Psychological Factors In Nail Fungal Infections (For Professionals)

Psychological Factors In Nail Fungal Infections (For Professionals)

• Prevalence

1. affects at one time 3-8% of the general population
2. Represents half of the total number of cases of nail conditions
3. Toes are 4-7 times more frequently affected than fingernails

• Having onychomysosis has an Influence on:

1. psyche
2. well being
3. social functioning
4. pain

• Two parameters are studied:

1. quality of life (QoL) impairement
2. social stigmatization

1. QoL

• QoL impairement is measured on the 3 factors defining QoL:

1. social integration and functioning
2. emotions
3. symptoms

• Emotional/social issues of having onychomycosis:

1. fear of contagion and spreading infection to others

• Epidemiological Factors:

1. Females more often than males complain of an impairment of QoL
2. Influence of age:

-males over 50 think its going to last all the life

-19 to 40 years of age complain that onychomycosis means having to spend money for a treatment that tends to be prolonged

• Educational Factors:

1. the higher the level of education, the higher the impairement of the Dermatology Life Quality Index (DLQI), which is an objective measurement of QoL

• QoL is more impared in urban areas

• Influence of the severity of the nail fungal infection:

1. If the nail dystrophy is total patients tend to think that the infection will last all the patient’s life
2. If there is proximal nail involvement patients fear that nails should be cut short, also that more treatment is needed and for a longer duration.
3. The number of nails infected also has an influence: patients are more worried about the opinion of others if 2 or more nails are affected.

2. Social Stigmatization

definition of stigmatization: a central experience with social and emotional consequences

• Epidemiological Factors

1. no difference between the sexes
2. Young people feel more stigmatized than older people

• Facts

1. 1/4 of patients think they are unattractive because they have onychomycosis
2. Patients think that others are starring at the lesions and that others feel the lesions unpleasant to touch (because they think that it is contagious)
3. On the other hand patients are not worried about unpleasant comments by others
4. The feeling of stigmatization is present 4 times more frequent before than after treatment

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Szepietowski JC. Onychomycosis: is it only a nail disease ? 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige)