How Is The Diagnosis Of Onychomycosis Confirmed
Clippings should be taken from crumbling tissue at the end of the infected nail. The discoloured surface of the nails can be scraped off. The debris can be scooped out from under the nail. The clippings and scrapings are sent to a mycology laboratory for microscopy and culture.
Previous treatment can reduce the chance of growing the fungus successfully in a culture, so it is best to take the clippings before any treatment is commenced:
- To confirm the diagnosis antifungal treatment will not be successful if there is another explanation for the nail condition
- To identify the responsible organism. Moulds and yeasts may require different treatment from dermatophyte fungi
- Treatment may be required for a prolonged period and is expensive. Partially treated infection may be impossible to prove for many months as antifungal drugs can be detected even a year later.
A nail biopsy may also reveal characteristic histopathological features of onychomycosis.
How To Get Rid Of Yellow Nails
Treatment of yellow nails will depend on the cause. Most likely, your nails have become discolored because of an infection you have or a product you used. These home remedies are based on those causes of discoloration. However, it is important to be aware that home remedies are not always effective. See your physician if home remedies arent helpful in eliminating discoloration. If you dont already have a doctor, our Healthline FindCare tool can help you connect to physicians in your area.
What To Watch For When Taking Oral Medication For Toenail Fungus Treatment
All of the pills for toenail fungus can cause liver toxicity. This is rare and is reversible after the medication is stopped. Still, liver function blood testing will be done before you start your treatment and again midway through your treatment.
Medications like Terbinafine and Itraconazole can also interact with certain drugs. Your healthcare provider will look at your medication list to make sure there arent any drug interactions.
Recommended Reading: Varisi Nail
What Causes Fungal Nails And What Are Some Of The Risk Factors
In normal, healthy people, fungal infections of the nails are most commonly caused by fungus that is caught from moist, wet areas. Communal showers, such as those at a gym or swimming pools, are common sources. Going to nail salons that use inadequate sanitization of instruments in addition to living with family members who have fungal nails are also risk factors. Athletes have been proven to be more susceptible to nail fungus. This is presumed to be due to the wearing of tight-fitting, sweaty shoes associated with repetitive trauma to the toenails. Having athlete’s foot makes it more likely that the fungus will infect your toenails. Repetitive trauma also weakens the nail, which makes the nail more susceptible to fungal infection.
Elderly people and people with certain underlying disease states are also at higher risk. Anything that impairs your immune system can make you prone to getting infected with the fungus. These include conditions such as AIDS, diabetes, cancer, psoriasis, or taking any immunosuppressive medications like steroids.
How Effective Are Topical Treatments
So far, only a few studies have looked into topical nail fungus treatments with nail polishes or creams. Because these studies had weaknesses, the results should be interpreted with caution. Amorolfine has not yet been well studied. Ciclopirox polish and treatment sets with urea and bifonazole cream were tested in a few studies.
Research on the effectiveness of nail polish containing ciclopirox showed that, after one year:
- About 10 out of 100 people who did not use ciclopirox no longer had a detectable fungal nail infection.
- About 32 out of 100 people who used ciclopirox no longer had a detectable fungal nail infection.
In other words, treatment with ciclopirox got rid of the fungal infection in about 22 out of 100 people. But even if the fungus had gone away, the cosmetic result wasnt always satisfying. The nails only looked healthy after treatment in 7 out of 100 people.
Treatment with sets containing urea and bifonazole cream was tested in one study. It was compared with a treatment in which only urea cream was applied and the nail was removed, but without applying bifonazole cream afterwards. Three months after treatment was completed, it was found that:
- No fungus was visible or detectable in about 41 out of 100 people who only used urea cream.
- No fungus was visible or detectable in about 51 out of 100 people who used both urea and bifonazole cream.
Recommended Reading: Para Que Sirve Fungi Nail
When To See A Doctor
In most cases, toenail fungus is considered a cosmetic problem. Still, it may cause serious complications for some people.
If you have diabetes, toenail fungus may lead to foot ulcers or other foot problems. According to a 2012 study, chronic toenail fungus is a significant risk factor for bacterial cellulitis of the leg.
If you have diabetes or a weakened immune system, you shouldnt use home remedies for toenail fungus. Contact your doctor for the appropriate course of action.
Complications Regarding Toenail Fungus
Toenail fungal infections are typically painless or at least start off that way. But without proper self-care and treatment, the condition can spiral into a more severe case of nail fungus, which can be painful and may cause irretrievable damage to your nails.
Moreover, the toenail infection can sprout other serious infections that can spread beyond your feet, particularly if you have a suppressed immune system due to certain medications, diabetes, or other conditions.
Because people with diabetes are already predisposed to reduced blood circulation and nerve supply in their feet, their odds for catching toenail infections as well as bacterial skin infection are quite high.
Thus, it is imperative for people with diabetes to seek professional medical help for any seemingly minor foot injury including a nail fungal infection to avoid any future complications.
Also Check: How To Trim Color Street Nails
Clean Socks And Shoes
Regularly changing your socks and shoes can also cut down on the growth of unwanted foot fungus. Both socks and athletic shoes can also be washed in hot water to rid the growth of yeasts and fungi that may be growing on the fabric. Some shoes can be machine dried. Drying shoes in the sun is another option when cleaning footwear.
Adding a half-cup of baking soda or one cup of vinegar to the washing machine can help eliminate bacteria or fungus on socks or shoes.
Boots and other footwear that are not machine washable could be wiped out with a vinegar and water solution or sprayed with an over-the-counter antifungal spray. Medicated powders are also helpful in treating shoes for foot fungus.
Allowing the feet to breathe by taking off shoes and socks when possible can prevent fungal growth. Protect your feet by wearing breathable footwear and clean socks. Antimicrobial socks and shoes made from bamboo, copper, or specialty fabrics are also available. They can help reduce unwanted bacteria and yeast from growing in your footwear.
A proactive approach to keeping your feet clean and dry can prevent the spread of toenail fungus. You can wash or soak feet with warm soapy water or a foot bath using everyday household items. Soaking your feet in an all-natural, homeopathic concoction can be beneficial in reducing or eliminating toenail fungus.
How Long And How Frequent Should I Use Clotrimazole For Toe Nail Fungus
How Do I Treat Toenail Fungus Home Remedies Coconut Oil And Tea Tree Oil For Foot Fungus Recipe Salt Water Soak To Kill Nail Fungus, Ergotism Toe Fungus Fungus On Kid Skin Types Of Toenail Fungus And Treatmemt With Pictures.
Diet For Toenail Fungus Toenail Has Fungus Grows Out. Will Baking Powdetcure Toenail Fungus Foot Fungus In Babies Tea Tree Oil For Nail Fungus Reddit. Will Baking Soda Kill Toenail Fungus How To Stop Fungus On Toenail.
Read Also: Does Vitamin E Kill Nail Fungus
Why Trust Verywell Health
As a seasoned health writer, Danielle Zoellner knows the importance of finding just the right product to fit your medical needs. Throughout her career, Danielle has interviewed a variety of experts in the medical and health fields while reviewing dozens of products. Her experience and knowledge in the field work together to help readers like yourself find the best products for your daily life.
Additional reporting for this story by Jennifer Nied
For over 10 years, Jennifer Nied has reviewed products, interviewed experts, scrutinized ingredients, and pored over research studies and claims, to help readers like you understand what works for your specific conditions. Every product in this piece was selected taking into account recommendations from doctors, published research, and real customer reviews.
See A Dermatologist To Pinpoint The Problem
Foot fungus wont just go away on its own, Dr. Ng says. If you think you have foot or toenail fungus, see your dermatologist, she says. There are several tests that your dermatologist can perform to identify exactly whats going on.
Its important to be aware that there are other diseases which can cause nail changes, she says. For example, we do see things like squamous cell skin cancers in the nail beds and even melanomas, which have a brownish or blackish discoloration.
Recommended Reading: How To Remove Impress Nails
Nail Fungal Infection Treatment
Prescription medicines can treat a fungal nail infection. Oral antifungal medicines help a new nail grow. This will replace the infected nail. You may need to take antifungal medicine for 6 to 12 weeks. Some oral medicines are not safe for people who have liver problems. They are not safe for people who have a history of congestive heart failure. Tell your doctor if you have one of these conditions. Your doctor will decide which medicine is right for you.
Apply topical treatments to the top of your nail. Topical medicines usually do not cure fungal nail infections.
In severe cases, a doctor might remove the nail completely. It can take several months to a year for the infection to go away.
How Do You Get A Fungal Nail Infection
Most fungal nail infections occur as a result of the fungi that cause athlete’s foot infecting the nails.
These fungi often live harmlessly on your skin, but they can sometimes multiply and lead to infections. The fungi prefer warm, dark and moist places like the feet.
You’re more likely to get a fungal nail infection if you:
- don’t keep your feet clean and dry
- wear shoes that cause your feet to get hot and sweaty
- walk around barefoot in places where fungal infections can spread easily, such as communal showers, locker rooms and gyms
- have damaged your nails
- have a weakened immune system
- have certain other health conditions, such as diabetes, psoriasis or peripheral arterial disease
Fungal nail infections can be spread to other people, so you should take steps to avoid this if you have an infection.
Don’t Miss: Does Dollar General Have Nail Polish
How Effective Are Tablets In Treating Nail Fungus
Tablets for the treatment of nail fungus have been tested in several studies. All participants had an infection on their toenails caused by a skin fungus. Overall, the study results showed that tablets are considerably more effective than nail polishes or creams.
One year after a three-month treatment with terbinafine:
- About 17 out of 100 people who didnt have this treatment no longer had a detectable fungal nail infection.
- About 76 out of 100 people who had this treatment no longer had a detectable fungal nail infection.
In other words, the treatment with terbinafine got rid of the fungal infection in about 59 out of 100 people.
Itraconazole also proved to be effective. After one year,
- 7 out of 100 people who didnt have this treatment no longer had a detectable fungal nail infection.
- About 43 out of 100 people who had this treatment no longer had a detectable fungal nail infection.
In other words, the treatment with itraconazole got rid of the fungal infection in about 36 out of 100 people.
Some studies directly compared itraconazole and terbinafine with each other. They confirm that terbinafine is somewhat more effective than itraconazole.
Treatment with breaks is thought to be about as effective as continuous treatment. But that has only been looked into in a few studies.
What Side Effects And Drug
The possible side effects of itraconazole include headaches, dizziness, stomach and bowel problems, and rashes. Itraconazole can also interact with a number of other drugs. These include cholesterol-reducing and blood-sugar-lowering medications, as well as certain sleeping pills. It is therefore important to let your doctor know about any medication you take. Itraconazole is not an option for people with heart failure . It also isnt suitable for women who are pregnant or breastfeeding.
Terbinafine can cause gastrointestinal problems and a temporary loss of taste and smell. It can also interact with certain antidepressants and heart medications. Overall, terbinafine has far fewer drug-drug interactions than itraconazole. Nevertheless, its still important to tell your doctor if you are taking any other medication. As a precaution, this medication should not be taken during pregnancy or if you are breastfeeding.
The studies only rarely reported on how often the different side effects occurred. But most people tolerate nail fungus medications well. Only a few people in the studies stopped treatment because of side effects.
But there is a very small risk of liver damage from taking itraconazole or terbinafine. For this reason, people with a liver disease are only given these medications if its absolutely necessary.
Read Also: Does Hongo Killer Nail Formula Work
When To Refer To Podiatry
Before initiating topical or oral therapy, patients should ideally be referred to a podiatrist for nail trimming and debridement. This assists with removing as much fungus as possible and improves topical drug penetration. Debridement alone cannot be recommended for the treatment of OM patients using a combination of debridement and topical nail lacquer have shown a significant improvement in mycological cure compared with debridement only. Patients with nail trauma owing to footwear, dystrophic toenails affecting other toes or who describe discomfort when walking owing to thickened toenails should also be referred.
When there is treatment failure with topical, oral and combination therapies, a podiatrist may be able to carry out a chemical or surgical nail avulsion .
If there is doubt over the original diagnosis, or where no improvement has been seen with treatment, pharmacists should refer patients to a podiatrist or their GP.
Supported by RB
RB provided financial support in the production of this content.
The authors were paid by The Pharmaceutical Journal to write this article and full editorial control was maintained by the journal at all times.
What Is Toenail Fungus
Toenail fungus is an infection that gets in through cracks in your nail or cuts in your skin. It can make your toenail change color or get thicker. It can also hurt. Because toes are often warm and damp, fungus grows well there. Different kinds of fungi and sometimes yeast affect different parts of the nail. Left untreated, an infection could spread to other toenails, skin, or even your fingernails.
Don’t Miss: How Do You Get Dip Nails Off
Treatments For Fungal Nail Infections
Treatment isn’t always needed for a mild fungal nail infection because it’s unlikely to cause any further problems and you may feel it’s not worth treating.
Whether you decide to have treatment or not, you should still practise good foot hygiene to stop the infection getting worse or spreading to others.
Speak to your GP or pharmacist if you’re bothered by the appearance of the affected nail, or it’s causing problems such as pain and discomfort. They’ll probably recommend:
- antifungal tablets tablets taken once or twice a day for several months
- antifungal nail paints special paints applied directly to the nail over several months
- nail softening kits where a paste is used to soften infected parts of the nail, before they’re removed with a scraping device
A procedure to remove the nail completely may be recommended in severe cases. Laser treatment, where a high-energy laser is used to destroy the fungus, is also an option. But this is only available privately and can be expensive.
You can reduce your risk of developing a fungal nail infection by:
Nail salon equipment can sometimes be the source of fungal nail infections. If you regularly visit a salon, make sure any equipment used is properly sterilised between uses.
How Do I Know If I Have A Fungal Nail Infection
Because other infections can affect the nail and mimic symptoms of a fungal nail infection, the only way to confirm a diagnosis is to see a doctor. Theyll take a scraping of the nail and look under a microscope for signs of fungus.
In some cases, your doctor may send the sample to a lab for analysis and identification.
Over-the-counter products arent usually recommended to treat nail infections since they dont provide reliable results. Instead, your doctor may prescribe an oral antifungal medication, such as:
Recommended Reading: Does Vitamin E Kill Nail Fungus
Are There Home Remedies For Toenail Fungus
The Internet is filled with anecdotal information on how to cure toenail fungus using home remedies. Vinegar is a commonly recommended home remedy. Some people apply various oils such as tea tree oil, coconut oil, essential oils, and oil of cedar leaf to their nails as well. The effectiveness of these home remedies is highly doubtful. Application of household bleach and hydrogen peroxide is also not recommended due to lack of evidence that these treatments work. These agents can also cause unwanted skin irritation. Thickened nails that have been affected by fungus can be difficult to trim. Using topical urea cream will soften the nail and make it easier to trim. These creams do not require a prescription.
Other Options For Toenail Fungus Infections
Removal of the toenail is only used when just one nail is infected, but it does work. Light therapy and lasers are also being studied as possible toenail fungus treatments. Laser therapy has shown promise when combined with oral or topical antifungals. A multicenter trial investigating the efficacy of a device, the Pinpointe FootLaser, is currently underway, so stay tuned to that.
Recommended Reading: Does Dollar General Have Nail Polish