Regional Differences in Fungal Toenails

Pharmaceutical companies have done such an effective job in advertising the latest cure for fungal toenails that we might be lead to believe that every thick and discolored nail has a fungal infection. But interestingly, lab testing shows that some thick nails aren’t fungal, and not every infected toenail has the same type of fungus. This is only important because some fungal infection are proving easier to resolve than others. And it appears that in the Midwest we tend to have a higher occurrence rate of the fungal infection that is harder to treat.

According to the research, the most common fungal nail infection is caused by a group of organisms called Dermatophytes. Within that group, the most common species is Trichophyton rubrum or “T. rubrum”.

Another group of organisms that cause infection are called Saprophytic fungi. Studies indicate that Saprophytic fungi account for only 2-12% of all fungal toenails. However, in my experience that incidence rate is much higher in the Midwest. Of the four results I’ve reviewed in the last few days, two of them were positive for Saprophytic fungi. And that’s not highly unusual for my clinic. Those results have me wondering why it’s different here, and questioning if perhaps lifestyle differences are to blame.

Saprophytic fungi

While Saprophytes are beneficial to gardening, they aren’t so beneficial to nail health. And in my casual, non-scientific questioning of my patients that test positive for this fungus, nearly all of them have been avid gardeners. And perhaps that’s the reason behind the discrepancy that I’ve seen vs the published data. Perhaps our Midwestern lifestyle has increased our risk of infection by this organism that is generally otherwise found in the soil.

So here are some tips to reduce your risk of infection from this otherwise beneficial group of organisms:

  • Don’t let your gardening shoes get overly nasty. Throw them out and start over now and then.
  • Actually wear shoes while gardening. Barefoot is really not your friend here.
  • Wash your feet well, using a nail brush, after you’ve been out gardening.
  • If your nails start to look discolored and thick, get it checked out with lab testing sooner rather than later. This fungus can progress quickly.