Eww...my sons toenails. Please help.?

You need to take your son to a podiatrist (foot doctor) as soon as possible!

It sure sounds like a fungal infection to me. If left untreated, can become very dangerous & very painful!!! If the fungus gets into the bloodstream (which, by the presence of blood, suggests it is highly likely it has), it can be carried every other organ in his body. This is not something to ignore.

The fungus in not just under the toenail, it is IN the toenail itself. This is why the nail has turned yellow. None of what you describe is normal. Actually, it sounds like a very, very bad infection.

It is possible that the wet shoes were a great breeding environment for the fungus which was probably already in his shoes. Fungi like dark, damp places, this is where they thrive. Also, they are contagious, you can get them from filthy showers.

The normal procedure to take care of this problem will be for the podiatrist to remove his toenails. This can be done in the doctor's office on an out-patient basis. It will not take very long, maybe 20 minutes, but it will be very painful. The doctor will give your son a local anesthetic before he removes the toenails, & also give him pain-killers because it will be an open wound & very painful, more painful when touched.

The podiatrist will be able to give you much more information about the procedure, and what to do in terms of after-care.

Chances are pretty good that your son will have this fungus in all his shoes by now, so be prepared to throw those out & get new shoes. That the wound has been leaking, has given it a chance to spread to all his shoes

Not having money is NOT AN ACCEPTABLE reason to skimp on medical care. Hospitals cannot, by law, turn you down if you do not have insurance; they MUST treat you. Most likely they will set up a payment plan. You may also want to check into your state's medicare plan. Also, since he is school-aged, isn't there some type of insurance available through the school? Whatever you choose to do, just be open & upfront with the billing people. They are there to help you, not just to collect money. Also, many doctors do 'pro bono' (which is Latin & means "for free") work. It never hurts to ask. Here in Illinois, the Cook County Hospital is free, but usually there is a long wait.

Personally, I would NOT take him to the emergency room, I would take him directly to a podiatrist. This is because the ER people will probably just refer you to a podiatrist anyway, because you need a specialist for this.

One other thing: "Pain" is a sign our bodies give us, telling us that something 'is not right.' It is NEVER a good idea to ignore pain. Treat 'pain' with the same respect you would treat any other potentially damaging force of nature, like a tornado or hurricane. Do not ever think that by ignoring it, whatever is causing it will go away on it's own. Fungal infections will NOT clear up by themselves. It is estimated that about 70% of the population have toenail fungal infection. Clearly, all these people are not going to doctors, because they are not in pain. That is why I say you son has a severe case. Please see a doctor as soon as humanly possible.

Good luck !

PS. I had a toenail fungal infection & had my toenail removed, but my symptoms were nowhere near as bad as your sons. Trust me, when he says he is in pain, HE MEANS IT! Tell him I hope his recovery goes well.

Dear Asker!

May be your child has got toenail fungus (mycosis)

TOENAIL INFECTION

Nails are made of keratin, the same protein as horses’ hooves

It takes 12 –18 months for a toenail to grow from root to tip

If you are right-handed, the nails on your right hand grow faster than on your left, but toenails grow at the same rate on each foot

Nails grow faster in summer than winter

TOENAIL PROBLEMS have strange medical words.

Onychogryphosis is the thickened, hard toenails that old people often have

onychomycosis is fungal nail infection

Thickened, ugly nails are common – up to 10% of the population have infected toenails – but can be very upsetting. Over 500 people were questioned about their nail fungus condition in a US Hospital in Massachusettes. The people who were questioned were embarassed about it, they had loss of confidence and self-esteem, and even had depression and social isolation. Fortunately, there are now some fairly effective treatments available.

Causes of thickened toenails

Physical damage to your toenail may cause it to be thick until the damaged area grows out. This is why thickening of the big toenails is common in young men, particularly football players. Old people also often have thickened, hard toenails, probably because of the damage they have sustained over the years, and because their nails grow more slowly, it takes longer to repair the damage.

Fungal infection can make your nails thick. The commonest infection is with Trichophyton rubrum, the same fungus that causes athlete’s foot. Occasionally, other types of fungus, such as yeasts, are responsible, and people who have been abroad may have some quite exotic fungi.

Psoriasis, a skin condition, can make nails thick, with tiny pits on their surface.

How a fungal infection occurs

It is easy to pick up fungi – they are particularly common on the floors of communal showers and changing rooms – and many of us probably already have fungi on our skin. They cause problems only when conditions are ripe for them to thrive, which means warmth and moisture. When human beings started wearing enclosed shoes, which trap sweat and heat, we created ideal conditions for fungi.

The fungi shelter under the tip of the nail and start to get a hold.

This is particularly likely to happen if:

the end of the nail has been damaged (for example, by ill-fitting shoes) and is already slightly separated from its toe

you have a condition such as diabetes or an immune deficiency

you are elderly

the fungus is already multiplying between the toes (athlete’s foot).

The nail fungus very gradually spreads towards the base of the nail and down the sides, loosening the nail from the underlying toe and filling the separated area with crumbly, yellowish-white gunk. The nail itself becomes thicker and yellowish brown in colour. This can take months or years.

Sometimes the infection starts at the base of the nail, giving a whitish area near the half moon, or it may just affect the surface of the middle of the nail, where it will appear as a white patch.

What you can do

Be patient. For any treatment to be successful, one of the most important elements is patience. You will have to use the treatment for at least 3 months, and some treatments take even longer to work. Nails grow from the base to the tip, as anyone who has used nail varnish knows. Because it can take 18 months for a nail to be replaced completely by a new one, it may be a long time before you see a result.

Care for your feet sensibly by following these rules.

Give your feet plenty of air, because warmth and sweat encourage the fungi; so follow the advice given for sweaty feet. When you are at home, go barefoot whenever possible, and if you don’t want to expose your toenails, search for some strappy sandals that cover the toes.

Choose shoes that give your toes plenty of room.

Dry your feet very thoroughly after washing, using a tissue to dab underneath the end of the nail to make it as dry as possible.

It is tempting to use nail varnish to disguise the nail, but nails need to breathe so use it for short periods only, removing it as soon as possible.

Treat athlete’s foot promptly. If you ever develop athlete’s foot in the future, treat it so it does not spread to the nails.

Treatment

Onychomycosis due to Trychophyton rubrum, right and left great toe.Treatment of onychomycosis is challenging because the infection is embedded within the nail and is difficult to reach. As a result full removal of symptoms is very slow and may take a year or more.

Pharmacologic Rx

Most treatments are either systemic antifungal medications such as terbinafine and itraconazole, or topical such as nail paints containing ciclopirox or amorolfine. There is also evidence for combining systemic and topical treatments.

A 2002 study compared the efficacy and safety of terbinafine in comparison with placebo, itraconazole and griseofulvin in treating fungal infections of the nails. The main findings were that for reduced fungus terbinafine was found to be significantly better than itraconazole and griseofulvin, and terbinafine was better tolerated than itraconazole.

Hope that may help you!

Good luck!