cautious of toenail fungus, as it can cause serious complications ifnot taken care of properly. Infected toenails can become brittle and tend tobreak into sharp or pointy shapes, thereby increasing the risk of cuts, wounds,tissue and skin damage, and ultimately allowing bacteria to creep in.
Manypeople with diabetes suffer from nerve damage or neuropathy, which can causeloss of sensation in their lower extremities. The patients may not be able tofeel any cuts or scrapes which can expose them to further infections, pus, andthe likelihood of ulcers.
Itis important for anyone to keep their feet healthy and free of fungalinfections, especially for anyone who has diabetes.
Here are a few simple footcare tips to adopt into your everyday routine:
· Check your feetregularly for anything unusual such as sharp objects, cuts, and blisters.
· Wash your feetdaily in soapy water and dry them thoroughly, especially between the toes.
· Protect your feetat communal showers, public pools, spas, and gym by wearing socks and shoes.
· Select yourfootwear wisely so that sweat and moisture do not get locked inside them.
· When trimmingyour toenails, make sure that you use clean and properly sterilized tools.
Causes Of Nail Fungus
With fungal nail infections, the main cause is typically
Certain behaviors and preexisting conditions that can affect your risk of nail fungus include:
There are many overlaps between nail fungus and nail cancer. Since its easy to mistake cancer of the nail for a fungal infection, you should see a doctor immediately to get a definitive diagnosis.
See a doctor immediately if you suspect you have toenail fungus or subungual melanoma.
Since the prognosis of subungual melanoma gets worse the longer it takes to diagnose, its better to be safe and get any possible symptoms checked out and cleared as soon as they appear.
Fungal infections are not considered life-threatening, but the 5-year survival rate for subungual melanoma can vary dramatically depending on how early the cancer is identified. According to the Canada Dermatology Association, chances of recovery can range anywhere from 16 to 80 percent .
If you wait too long for diagnosis and treatment, theres a risk of the cancer spreading throughout the bodys organs and lymph nodes.
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Topical Creams Or Suppositories
A doctor will usually recommend these first, as they work well during the early stages of an infection.
The doctor may prescribe an antifungal cream to apply directly to the affected area for up to 7 days.
Antifungal creams and suppositories are available over the counter, but a person should speak to a doctor before using them.
This is because:
- The problem may not be a yeast infection.
- Using these medications too frequently can cause yeast to become resistant to them.
Surgery And Laser Treatments:
Removing the nail sounds like the best solution to treating a recurring and severe nail infection. However, diabetics should be warned about the possible complications of this procedure. Surgical nail avulsion is rarely used to treat onychomycosis in diabetic patients because of the increased risk for secondary infections, gangrene, and poor wound healing. Laser treatment, on the other hand, is the newest technology in medical treatment of nail fungus. Its a very expensive aesthetic procedure wherein laser is used to destroy and kill fungus. Although it is a promising treatment, not enough research has been conducted to prove its efficiency.
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When To See A Doctor
Toenail fungus is a common problem that can cause your nails to become discolored, thick, and brittle. If you think you might have toenail fungus, its important to see a doctor so they can confirm the diagnosis and prescribe the appropriate treatment. Here are some signs that its time to see a doctor for your toenail fungus:
-Your nails are yellow, brown, or black and theyre thickening or crumbling.
-Your nails have become unusually brittle.
-Youre experiencing pain in your toes or nails.
-You have diabetes or another condition that affects blood flow to your feet.
Extra Sugars In Yeast
Diabetes can also make it easier for yeast and other pathogens to cling to skin cells and mucus glands. This may be because of the presence of extra sugars, which allow the yeast to colonize at unhealthy levels.
When blood glucose levels are high, the body may excrete extra sugar in the:
Yeast feeds on sugar, making these secretions the most likely factor in overgrowth.
People with diabetes also have increased glycogen levels, a polysaccharide that the body uses to store glucose. Extra glycogen in the vaginal area can lead to an increase in acidity. According to a study published in 2009 in the American Journal of Obstetrics and Gynecology, this can contribute to yeast growth.
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Can Diabetes Affect Your Toenails
The nails may become yellow, yellow-brown, light brown, or even black. You need to be extra careful when it comes to foot infections because letting an infection go untreated could lead to serious complications like amputation.
Fungal infections are very hard to treat and you should see your doctor as soon as you notice any discoloration which may cover either part of the nail or the entire nail.
Can I Wear Nail Polish If I Have Toenail Fungus
You may feel tempted to cover up a discolored toenail with nail polish. But if youre using a topical antifungal, you probably shouldnt use polish. Your healthcare provider may tell you not to wear it in any case.
Nail polish traps in moisture from your nailbed . Because fungi thrive in moist environments, wearing nail polish may make a fungal infection worse. However, your nail continues to grow with or without polish.
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