Nail fungus begins as white or yellow spots under the fingernail tip. As the fungal infection penetrates further, nail fungus causes discoloration and the nail is set to crumble and thicken at the edge. It can impact a lot of nails. If the condition is excessively mild and does not bother you, treatment may not be required.
But, if the nail fungus is painful and leads to thickened nails, medication and self-care steps can help. Even if treatment is successful, fingernail fungus often returns. Fingernail fungus is also known as onychomycosis. This is when a fungus infects the area between the skin and toe of the feet. It is known as athlete’s foot or tinea pedis, too.
Fingernail fungus has the following symptoms:
- It has thickened nail fungus.
- It comes with whitish to brownish yellow discoloration
- It is brittle, ragged or crumbly.
- It is also distorted in shape.
- There’s a dark color, caused by debris building under the fingernail.
- The fingernails also smell extremely foul.
Fingernail fungus can become increasingly thickened, deformed or discolored. Check with a doctor if you have diabetes and think you are developing nail fungus.
Fungal nail infections are caused by numerous fungal organisms. The most common is a type of fungus known as a dermatophyte. Yeasts and molds can also lead to nail infections. Fingernail fungal infection develops at almost any age, but it is more common among older adults. The nail ages and becomes brittle and dry. The resulting nail cracks allow fungi to enter. Other factors like reduced blood circulation to the extremities and a weak immune system also may play a role.
Factors that raise the risk of developing fingernail fungus include:
- Being older, owing to reduced blood flow
- Slower growing nails
- More exposure to fungi
- Heavy sweating
- Having a history of athlete’s foot
- Walking barefoot in shared areas like gyms, shower rooms and swimming pools.
- A minor skin or nail injury or skin condition like psoriasis can also be the cause.
- Additionally, diabetes, weakened immune system or circulation problems are other causes.
A severe case of fingernail fungus causes pain and permanent damage to nails. It can lead to several serious infections that spread beyond the feet, if there is a suppressed immune system due to conditions like medication or diabetes.
If one has diabetes, there can be reduced nerve supply and blood circulation in the feet and hands. One is also at the risk of bacterial skin infections like cellulitis which trigger nail fungus. Any minor injury to the feet include a nail fungal infection leads to serious complications. If you have diabetes and are developing nail fungus, you need to carry out preventative measures.
Picture of Fingernail Fungus
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Fig:- White Toenail Fungus
Image Source:- toenailproblems.net
Image Source: –toenail-fungus-treatments.com
Types of Fingernail Fungus
Microscopic organisms known as fungi lead to nail fungal infections. This does not require sunlight to survive and thrive. The group of fungi like dermatophytes like Candida can work for dealing with nail fungal infections. Some yeasts and molds also lead to infections.
Trichophyton rubrum or the most common and well-known dermatophyte that causes nail fungal infections. Other dermatophytes include trichophyton interdigital, epidermophyton floccosum, Trichophyton violaceum, Trichophyton tonsurans, Microsporum gypsum and trichophyton soudanense. Common mold causes include Aspergillus, Scopulariopsis, Neoscytalidium among others.
Pathogens leading to nail infections enter the skin through small cuts or separations between the nail bed and the nails. The fungi grow when the nail provides a warm and moist environment. One can get fungal nail infections, but these are more common in men and elderly than women and young. Additional traits and factors raise the risk of fingernail fungal infection. This includes diminished blood circulation, nails that are growing slowly, and a family history of fungal infections as well. Then, there’s heavy perspiration, moist or humid work environment, wearing socks and shoes blocking ventilation as well as artificial nails. Walking barefoot in damp communal areas or public places impacts the feet as well. Previous injuries or infections to the skin or nails can also result. Diabetes, AIDS, circulation problems and a weakened immune system are also reasons for fingernail fungus.
Tight footwear can also be a problem with the crowding of toes. Exercise that leads to repeated minor trauma to the point where the fingertip attaches to the nail is important. The elderly can also suffer this condition as lower blood circulation and slower growing nails are an important and critical part of the natural aging process.
Nails infected with fungus are thick, brittle, crumbly, distorted, ragged, dull and dark or yellowish in color. There is also scaling under the nail or hyperkeratosis, lateral onychomycosis or yellow and white streaking, proximal onychomycosis refers to the yellow spots at the bottom of the nail, and there’s also onycholysis or infected nails separating from the nail bed. Nail fungal infections can result in toe or fingertip pain, and even emit a foul odor.
Another symptom linked with fungal infections in the nail are fungi-free skin lesions known as dermatophytids. These appear in the form of rashes or itching in body areas not impacted by the fungus, much like allergies.
Diagnosing fingernail fungus infection is carried out by studying debris scraped from beneath the nail. The nail scrapes can be used in tests like fungal culture/potassium hydroxide smear. Physicians need to diagnose nail infections because several other conditions can result in similar symptoms. This includes lichen planus, psoriasis, contact dermatitis, nail bed tumor, yellow nail syndrome, and eczema.
Patients with diabetes are susceptible to complications and need to consult with their healthcare practitioner. Fungal nail infections have effective prognosis when promptly treated. When unpleasant or difficult to cope with, nail fungal infections can be successfully treated without complications after the treatment. The long treatment is essential for curing the infection. It may even require additional treatment. Complications can, in the event of some cases, cause nail damage or hearing loss on a permanent basis, or infection infestation. There are also chances of developing cellulitis.
Fungal infections can harm any part of the body. Fungi can normally be found in and around the body alongside multiple bacteria. When fungus begins to overgrow, one gets an infection. Onychomycosis is also known as tinea unguis which is a fungal infection impacting the fingernails. Fungal infections advance across time, so the instant difference in how a nail appears is too subtle to see first.
A fungal nail infection results when there is an overgrowth of fungi on top of, beneath or under the nail. Fungi thrive in moist, warm environments, so natural overpopulation can be caused. The sale of fungi that lead to conditions like ringworm and athlete’s foot can cause nail infections. Fungi already present in or on the body causes nail infections. If one comes in touch with someone with the fungal infection, it can reach you as well. As per the American Academy of Dermatology, fungal infections impact toenails more than fingernails. Toes are confined to the shoes when it is in a warm, moist environment. Tools such as nail clippers and emery boards can cause fungal infections to spread fungal infections from person to person if they are not sanitized.
Who Can Develop Fungal Infections?
There are many different causes of fungal nail infections; each cause has a treatment of its own. Many causes of fungal nail infections are preventable, some risk factors raise the likelihood of developing this condition. Nail infections occur more than men than women, and infections in adults are more often than children. If one has family members who get different types of fungal infections, you’re more likely to get this fingernail fungus. They have poorer circulation, and nails grow slowly and thicken as they age.
A fungal infection of the nail may impact part of the nail, the entire nail or several nails. Common signs of a nail fungal infection include distortions in the nail that lift off the nail bed, a smell emanating from the infected nail, a thickened or even a brittle nail.
Other infections mimic symptoms of fungal nail infection, the only way to confirm a diagnosis is to see the doctor. They will take the scraping of the nail and look under the microscope for indications of fungus. Doctors may have to send a sample to the lab for analysis and identification. These habits can prevent nail fungus.
Wash the hands and feet regularly and wash your hands after touching an infected nail. Moisturize your nails after washing. Trim nails right across, smoothen the edges with the file and work on thickened areas. Disinfect nail clippers even after a single usage.
For diagnosing, the doctor will need to examine the nails. He or she may also take nail clippings or scrape debris from under the nail. The sample must be sent to the lab to identify the nature of fungus leading to the infection. Other conditions like psoriasis can mimic fungal infections of the nail. Microbes including yeast and bacteria also affect the nails. Understanding the cause of the infection helps in determining the best treatment cause.
Fungal nail infections are difficult to treat. Check with the doctor if OTC products or self-care strategies have not helped. Treatment depends on the severity of the condition and the type of fungus associated with it. It takes months to see results. If the nail condition improves, repeat infections can result.
Doctors prescribe antifungal drugs taken orally or applied to the nail. In certain situations, it can combine oral and topical antifungal therapies.
Oral Antifungal Drugs
These drugs are the first choice as they clear the infection more quickly than topical drugs. Options include Sporanox/itraconazole or Lamisil/Terbinafine. These drugs help a new nail emerge without developing an infection, slowly replacing the part which is infected.
Typically, this type of drug for 6-12 weeks. But you won’t see the end result of treatment until the nail grows back. It may take four or more months to ward off an infection. Treatment success rates are lower for adults aged 65 or more.
Oral antifungal drugs may cause side effects from liver damage to skin rash. One may need occasional blood tests to check how one deals with these type of medicines. Doctors may not recommend these for individuals with liver disease, or those suffering from congestive heart failure or those taking specific medications.
Medicated nail polish is known as ciclopirox or Penlac. One paints it on infected nails and surrounding skin in a day. After 7 days, you need to clean it up with alcohol and begin fresh applications. You need to use this type of nail polish daily for at least a year.
Medicated nail cream can serve as a potent antifungal treatment, which can be applied to the infected nails post the soaking session. For applying the cream effectively, you need to thin the nails. This prevents medications from not being able to reach beneath the tough nail surface to the underlying fungi infections. For thin nails, nonprescription lotion rich in urea works very well. Or your doctor may thin the nail’s surface with another tool like a file.
Doctors might prescribe short-term nail removal, so the antifungal drug can be applied directly to the infection found under the nail. Some fungal nail infections don’t respond well to medicines. Permanent nail removal may be required if the infection is severe or painful.
Preparing For Medical Appointments
You are likely to start by seeing the family doctor or GP. Here are the questions you may need to prepare for an appointment.
- Write down the symptoms including anything unrelated to nail fungus.
- Describe important personal information, such as major life stressors or changes.
- Note all medications, supplements, vitamins one is taking.
- Check questions to check with your doctor.
For fingernail fungus, the questions one needs to ask are:
- What is likely to cause the condition or symptom?
- What are other symptoms or conditions causes?
- What are the tests required?
- What is the best action course?
- What are the alternatives for the primary approach one is suggesting.
- I have health conditions and need guidance on how to manage them together.
- Is the generic alternative available for medicine prescribed?
- Do you have brochures, or any printed material one can take home?
- Should websites on nail fungus be recommended?
Nail fungal infections are a common disease of the nails. It makes up half of the nail pathologies. Fungus is normally located on the body, but if it grows beyond a time, it can be a problem.
Fingernails are prone to infections, which appear as discoloring or nail thickening and crumbling edges. The condition is most common in the case of toenails. Around 10 percent of the adult population suffers from nail fungus infection. Microscopic fungi in the nail lead to the condition. It can affect fingernails and toenails, but it is common in the feet. Diagnosis is carried out by examining the debris under the nail.
One of the simple methods for nail fungal infection is keeping nails clean and short. Treating nail fungus infections can be a long and costly process. There are oral medications, as well as alternative courses of therapies and topical ointment as well. OTC ointments and creams are available, but they have not proved very effective.
Oral medicines for individuals include terbinafine/Lamisil, Sporanox/itraconazole, and Diflucan or fluconazole. These take a total of 4 months before replacing the infected nail with a nail that is normal. In extreme cases, the physician can remove the entire nail.
Topical nail fungus treatment clears up fungal infections, but often does not completely cure infections. Other home-based remedies have a potentially promising clinical impact on nail fungi.
Snake-root extracts: A study in 2008 demonstrated this naturally antifungal plant can be as effective as ciclopirox for treating the condition; this is referred to as a prescription antifungal treatment.
Oregano oil: This is rich in thymol. It contains anti-fungal properties. Oregano oil is combined with tea tree oil in treatments, but potent side effects can combine to increase the possibility of the allergic irritation or reaction.
Ozonized Oils: Olive oil and sunflower oil are examples of oils infused with the same gases present in the ozone layer. There are various studies confirming the benefits of this oil in treating nail fungus. As per the study, ozonized sunflower oil showed massive clinical impact, as opposed to prescribed antifungal medication ketoconazole.
Other alternative medications used to treat nail fungal infections range across Australian tea tree oil, Listerine, vinegar, and grapefruit seed extract.
Preventing nail fungus infections requires hand and foot hygiene. The suggestions include keeping nails dry, clean and short. Wearing socks which breath such as synthetic is the key. It is important to use antifungal sprays or powders. Wearing rubber gloves to avoid overexposure to water, refraining from biting or picking nails, wearing shoes or sandals in public places and pools, ensuring the manicure or pedicure salon sterilizes tools. It is also important to use artificial nails and nail polish on a regular basis. Washing hands once infected nails have been touched is a powerful precautionary measure.
OTC products are not usually recommended to cure nail infections because reliable results are not provided. Instead, the doctor may prescribe oral antifungal medicines like Lamasil/terbinafine, Sporanox or itraconazole, Gris Peg or griseofulvin and fluconazole or Diflucan.
Antifungal treatments such as topical solutions or antifungal nail lacquer are brushed onto the nail the same way nail polish is applied. Based on the type of fungus leading to infections, and the extent of infection, medications may have to be used for several months. Topical solutions are not able to cure many fungal infections. Treatment does not assure getting freedom from fungal infection completely. In half the cases, the fungal infection will return. Complications from fungal infections are also possible.
Making some simple lifestyle changes can help avert a fungal nail infection. Tending to the nails by keeping them clean and well trimmed is an excellent way to prevent infections. One should also avoid the injury of skins around the nails. If one is going to have damp or wet hands for a longer period of time, one may want to wear rubber gloves.
Other ways to prevent a fungal infection of the nails include using powders or antifungal sprays regularly. Washing hands after touching nails which have been infected, drying the feet well after taking a shower, especially between the toes is critical too. So is getting manicures and pedicures from well-known salons. Using other’s items for manicures and pedicures is not a good idea. Desist from wearing socks that minimize moisture, avoid moving around barefoot in public places, and reduce the use of artificial nails or nail polish.
For some individuals, a fungal infection of nails can be difficult to cure. The first round of medication may not work. Nail infection cannot be considered cured, till a new, infection-free nail has grown in. Nails are no longer infected. It is possible for fungal infections to return. While the nail is no longer infected, it is possible for the fungal infection to return. In severe cases, this can cause permanent damage to nails and may have to be removed.
The main complications associated with a fungal nail infection are the progression of infections, permanent loss of nails impacted, discoloration of the infected nails, the spread of infections of the body and possibly the blood-stream, and the development of cellulitis, a form of bacterial skin infection. It is especially important to check with doctors if there is diabetes-induced fungal nail infection. People with diabetes are at greater risk for developing potentially serious complications caused by infections. Check with your doctor if you have diabetes and think you’re developing a fungal nail infection.
Lines and ridges are common and are considered normal. This can worsen during pregnancy. A large groove down the nail’s center can be caused by nail-biting. Some people develop these changes following chemotherapy. As one age, the nails become brittle and develop separation and ridges of the nail layers at the end of the nail. To prevent this, try these clean solutions and don’t soak the nails in water. Yellowish and whitish nails can occur due to onycholysis. This means separation of the nail from the nail bed. The color is the air beneath the nail. The treatment involves trimming nails short, not cleaning under it, and polishing it if you want to hide the color. Persistent onycholysis makes fungal infections possible.
Red or black nails due to the hematoma, or blood under the nail occur from the trauma, like whacking oneself on the thumb with a hammer. The discolored area will grow out with the nail and be trimmed off as your nails are trimmed. If the nail has a black spot not associated with trauma, one may want to see a dermatologist or podiatrist check for melanoma. This is a type of skin cancer associated with pigmented cells. A simple biopsy can rule out cancer malignancy.
Green nails infected by Pseudomonas bacteria can emanate a foul odor of nails. The treatment involves trimming the nail short every 4 weeks, not cleaning it, polishing it if one wants to hide the color and waiting a couple of months. It is also advised to prevent soaking the nail in any kind of water even if inside the gloves and to dry the nails thoroughly post the bathing. In case the problem continues, prescription treatments are to be tried by doctors.
Pitted nails are linked to psoriasis and other skin problems that impact the nail matrix. This is the area under the skin just behind the nail. This is the point where the nail grows. Nails impacted by psoriasis are also appearing tan in color. Redness and swelling of the skin in and around the nail are referred to as paronychia. This is an infection of the skin at the nail or cuticle’s bottom. If the infection is acute or has a rapid onset, it usually results in bacteria. There may be warm soaks, but these need to be drained by a doctor. A chronic paronychia occurs when the inflammation or irritation of the cuticle takes place over time. Yeast takes advantage of the damaged skin and infects the area as well. Therapy involves keeping the skin dry and out of the water. If the problem persists, a physician needs to be consulted. Antibiotics are not often used but may be required in the event of a severe infection.
Chronic nail linked trauma like kicking and other athletic endeavors can lead to damage resulting in fungal nails. This repeated injury and trauma can occur with tight-fitting shoes. Certain traumas can cause permanent changes that impact the appearance of fungal nails.
In healthy, normal people, fungal infections are caused by a fungus that is emanating from moist, wet areas. Communal areas should be given a wide berth. Visiting nail salons with lack of sanitized instruments can also emerge as a risk factor. Athletes are more susceptible to nail fungus. Physical examination alone is shown to be an unreliable method of diagnosing fungal nails. Many conditions can make the nail appear damaged. Doctors can have a tough time, therefore. Studies have found only 50% of cases of abnormal nail appearance are due to fungus.
Lab testing is, therefore, essential. Some insurance companies may ask for lab test confirmation of diagnosis for antifungal medicines to be covered. A nail sample is sent to the lab, where it is stained, tested or cultures by PCR to identify the genetic material of organisms to identify the presence of the fungus. Staining and culturing can take up to 6 weeks to get a result. But PCR is identifying the fungal genetic material in a single day. This test is not widely used on account of its high cost. If a negative biopsy result is accompanied by clinical suspicion on account of thickened, crumbly, discolored or ragged nails, false negative results in tests must be carried out.
Most medication used to treat nail fungus has side effects, so you need to be clear about what you are treating.
Treatment for onychomycosis is recommended in those experiencing discomfort and pain on account of symptoms in the nails. Those with higher risk factors for infections like diabetes and cellulitis near impacted nails can also benefit from the treatment. Poor cosmetic appearance is another reason why medical treatment is a must.
Several doctors provide nail fungus treatment. This includes primary care providers, dermatologists or podiatrists who can treat nail fungus. Any of the doctors provide efficient diagnosis and prescribe medication related to fungal infections. A podiatrist or dermatologist shaves the top layer of the nail or removes parts of it.
Keeping nails neatly filed and trimming them can reduce the amount of fungus in the nails. This offers pain relief when thickened nails cause pressure-related pain. Creams, as well as other topical medications, have been less workable and impactful against nail fungi than oral medicines. This is because nails are hard for external applications to enter. It is also extremely cumbersome to adhere to topical medication schedules. These medications require daily applications for up to one year to see results. A massive benefit of topical treatment is the minimal side effects risk and drug interactions as opposed to oral therapy.
Ciclopirox or Penlac is a topical solution for treatment which works around 22% of the time, as per one study. The medication is applied to affected nails once daily for up to a single year. The lacquer needs to be wiped clean with alcohol once per week.
There is also amorolfine topical solution 5% which involves using antifungal nail lacquer containing amorolfine to prevent reinfection post a cure. This has a success rate of 70%. The drug is presently not available in the US.
Efinaconazole or Jublia is a medication that was manufactured and approved in 2014. It is a topical medication applied to the skin and is antifungal due to two most common fungal species impacting nails called Trichophyton rubrum and Trichophyton mentagrophytes. Once-daily applications are required for 48 weeks. The most common side effect of public includes ingrown toenails and application site dermatitis and pain.
Tavaborole or Kerydin is another new medication for the treatment of onychomycosis. This medicine has the same impact and indications as efinaconazole. It requires an application once every day for 48 weeks. Common side effects of Kerydin are akin to that of Jublia. Oral antifungal therapy comes with a high treatment success rate, on account of the medication. It takes 9 to 12 months to check if it has worked or not because that is the duration of time it takes for a nail to grow out. Even when therapy takes place, the fungus may return. Oral antifungal therapy is considered the optimal treatment for fingernail fungus because of higher cure rates and shorter duration of treatment, as against topical therapy.
Prescription oral medicines that work effectively include:
- Griseofulvin (Gris Peg/Fulvicin/Grifulvin):
The drug is the main factor in curing oral antifungal therapy for many years. Long-term results, however, are negative and new medicines have led the way for treatment, consequently.
This drug is taken for six weeks for fingernails. The drug is highly effective, efficient, safe and produces fewer side effects. It needs to be used cautiously in those suffering from liver disease. The medicine is also cost-effective.
It comes in pulse doses, one week per month for a couple of months. It also has interaction with drugs such as antibiotic erythromycin or even certain asthma medicines. It is considered the treatment of choice for onychomycosis led by Candida linked yeast and non-dermatophyte molds.
- Fluconazole or Diflucan:
This drug is given once per week for a lot of months. The dosing of the drug requires modification if the patient has impaired kidney function or is taking the medication with other drugs. It is not as effective as Lamisil or Sporanox and should be used with caution in those with a liver disease. Doctors carry out blood tests to check for a liver-based disease. Several innovative treatments are being tested.
- Laser Therapy or Photodynamic Therapy:
It involves the application of light-activated factors to the nail. This is followed by applying light of a certain, proper wavelength on the nail. The electrical current helps in absorption of topical antifungal medicines onto the nail. This is known as iontophoresis. This is the use of nail lacquer that changes the nail’s microclimate to make it inhospitable for the fungus to grow. If this works, it may be an inexpensive way to treat future problems.
A way to get rid of this fungus is through surgery. A surgical cure for onychomycosis needs nail removal. This offers temporary relief, and recurrence is common until additional medication, whether oral or topical, is used. Surgical removal is warranted when the affected nail is linked to factors like infection/trauma.
Oral medicines for nail fungus are toxic. Latest drugs are unlikely to cause liver problems in patients without any known liver disease. Blood tests are not needed for once-weekly treatment with fluconazole or Diflucan.
People taking longer courses often have their liver function tested before commencing treatment and then retesting in the course of treatment. It is important to notify the doctor of all side effects while on medication. Tell your doctor about current medications to prevent potential serious drug interactions.
Cost is a further consideration. Treating nail fungus is difficult and the treatment takes up to eighteen months. Relapse and reinfection are common. Modifying or eliminating risk factors are vital for preventing reinfection. Those suffering from medical illnesses leading to fungal nails face a lot of obstacles in removing the fungi permanently.
Tinea pedis, also known as foot fungus or athlete’s foot can lead to recurrence of fungal nails. It is important to manage this condition. OTC antifungal medicines like Lotrimin/clotrimazole or terbinafine/Lamisil cream is needed for the affected skin. Keeping socks and footwear clean can be useful. Portable UV light sanitizers must be used to disinfect shoes.
Nail fungus causes 50% of abnormal-appearing nails. It is hard to tell the difference between different types of discolored nails. Onychomycosis is not treated. Reasons to receive treatment include:
- Leg Infection or cellulitis
- Pain or discomfort from the nails
- Treatment for cosmetic reasons
Fungal nail infection can be identified by appearance. Other conditions and infections can lead to problems in the nails that appear to be fungal nail infection. Fungal nail infection needs to be confirmed by lab tests before commencing treatment. Treatment is long, expensive and has risks. The sample of the nail can be examined under the microscope for detecting fungi. Nails need to be clipped and treated with an alcohol swab for removing bacteria and dirt so fungal structures can be effectively visualized and conceptualized. If the doctor suspects distal lateral subungual onychomycosis, a specimen should be examined from the nail bed. Samples need to be taken from the site closest to the cuticle, where the fungi concentration is the greatest.
In case proximal subungual onychomycosis is suspected, the sample studied from the underlying nail bed close to the lunula is taken.
The nail surface’s piece is taken for examination if the white superficial onychomycosis is suspected.
To detect candidal fungal nail infection, doctors need to take a sample from impacted nail bed edges close to the sides and cuticles of the nail.
In a laboratory, samples are treated from a solution made of 20 percent potassium hydroxide to help edge out or easily verify the presence of fungi by reducing human tissue and debris in the sample.
Specimens are applied with dye through staining to see the fungal structure through the microscope and identify pathogenic species.
In case fungi are impacted by the infected nail, they can be microscopically examined. The exact type of species cannot be determined by looking through a microscope. To identify what is causing fungal nail infection, a fungal culturing is used. Use a fungal culture for locating the particular fungus as regular therapy does not work on molds that are non-dermatophyte.
Additionally, the infected nail is clipped or scraped. These scrapings or clippings are placed in containers, once they are crushed. Any fungi in the sample grow in labs in special containers. The species of pathogen namely fungus can be identified from cultures in the lab by technical experts The species of pathogen namely fungus can be identified from lab-grown cultures by technicians for recognizing microscopic structures for identifying fungal species.
Medicines were used to treat fungal nail infections, and these were minimally effective. Fungal nail infections are tough to treat because there is very little blood supply. Recent advances in treatment options include oral or topical medications. Latest oral medications have improved the treatment of fingernail fungal infection. But the recurrence rate is high, even with novel medications. Treatment comes with certain risks and recurrence is possible.
Topical antifungal is medicines applied to the skin and nail area that destroy fungi, among other pathogens. These topical agents if just slightly less than half a nail are involved. It may also be prescribed when oral medication is not an option. Medicines include amorolfine such as curanail, loceryl, and omnicure. This is approved for use outside the US. Then, there is ciclopirox olamine or Penlac which is applied much like nail polish. There’s also efinaconazole, or Jublia, sodium pyrithione, urea, bifonazole, propylene glycol urea lactic acid, ketoconazole like xolegel or Nizoral cream, like terbinafine or Lamisil cream, tavaborole 5 percent solution (Kerydin), tolnaftate or tinactin, naftifine or naftin, butenafine or Lotrimin, among others.
Topical treatments are limited as they cannot penetrate the nail enough, so they cannot cure fungal nail infections. Topical medicines can be used in the form of additional therapy along with oral medicines. The results are treatment medicine concentrations that come topically and orally. Newer oral prescription medicines are also available. These antifungal medications are effective because they go through the body to penetrate the nail plate within days of commencing therapy.
Newer oral antifungal drugs like terbinafine, Diflucan or fluconazole, and itraconazole/Sporanox capsules have replaced earlier therapies like griseofulvin in treating fingernail fungal infection. There are limited treatment periods as oral antifungal medications are administered across a three-month period, and there are fewer side effects, but higher success rates for treatment. These medications are safer, with fewer contraindications/side effects. They should not be taken by patients with heart failure or liver disease.
Before the medication is prescribed, doctors often work for a blood test to ensure the liver is functioning properly. Common side effects include stomach pain and nausea. Fluconazole or Diflucan is not US-FDA approved for treating fungal nail infections, but it is used by clinical experts to propose an alternative to other drugs. To decrease the side effect and impact of oral therapy, topical and surgical treatments need to be combined with oral antifungal management.
Surgical approaches for curing fingernail fungal infection treatment include chemical or surgical removal of the nail through nail avulsion or matrixectomy. Thick nails can be removed chemically by using a urea compound. This line of treatment is carried out by surgeons and dermatologists. Surgically removing the nail plate is not the treatment for fungal nail infections if additional therapy is not offered. The procedure should be considered as an adjunctive treatment combined with oral medication therapy. Combination of topical, oral and surgical therapy increases the impact and effectiveness of treatment, besides reducing ongoing treatment costs.
A new treatment to kill pathogens impacting nails is laser therapy. The laser beam cuts through nail tissue and fungal pathogens are disrupted enough to eliminate them. Some patients may also experience mild pain or discomfort during the procedure. Reports indicate laser therapy is as effective as medical therapy. Certain patients require more than a single treatment. This treatment can be costly and the cure rate is poor.
Lifestyle and Home Remedies
Often, one can take care of a fungal nail infection at home. Trying OTC antifungal nail creams and ointments is one step. Several products are available. If the white markings on the nail surfaces are there, these need to be filed off and the nails must be soaked in water, dried and then apply the medicated cream or lotion. Thin and trim the nails. This helps reduce pain by reducing nail pressure. Also, if this is done before applying an anti-fungal, the drug reaches deeper nail layers.
OTC products such as Vicks, Listerine and beer foot soaks, hydrogen peroxide and others can work. Home remedies are many including tea tree oil, coconut oil, baking soda, garlic, white vinegar, orange and lavender oil. These are only some home remedies. But there is no data to support these claims. Certain commercially prevalent or OTC products do not single-handedly cure an infection, but certain individuals use them for alternative therapies.
While it is not possible to prevent fungal nail infection, there are means of reducing the person’s chance of contracting this condition. A nail infection can be passed from one person to another so washing hands and feet after contacting a person with nail infections is the right practice. Another point is not to go barefoot in public showers or locker rooms. For gym shoes especially, use antifungal spray or powder in shoes. In case a manicure or pedicure is carried out, instruments are sterilized before a person is exposed to them. The feet also need to be kept as dry and clean as possible. Keeping the fingernails trimmed is also essential. Never pick or chew the fingernails or skin surrounding it. Avoid caustic agents by wearing gloves.
So while fingernail fungus can be caused by pathogens and poor hygiene, these simple steps can prevent this troublesome condition from affecting you. Ensure that you follow certain precautions and you can ensure healthy nails. After all, health is wealth!