NAILS, RINGWORM INFECTION OF (Onychomycosis; Tinea Unguium)
DESCRIPTIONRingworm is a fungus infection of the toenails (usually) or fingernails (occasionally) in which nails become pliable, opaque, white, and thickened. This is contagious. Ringworm can affect both sexes, all ages, but is most common in older adolescents.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Surgical removal of the nail.
SIGNS & SYMPTOMSBegins with a small separation between the end of the child's nail and the nail bed.
Soft yellow material gradually builds up in the separation.
The condition usually doesn't itch and is painless, unless the area is extensive and becomes infected.
Eventually the child's entire nail is separated, resulting in a partially destroyed, misshapen, yellow nail.
Infection with the trichophyton fungus. Fingernail infection occurs only if your child's nail has been injured or if the nail is affected by another skin disease on the hand. Toenail infections can occur without injury.
RISK FACTORSExposure to heat, wetness, and humidity, such as with cooking, dishwashing, and household chores.
Hot, humid weather.
PREVENTING COMPLICATIONS OR RECURRENCE
Encourage your child to keep feet cool, dry, and exposed to sunlight as much as possible.
Urge your child to wear cotton or wool socks and to avoid footwear made from synthetic fibers.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory fungal cultures of the material under nails.
POSSIBLE COMPLICATIONSPermanent nail loss or deformity.
Most fingernail infections are curable with 6 months of continuous treatment. Toenails require 12 to 24 months of treatment because of their slower growth rate. Most fingernail infections respond well to treatment, but toenail infections are more resistant to treatment. Recurrence is likely.
HOME CAREInstructions for your child:
Dry feet and hands with extra care after bathing--even after the infection clears.
Wear light footwear, such as sandals, to allow free air circulation. Don't wear socks or shoes made of synthetic materials. During acute phases, go barefoot as much as possible. Keep feet and hands cool, dry, and exposed to sunlight.
For fingernail infections, wear cotton-lined latex or rubber gloves for dishwashing or other cleaning that requires immersion in water or chemicals.
MEDICATIONNon-prescription anti-fungal ointments, creams, and powders are available, but they are ineffective in curing these infections. Your doctor may prescribe oral anti-fungal drugs, such as griseofulvin or ketoconazole, to cure the child's infection.
See Medications section for information regarding medicines your doctor may prescribe.
No restrictions, but your child should avoid heat and excess sweating.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?Yes, unless school rules prohibit. Not readily contagious to others except with prolonged, intimate contact.
CALL YOUR DOCTOR IF
Your child has a minor nail infection that becomes a problem.
After 2 weeks of medication, your child's symptoms fail to improve.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.