Can Fungal Nail Infection Cause Pitting?

A fungal nail infection causes the appearance of the nail to change and may cause pitting. Nail psoriasis causes pitting on the surface of the nail the two conditions look very similar and require a medical diagnosis to differentiate between the two.  Treatment for both conditions is different because one is an infection and the other is an autoimmune disease.

Neither are contagious in the same way as catching a cold, a fungal nail infection spreads via wet towels and shower rooms.  Nail psoriasis is a medical condition and not infectious so you can’t catch it. Both conditions will get worse if you don’t receive the correct treatment so it is important to find out exactly what is causing the change in your nail.

Some people may have both conditions at the same time or just have one of them.  Treatment is different for both of them with nail psoriasis being more difficult to treat.  Fungal nail infections are treatable with antifungal treatments and lots of patience.

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What Is A Fungal Nail Infection?

Fungal nail infections are common and chances are we'll all have one at some time in our lives.  They occur on finger and toenails and thrive in damp conditions. You can’t catch a fungal nail infection sitting next to someone who already has one.  Generally, people catch them from towels they share and communal showers.

The infection starts with a discolouration at the side of the nails and gradually spreads to the middle.  Injuries to your feet or fingers don’t generally cause the infection to occur. A thick yellow texture forms under the nail causing it to thicken and eventually break. Nails look unsightly and people are particularly self-conscious about them during summer months because they wear sandals.

People with diabetes have to be extra vigilant if they have a fungal nail infection as it may lead to complications.  The infection gets worse over time and spreads to other nails and in between fingers and toes. Fungal nail infections thrive in damp conditions like shoes and washing up bowls so treating them is difficult.

Treatment involves antifungal creams or lacquer you apply to the nail.  Creams are unreliable because they wash off easily while lacquers, such as Loceryl (Amorolfine) seal the treatment in and allow it to work.  Lacquer needs to be reapplied until the nail is clear of infection.

What Is Nail Psoriasis?

Nail psoriasis is an autoimmune condition affecting different parts of the body including nails.  It causes red scaly patches on the skin and occurs on the nails. The symptoms of nail psoriasis are similar to a fungal nail infection.  Nails thicken, start pitting, become yellow or brown, nails fall off the nail bed, a chalky build up under the nail and tenderness. The condition doesn’t worsen over time like a fungal nail infection.

Treating nail psoriasis is difficult and topical medication is often unsuccessful.  Vitamin D cream or corticosteroid injections help to relieve symptoms. In the worst cases, nail removal is necessary.

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By Parv Sagoo (June 2018)