What do you see in practice?
Hmm… You can see a change, but is this actually an improvement? A frequently asked question from practices and clients who work with FungiSmart. Many products designed to treat nail fungus focus on inhibiting or, in the case of (mostly) pharmacological treatments, killing the fungus using chemical or antimicrobial substances. FungiSmart takes a different approach. The product works with Pythium oligandrum, an organism that targets the ‘breakdown of infected keratin and fungal structures.’
‘As a result, the pattern may look different to what one might expect.’
You might wonder why a nail sometimes seems to get “worse” at first, and why that can actually be good news. It doesn’t always make sense at first, so we’ll walk you through the stages of this process.
In our practice, we’ve noticed an interesting pattern in the questions asked by clients who are starting to use FungiSmart. The questions take various forms, but the core issue is often the same: the nail is getting darker or becoming more brittle. Is the fungal infection actually getting worse?
The short answer: usually not. In fact, in many cases we see exactly the outcome that is expected when the treatment works. And that calls for something that is perhaps the most important aspect of fungal treatment… knowledge, understanding and good expectation management, both for yourself and for the client.
Did you know that the response to the application of FungiSmart depends on the pathogen it is fighting? Indeed, an immediate improvement in colour is observed when the pathogen is non-aggressive, whilst a darker colour or increased breakdown of layers is seen when the pathogen is aggressive. More on this later in this article!
Nuance and understanding
Once you understand what the recovery process actually looks like, the whole experience of the treatment changes. Where uncertainty or doubt might initially arise (it seems to be getting worse), a sense of recognition can then set in: this is part of the process. FungiSmart targets the cause: the fungus itself. But the nail then needs time to repair itself. And that is precisely where the key to success lies: realistic expectations, proper, expert guidance and patience. Whilst clients often hope for a rapid cosmetic improvement, practitioners sometimes see the exact opposite at first:
- the nail is getting darker
- the nail becomes brittle
- dark spots sometimes appear
- old layers come away more easily
A change of this magnitude can be a bit of a shock, as we’re not used to it. But from a biological point of view, it’s a logical stage in the recovery process. Change is often actually a positive sign. What if, instead of focusing on ‘I can’t really see any improvement yet’, you focused on ‘there is change’, and that means things are moving forward? Your mindset and understanding can make a big difference to your confidence in the process. Many practitioners recognise the moment when they start to rethink things: ‘Yes! Something’s happening something‘!
Is colour a reliable indicator?
No. This is because nail recovery always follows the well-known biology of nail growth. And that biology has one fixed rule: nails grow slowly. Furthermore, the natural process of nail recovery is also a complex and slow one. The colour of a nail is not a reliable indicator of the presence of fungus. A nail may:
- appear (barely) unchanged, whilst the infection is already stabilising
- are still dark or discoloured to a yellowish hue, even though the mould has already disappeared
- make the eyes look worse, even though the infected material is actually being shed
For years, treatments have mainly been assessed on the basis of cosmetic improvement, but in the case of a treatment With products such as FungiSmart, which break down the fungus biologically and remove infected keratin, the process may look slightly different for a while. Take a look below at the stages the nail goes through during such a biological breakdown process.
- The nail thickens less
- Infected layers come away more easily
- The nail becomes drier and brittle
- Discolouration shifts or changes
These are all signs that the nail tissue is starting to move. And a standstill is often more problematic than no change at all.
What does change mean?
It is important for clients to understand that nail fungus is still not a quick fix. Key points to emphasise:
- Discolouration of the nail is not harmful
- The dark colour will grow out or flake off
- Allowing time for healthy tissue to form
Why managing expectations is important
When clients focus solely on changes in colour, uncertainty can quickly arise. But when both the practitioner and the client understand that changes to the nail can be part of the process, and that discolouration does not always mean the fungus is active or that the nail needs time to recover, the whole experience of the treatment changes. What initially feels like a setback is then seen as a step towards recovery.
Why do nails sometimes get darker? Not all the time, though…
In cases of more severe or aggressive fungal infections, we regularly observe that the nail temporarily darkens after starting treatment with FungiSmart. This can have various causes: the loosening and drying out of infected keratin, the oxidation of decomposing fungal debris, the shedding of affected nail layers, or the fragmentation of old infected tissue. In other words, the process first clears away the damaged material before visible recovery can take place. What sometimes feels to the client like a “setback” is in reality often the beginning of stabilisation.
The difference between aggressive and non-aggressive
In the fungal kingdom, we distinguish between aggressive and less aggressive fungi. Really? Yes! The more aggressive fungi have the ability, for example, to form biofilms, which makes them more resistant to mycoparasitism. There are also several fungi that produce thick-walled macroconidia.
And to make matters worse, there are actually fungi that can form both types and are therefore very aggressive, such as Trichophyton rubrum – a common fungus that causes fungal nail infections. So it’s quite a complex issue…
The key insight for practice
Right, we now know that not every improvement starts with a prettier nail. When practitioners recognise this and explain it clearly to their clients, something important happens: realistic expectations and greater confidence in the treatment process. And that ultimately makes the difference between doubt about a treatment and a successful course of treatment where the client adheres to the therapy.
