Nail Fungus Statistics

We hear that more people are getting fungal nail infections (onychomycosis) than ever before, and that these infections are more prevalent in certain groups, but how often do we get any real nail fungus statistics? Just how many people get onychomycosis; what are the risk factors, and what types of infections do they get? Are the numbers we hear passed around accurate? What’s the most common form of treatment? Very few scientific studies have tried to accurately answer these questions. Recently, researchers in France published the results of a fifteen month survey of dermatologists in that country.

One of the more interesting statistical facts for onychomycosis coming from the study is that in many cases, the dermatologists did not do any laboratory testing before treating patients for the infection. This is important because, of those who did have samples sent to the lab for fungal culture, about a third had negative results. Although some of these were probably false negatives, it’s clear that not everyone with suspicious symptoms actually has onychomycosis—and when people are treated without confirming the diagnosis, it puts them at risk of side effects and skews nail fungus statistics.

Also of interest, the study found that the majority of patients had toenail infections (88.7%), and that the majority of these infections were caused by a dermatophyte – a fungus that lives in hair, skin, and nails. The nail fungus statistics results showed that the few people with fingernail infections usually had yeast infections – infections caused by the same organism that causes oral thrush and vaginitis, or a closely related organism.
Almost three quarters of toe infections involved the nail bed nearest the tip of the toe. Statistical facts for onychomycosis gathered also identified some associated diseases, such as diabetes; however, these involved only a small number of patients.

The study looked at treatment as well. As would be expected, French dermatologists often used oral pharmaceutical treatments (59% of cases) as opposed to topicals, and the resulting statistical facts for onychomycosis do not provide any information about popular home remedies or alternative treatments. In 65% of treated infections, two medications were used at the same time, reflecting the current difficulty of treating these stubborn fungal infections. Though one study does not does not give us the whole truth about nail fungus statistics, it does provide valuable information about the current situation.

Source: Guibal, F., R. Baran, E. Duhard et al. “Epidemiology and Management of Onychomycosis in Private Dermatological Practice in France.” Ann Dermatol Venereol 2008 Aug-Sep; 135(8-9):561-6.

Nanoparticles for Nail Fungus

One of the most recent advances in the treatment of fungal nail infections (onychomycosis) is the development of nanoparticles for nail fungus. The particles, droplets one millionth of a millimeter wide, are suspended in a liquid that scientists hope will prove a potent topical treatment for a stubborn health problem. When these tiny droplets come in contact with fungal spores or hyphae (the long branching stalks typical of actively growing moulds and other fungi) they fuse with the cell membrane and cause it to disintegrate, spilling its contents and killing the cell.

A nanoemulsion treatment for onychomycosis makes sense because one of biggest obstacles to treating fungal nail infections is getting a topical antifungal to the infected area. Fungi typically begin to grow under the edge of the nail and spread adjacent to the nail bed, protected from the outside world by the hard, impermeable nail. Topical ointments applied from above can’t penetrate the nail, but nanoparticles for nail fungus are so tiny that they not only go through the nail, they also penetrate the surface of the skin and travel through the nearby tissue to reach the fungus.

Nanoemulsion treatment for onychomycosis appears to be safe. A study that followed twenty volunteers who used the suspension found that there were very few side effects, and the majority involved only mild skin irritation. In addition, the nanodroplets do not appear to be absorbed into the body except in the local area of infection. Volunteers in the study applied the nanoparticles for nail fungus to the surface of the nail and surrounding skin twice each day for four weeks. Study conclusions were that the treatment was safer than the oral drugs currently available to treat this type of infection.

It remains to be seen how well nanoparticles for nail fungus will work over the long term and with infections caused by different species of fungus. In laboratory testing, the suspension had lethal effects on four common dermatophytes (fungi that infect skin, hair, and nails) and against yeast, at a concentration about one thousand times less than the concentration of the solution used in the study. This bodes well for the future of the treatment. More clinical trials have already begun to confirm the efficacy and safety of nanoemulsion treatment for onychomycosis.

Source: Jones, T., M. Flack, M. Ijzerman, and J. R. Baker Jr. “Safety, Tolerance, and Pharmacokinetics of Topical Nanoemulsion (NB-002) for the Treatment of Onychomycosis.” Presented at American Academy of Dermatology Annual Meeting, February 1-5, 2008, San Antonio, Texas.