Why Seniors are at greater risk for nail fungus and harder to treat

Nail fungus, medically known as onychomycosis, is a common condition in adults and especially seniors. It consists of a fungal infection of the fingernails or the toenails, with the big toe or the little toe nails most frequently affected. Usual symptoms are a yellow or white discoloration as well as thickening and disfigurement of the nail. The condition is caused by a variety of types of dermatophytic fungi that invade the nail plate directly or through the surrounding tissue and then continue to spread by feeding off of the keratin proteins that make up the hardened surface of the nail plate.

Incidents of nail fungus are unusual in children but increase markedly with age. A large scale epidemiological  study[i] found that nearly 20% of those over 60 years of age in the United States were suffering from onychomycosis and it is estimated that half of the population over 55 will have at least one finger or toe affected by the time they are 70. So, as a senior, even if you do not have onychomycosis now, it is very likely you will have to deal with it at some point in the near future.

Unfortunately, aging often brings a number of complications that make nail fungus treatment far more difficult and the condition more dangerous. Circulatory problems, diabetes, depressed immune systems and lessened hygiene can substantially increase infection rates and coupled with slower nail growth, difficulty taking oral medicines that are hard on the liver and inability for insurance to cover expensive treatments make treating onychomycosis more challenging. Without proper treatment, finger and toenail fungus can become a chronic condition that can lead to dangerous complications as you get older.

  • Circulatory Problems – As people age, they are likely to experience problems with poor blood circulation as their activity level diminishes. They begin to have a progressive loss of muscle fibers which can make exercise more difficult and complications from diabetes can also impair blood circulation. Diminished blood circulation limits the nutrients the extremities needs to fight off fungal infections and it takes longer to heal and repair. Plenty of low impact exercise, massage therapy, hydro therapy (alternating hot and cold water) and vasodilators like nitroglycerin can keep the blood flowing properly.
  • Weakened Immune Systems – Seniors often have a range of medical issues that depress the body’s immune systems and increase vulnerability to invasion by pathogens of all types. Dermatophytic fungi, the primary cause for onychomycosis, can more easily spread from one person to another and from one digit to another where the normal defense systems have been compromised. Auto-immune diseases, immunodeficiency disorders and certain medications can further contribute to disabling the body’s natural defenses against fungal infections.

  • Slow Nail Growth – The rate of nail growth is inversely proportional to age. In healthy people, the average rate of nail growth in fingernails is 3.5mm per month, taking about 4-6 months to grow out and for toenails only 1.6mm per month, taking anywhere from 6 months to 12 months to grow out completely. Growth drops significantly as you get older, however, decreasing 0.5% each year between 20 and 100 years of age.[ii] The slower nail growth facilitates the spread of the infection throughout the nail and means it takes longer to get clear nails once the infection has been eliminated.

  • Diabetes– The additional pounds and resistance to insulin due to diets in highly processed foods are causing the rates of Type 2 Diabetes to skyrocket, most especially in the over 55 population. Diabetes causes poor circulation, particularly in the extremities, and weakens the immune system, and being weakened, the body has increased vulnerability to invasion by pathogens, including dermatophytic fungi. A fungal infection of the nail can cause the loss of the nail itself and increase susceptibility to a secondary bacterial or viral infection which can lead to amputation of the toe or finger.
  • Hygiene – Often hygiene can suffer when health deteriorates, as every day actions like bathing and changing clothes can become more difficult. This can make it much easier to contract nail fungus in the first place. When socks and shoes are not changed daily, it can make toenail fungus spread to other toes and the other foot and make it far more difficult to eradicate.  Best practices are to wash your hands (and feet when you can) with a good antimicrobial soap often and make sure to have clean socks at least once a day.
  • Trouble Taking Oral Medications – Podiatrists often prescribe Lamisil, an oral form of the antifungal medication terbinafine for patients suffering from nail fungus. While oral terbinafine can be reasonably effective in treatment, the drug causes significant duress on the patient’s liver. Unfortunately, many seniors and diabetics already have lowered liver function and cannot afford to risk further damage.

  • Lack of Insurance Coverage for Treatment – Treatment of onychomycosis is often not covered by most insurance plans or Medicaid unless there are already additional complications. When treatment is covered, usually only oral medication is made available while even more expensive methods like laser therapy remain out of pocket. Popular topical treatments are also not usually covered. This can represent an additional hardship in seeking successful treatment to those seniors who are on fixed incomes.

If you are a senior, nail fungus is a medical condition you will need to address now and in the coming years. The best course is diligent prevention and proper diet, exercise and general hygiene can go a long way toward keeping you “fungus free”. If, in spite of your precautions, an infection does occur or you have nail fungus now, it is important to get treatment with a strong antifungal like FixaFungus ToeNail Fungus Treatment as early as you can. By taking action sooner than later, you can keep the infection from spreading and help ensure successful therapy, while avoiding more dangerous complications and expensive medical visits.


[i] Ghannoum MA, Hajjeh RA, Scher R, et al. A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000;43:641-648

[ii] Singh G, Haneef NS, Uday A. Nail changes and disorders among the elderly. Indian J Dermatol, Veneveol Leprol. 2005;71:386–92.

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