Fungal infection

Dear Dr. Jen,

My nails have turned yellow and deformed the past several months. My doctor has treated me with oral medication which temporarily stopped the deformities for a while.  But they seemed to have come back.  Is this a fungal infection or could I be suffering from a more serious condition? I am 30 years old and my executive panel results are all fine.

Tyra

Dear Tyra,

Deformed and discolored nails can be a sign of many things, such as internal organ problems (lung, liver or kidney), underlying cancer, and vitamin deficiencies. The more common reason is a fungal infection, or onychomycosis.  This can only be treated by two methods: taking oral antifungal meds or placing a medicated nail lacquer for a period of time.

When onychomycosis recurs, there is usually another factor to be considered.  Constantly exposing the nails to water, such as washing clothes or dishes or constant washing of hands can cause the nail folds to be frequently wet, allowing fungus to grow.  Using infected nail paraphernalia repeatedly even after the infection has been controlled may cause a re-infection. Also, having your cuticles removed can contribute to this nail condition.  Controlling the factors that may encourage fungal infection can go a long, long way in prevention of recurrence.

Dear Dr. Jen,

I get very bad scars from mosquito bites on my legs.  I've been having the same reaction since I was child.  Meanwhile, my siblings don't seem to have a problem with their mosquito bites.  What is going on?  Is there a way to help me?

Marian

Dear Marian,

Have you ever heard of allergies to insect bites?  This may be what is going on with you.  While the general population will react with mild itching to mosquitos, some people are actually really allergic to it.  This is accompanied by swollen, red, and extremely itchy spots where the mosquito bit you.  This takes even longer than the usual two days to heal.  Sometimes, because of the deep scratches you inflicted on the itchy bites, it may even have become infected or wounded at some point.  And when it eventually doesn't become itchy anymore, the bite turns into a horrible brown mark.

Sounds familiar?  Your siblings may not be allergic to the bites which explains the different reactions you have.  The only way to combat the bite from being a huge swollen nodule, is to apply a cortisone-based cream or ointment for several seconds as soon as the itching starts. Massaging the anti-inflammatory into the bite the first time around is sometimes good enough to prevent swelling and itching.  Sometimes a second application of cream is in order after a few hours.  Early treatment of the bites will ensure that it doesn't form into a darkened scar.

As for the dark scars, using a vitamin C based cream for a few weeks will lighten it.  Using creams that may contain strong bleaching properties can irritate your sensitive skin, so always stop whatever you are using if you experience any itching or stinging on the scars.

Dr. Tan is a diplomate of Philippine Dermatological Society (PDS) and is affiliated with Perpetual Succour Hospital (PSH). For information on PDS, check http://www.pds.org.ph/. For questions or concerns, please text to: 0932 857 7070; or email to: [email protected]; or call The Freeman: (032) 2531276, or PSH: (032) 233 8620 and 232 5929. Your inquiries will be forwarded to Dr. Tan.