Onychomycosis, or nail fungus, is a very common condition. In fact, nail fungus causes as much as half of all nail problems, and it accounts for about 30% of all skin fungus infections.
If you have diabetes, you’re at a higher risk of contracting nail fungus, and any infection you get can be more severe than it is for someone without diabetes. Studies show that about one in three people with diabetes also have nail fungus. This is a dangerous combination, because even a mild case of nail fungus can lead to serious complications when you have diabetes.
This article will give you a full overview of the connection between diabetes and nail fungus. We’ll explore the reasons why people with diabetes are more vulnerable to nail fungus infections, how nail fungus is diagnosed, and what treatments are available. We’ll also talk about ways to prevent nail fungus infections from happening in the first place.
The link between diabetes and nail fungus
If you have diabetes, you’re more likely to get nail fungus. And if you get nail fungus, it can lead to more serious problems.
Why are people with diabetes more susceptible?
Diabetes can make you more vulnerable to nail fungus for several reasons:
- Weakened immune system. High blood sugar can weaken your immune system and make it harder to fight infections.
- Poor circulation. Diabetes can reduce blood flow to your feet, which means your body can’t deliver enough immune cells and nutrients to fight the infection.
- Diabetic neuropathy. Nerve damage can reduce sensation in your feet, so it’s harder to notice the early signs of infection. The pain and discomfort you’d expect from an infection may not be there.
- Elevated blood sugar. Fungus thrives on sugar, so high blood sugar levels make your nails a welcoming place for fungal growth.
- Microtrauma. Small injuries to your nails and the skin around them can create openings for fungi to enter.
Potential complications
Nail fungus can cause serious problems for people with diabetes:
- Secondary infections. People with diabetes and nail fungus have a higher risk of developing secondary infections in their feet.
- Gangrene and foot ulcers. People with diabetes and nail fungus are more likely to develop gangrene or foot ulcers.
- Increased risk of amputation. Nail fungus can increase the risk of serious complications that lead to limb amputation.
How do I know if I have nail fungus?
If you have diabetes, it’s important to pay close attention to your feet and nails. Changes in your feet could be a sign of something serious, and you may want to find ways to fix ugly toenails.
Here’s what to look for if you think you might have a nail fungus.
Symptoms of nail fungus
If you have a nail fungus, you may notice these signs:
- Changes in nail color: Your nail may be yellow, white, or darker than usual.
- Changes in nail texture: Your nail may be thicker, brittle, or crumbly.
- Changes in nail shape: Your nail may be distorted or lift up and away from the nail bed.
- Pain or discomfort: Although nerve damage from diabetes (neuropathy) can mask pain, some people may still have pain or discomfort.
How is nail fungus diagnosed?
If you notice any of the symptoms above, see a healthcare provider for a diagnosis.
A healthcare provider will visually examine your nail and the skin around it. They may also order lab tests to figure out what’s going on. These tests can include:
- KOH preparation
- Fungal culture
- Histopathology (PAS stain)
It’s important to get an accurate diagnosis so you can be sure you’re dealing with a fungal infection and not some other nail condition. Also, testing can help the healthcare provider identify exactly which organism is causing the infection.
Treatment options for nail fungus in people with diabetes
If you have diabetes and nail fungus, your doctor will probably recommend one of the following treatments.
Topical antifungal medications
These are creams, lacquers, and solutions that you put directly on the nail. They tend to work best for mild infections and are generally less effective than pills, except for a condition called superficial white onychomycosis. If you are looking for alternative treatments, you may consider researching Betadine for toenail fungus.
Examples of topical medications include ciclopirox, efinaconazole, and tavaborole.
The good thing about topical medications is that they are less likely to cause widespread side effects in your body.
The downside is that they don’t cure the infection as often as other treatments, especially for severe infections.
Oral antifungal medications
Oral medications travel through your bloodstream to reach the infection. Some common examples are terbinafine, itraconazole, and fluconazole. Terbinafine is often the first choice because it’s safe and doesn’t cost too much.
Pills tend to have a higher cure rate than topical treatments.
However, they can also cause side effects and interact with other medications. If you take oral antifungal medications, your doctor will need to keep an eye on your liver function.
Combination therapy
To increase your chances of getting rid of the infection, your doctor might recommend combining topical and oral medications.
In some cases, this can be more effective and shorten the length of treatment.
Laser therapy
Laser therapy uses focused light energy to kill the fungus. One example is the Q-Clear™ Nd:YAG laser treatment, which can help with severe toenail fungus when other methods don’t work.
Laser therapy is non-invasive and has few side effects.
The downside is that it can be expensive, and you might need to go back for multiple treatments.
Nail trimming and removal
Nail trimming
Your doctor might trim or file down the infected nail to make it thinner and easier for medications to penetrate.
Nail removal
In very severe cases, your doctor might recommend surgically removing the nail. But this isn’t the preferred option for people with diabetes because it can lead to complications.
The Importance of Foot Care and Prevention
If you have diabetes, taking care of your feet is one of the best things you can do to stay healthy. Here are some ways to prevent nail fungus and other foot problems.
Daily Foot Inspection
Make it a habit to check your feet every single day for sores, cuts, redness, swelling, or nail problems. If you spot anything unusual, don’t wait. Contact your podiatrist right away.
Proper Foot Hygiene
Wash your feet every day with warm water and a mild soap. After washing, dry your feet very well, especially between your toes. Moisture can create a breeding ground for fungus.
Nail Care
When you trim your toenails, cut them straight across. This helps prevent ingrown toenails, which can easily become infected. Don’t cut your nails too short.
Choosing the Right Footwear
Always wear shoes and socks, even indoors. Choose shoes that fit well and don’t squeeze your toes. Look for socks made of a material that wicks away moisture, like cotton or wool. Change your socks every day.
Regular Podiatrist Visits
If you have diabetes, it’s important to see a podiatrist regularly for checkups and preventive care. A podiatrist can spot problems early and help you take care of your feet. Dr. Francine Rhinehart encourages all her diabetic patients to schedule regular visits for foot care and maintenance.
Monitoring Blood Sugar Levels
Keeping your blood sugar levels in your target range is key to preventing all kinds of complications from diabetes, including foot problems. High blood sugar can weaken your immune system and make you more prone to infections, including nail fungus.
Frequently Asked Questions
How do I get rid of nail fungus ASAP?
Getting rid of nail fungus quickly can be tricky. While over-the-counter treatments exist, they often aren’t very effective. Prescription oral antifungals are usually the fastest route, but they come with potential side effects. See a doctor or podiatrist for the best treatment plan tailored to your situation.
Should I wear socks to bed with toenail fungus?
Wearing clean, breathable socks to bed can help keep your feet dry and prevent the fungus from thriving. Choose moisture-wicking materials like cotton or wool. Change your socks daily and wash them in hot water to kill any lingering fungus.
What do B12 deficiency nails look like?
B12 deficiency can manifest in your nails in various ways. You might notice bluish nails, darkened nail beds, or unusual ridges. Some people also experience rounded nail ends and nail thickening. If you suspect a B12 deficiency, consult your doctor for testing.
Why can’t diabetics cut their toenails?
It’s not that diabetics can’t cut their toenails, but they need to be extremely careful. Diabetes can cause nerve damage (neuropathy) and poor circulation, making it difficult to feel minor cuts or infections. What might seem like a small nick could quickly become a serious problem. Many doctors recommend that diabetics have their toenails trimmed by a podiatrist.
Which antifungal is safe for diabetics?
The safest antifungal for diabetics depends on the individual’s overall health and other medications they’re taking. Topical antifungals are generally considered safer than oral medications, but they might not be as effective for severe infections. Always consult with your doctor or podiatrist to determine the most appropriate and safe antifungal treatment for your specific situation.
Summary
If you have diabetes, you are at a higher risk of getting nail fungus. While it might seem like a cosmetic issue, onychomycosis (nail fungus) can lead to serious complications if you have diabetes. This is because diabetes can affect your circulation and immune system, which makes it harder for your body to fight off infections.
The sooner you catch and treat nail fungus, the better your chances of avoiding complications. You’ll also want to take extra care of your feet to keep them healthy and prevent future infections.
If you have diabetes, work closely with your healthcare providers to monitor your foot health and take steps to prevent nail fungus. You should have your feet examined regularly, even if you don’t have any pain or discomfort, because diabetes can cause you to lose feeling in your feet.
It’s important to educate yourself about nail fungus and how to prevent it. Taking good care of your feet is an important part of managing your diabetes and staying healthy.