Thing To Know About Fungal Nails
Many changes in fingernails or toenails may cause people to think they have a fungal infection of the nails, medically known as onychomycosis or tinea unguium.
Fungal infection of the nails sometimes makes the condition sound contagious or related to poor hygiene. In fact, up to 10% of all adults in Western countries have a fungal infection of the nails. This percentage increases to 20% of adults who are age 60 or older. Toenail fungus is much more common than fingernail fungus.
In reality, abnormal-looking nails may be caused by a number of conditions including, but not limited to, a fungal infection. There are many other reasons why your nails may look different.
The Lamisil Terbinafine Antifungal Cream Treats Fungus All Over The Body
Sarah is a freelance writer with a focus on health and wellness. She has written for publications like Womenâs Health, Healthline, and Parents. She taught creative writing for five years, and has a bachelorâs degree in English from Southern Connecticut State University.
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Toenail fungus is a common fungal condition that often starts after a rash on the foot spreads to the nails. When mild, it looks like white and yellow spots growing under the nail beds. If left untreated, the fungus can grow severely by hardening the nails and spreading to other toes.
Nail Fungus Prescription Medication Options
Prescription medications for nail fungus come in two forms, topical treatments to be applied to the nail and oral medications to be taken by mouth. Which one is prescribed generally depends on a number of factors, including the severity of the fungal infection and whether or not you have any other medical problems.
Oral antifungal drugs like fluconazole , itraconazole , and terbinafine are very effective but can have serious side effects, including liver damage. They are less effective in people over the age of 65. In addition, they may not be safe for people with heart or liver problems and cannot be taken with certain other medications. If prescribed, your doctor may order regular blood tests to monitor your liver function.
Topical antifungal medications like ketoconazole , terbinafine , and ciclopirox are safer but may be less effective in severe cases and may need to be used for much longer periods of time. For instance, while oral medications are usually prescribed for three months, topical treatments may need to be used for six months or longer. To learn more about topical treatments for nail fungus, check out our Nail Fungus Topical Treatment Guide.
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What Are Treatments For Toenail Fungus
Do you need to treat your nail fungus? Maybe it doesnât hurt, and the yellow, thick nails donât bother you.
But nail fungus doesnât go away by itself. And if you donât treat it, thereâs a chance it could get worse. It could spread to other nails or through your body. It could cause pain when you walk.
There are a number of ways to take care of it, including:
Nonprescription options. You can buy antifungal creams, gels, and nail polish at the store and online without a prescription. You might want to try one of them first if the infection doesnât look bad. Some people also swear by home remedies like menthol rub, tea tree oil, mouthwash, or snakeroot extract â but studies show mixed results.
Prescription polish and creams. Your foot doctor will likely trim your nail and file away its dead layers. They may also take a piece of your nail and send it to the lab to make sure itâs really a fungus and to find out what type it is.
The doctor might suggest an antifungal drug that you paint on your nails. This may work on its own, or they may suggest you take it with antifungal pills.
Do Prescription Topical Nail Fungus Medicines Work
In fact, there is are three topical medications on the market that has been shown in reputable studies to actually help kill the fungus AND make infected nails look better. It is important to note, however, that while they have been shown to help, none of them work particularly well. The best ones only work about 15% of the time.
The oldest one is the medication Ciclopirox. Ciclopirox Nail Lacquer is a topical nail solution that actually has been studied and found to be effective at clearing the nail in some patients. In addition, Ciclopirox is much cheaper than many OTC topicals. Ive seen in available for under $12 for a 3 month supply. You can read more detailed information here about Ciclopirox.
But here is the kicker even Ciclopirox only works about 8% of the time.
The reality is that no topical medication works well to clear nail fungus in most cases. None of them penetrate deep enough to make a difference in most people with the fungal infection.
We often use Ciclopirox to help prevent reinfection of the nail after treating the fungus with oral medication or laser, but do not consider any topical as an effective treatment on their own.
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Laser Treatment Of Nail Fungus
Laser treatment is used by many of our patients because it is safe, painless and has no potential liver side effects. The downside of the laser is that it is more expensive than oral medications and, while the laser is effective, it is not as well studied as the oral medications and probably not as effective . We will make sure you have all the information you need to decide if this is the treatment you want to try. Our definitive Guide to Laser Treatment of Fungal Toenails can be found here. Be sure to read this completely before you have laser treatment for nail fungus no matter where you have it done.
Using a combination of laser and oral medication may work better than either treatment alone according to a 2014 study.
Toenail Fungus Treatment What Are My Options
What is toenail fungus and fingernail fungus?
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Fungal infections of the nails can be a persistent and sometimes embarrassing problem and occasionally can become painful. These infections develop when fungi, known as dermatophytes, burrow under nails causing them to become crusty, thick, discolored, and distorted.
What are the symptoms of toenail fungus and fingernail fungus?
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The first signs and symptoms of fingernail or toenail fungus is a white or yellow spot appearing underneath the tip of the nail, which then thickens and distorts the nail as the infection progresses. As fungi grow under and into the nail, crusting, discoloration, and darkening begin. Moreover, infected nails often separate from the nail bed, which can cause pain in the tips of fingers and toes, as well as a slightly foul-smelling odor.
What are the causes of fingernail and toenail fungus?
What are the conventional fingernail and toenail fungus treatments?
Toenail Fungus Prevention
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Vinegar has been used traditionally to ward off nail fungus. Evidence of efficacy is sketchy at best, but you could try soaking your feet in one part vinegar to two parts warm water for 15 to 20 minutes daily.
Whatever treatment you choose, take these precautions to prevent recurrences:
A final consideration:
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> > > Nail Fungus: You Eat This Everyday And Its Feeding The Infection
Treatments Prescription Toe Fungus Treatment
There are a number of treatments for onychomycosis. Unfortunately, many are not very effective. The most aggressive and effective way to treat the fungus is with oral anti-fungal medications. The most common oral anti-fungal medications are Itraconazole and Terbinafine . Both medications are expensive and insurance companies tend to consider onychomycosis a cosmetic problem. If you are diabetic, your insurance company may consider onychomycosis a medical problem, and will cover the treatment. If you are experiencing pain or have developed ingrown toenails as a result, then your insurance company may cover treatment. The medication needs to be taken once daily for 3 months. The effectiveness of the medications ranges from 60 to 80%, with a recurrence rate of about 10-15%. Complete cure rates have been reported as low as 28%. Lamisil® appears to be more effective and has fewer drug interactions than Sporonox®. Prescription Toe Fungus Treatment
Treating Fungal Nail Infection
Treatment may not be necessary in mild cases of fungal nail infection. For more severe or troublesome cases, antifungal medication may be recommended.
A fungal nail infection is unlikely to get better without treatment, but if youâre not bothered by it you might decide itâs not worth treating because treatment can take a long time, may cause side effects, and isnât always effective.
Whether or not you decide to have treatment, you should still follow the self-help advice below to help stop the condition getting worse or spreading to others.
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Is Toenail Fungus Painful
Toenail fungus doesnt typically cause pain. However, in some cases, a severe fungal infection may become painful. As the fungus grows and the toenail thickens and turns brittle, the nail may lift off the nail bed, which can cause pain, especially when youre wearing shoes. Additionally, the jagged edges of a thickening toenail can cause pain when youre wearing closed shoes, making it difficult to walk.
People who have diabetes or a weakened immune system have an increased risk of developing a bacterial infection of the skin surrounding the affected toenail. This infection can be painful and can lead to more serious complications. You should see your healthcare provider if you develop a toenail fungus, especially if you have a chronic health condition.
Unsafe Home Remedies For Toenail Fungus
Although there are many effective home remedies for toenail fungus, there are still some natural and household products that can cause more harm than good. For example, you should never use bleach to get rid of toenail fungus. Its use may be toxic to the skin and cause severe skin irritation when not used properly.
Additionally, you should never use overly hot water when performing the variety of foot soaks mentioned above. Excessive heat to the nails and skin will not kill fungusand extreme temperatures may injure the skin causing burns, blisters, and sometimes permanent skin damage. Always use lukewarm water for soaking.
Urine is another home remedy that should be avoided. Previously, it had been believed to be effective against fungal infections due to its urea contents. While urea can help soften the nail bed to make it easier for antifungal medication to be absorbed, urine does not contain enough urea to be effective.
And, finally, do not remove or excessively trim toenails at home. Fungal toenails should be properly trimmed and maintained on a regular basis, but do not remove too much nail. If toenail clipping or removal is not done properly, damage to the nail bed may cause additional injury to the nail, which can be irreversible. There also is the risk of causing bacterial infections when the damaged nail is not removed properly.
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Description Of The Intervention
Drug therapy and its history
Prior to 1958, when griseofulvin was introduced as the first significant oral antifungal agent , only topical drugs existed for fungal infection . While the use of topical treatments may avoid the risk of adverse effects associated with systemic treatments, the response rate is poor, especially with multiple nail involvement or with involvement of more than the distal twothirds of the nail plate , although the more recently developed topical treatments tavaborole and efinaconazole have shown promising results .
Griseofulvin is produced by various species of Penicillium and is effective against dermatophyte infection but not against C albicans . In 1944, benzimidazole was the first azole discovered to have antifungal activity, and 1969 saw the introduction of clotrimazole and miconazole, followed by econazole in 1974 and ketoconazole in 1977 . No oral form of miconazole nitrate or econazole was ever marketed, as they are poorly absorbed from the gastrointestinal tract . Although clotrimazole is a broadspectrum azole, it is not used when oral treatment is required because orally or parenterally administered clotrimazole induces an enzyme reaction that results in the accelerated degradation of the drug with loss of antifungal activity . Ketoconazole has been available since 1977, but it is associated with hepatotoxicity . Although this appears to be a rare adverse effect, it has significantly reduced its popularity as an oral antifungal agent .
Dosage Frequency And Duration
The oral tablet contains 500 mg of active griseofulvin.
An adult should take 1,000 mg 14 times daily. The usual duration is 4 months for fingernails and 6 months for toenails.
The dosage for children of any age is 10 mg per kilogram of body weight per day.
Doctors will recommend continued treatment for at least 2 weeks after all signs of infection have cleared.
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What Is Toenail Fungus
Toenail fungus is an infection that lives underneath the nail, in the skin of the nail bed. Toenail fungus is more than a cosmetic concern.
Images show a range of disease severity.
Symptoms of toenail fungus may include:
- Thickening of the nail
Factors that can increase the risk of developing toenail fungus include:
- Wearing closed-toe shoes
- Getting pedicures with improperly sanitized tools
- Having a chronic illness, such as diabetes or HIV
- Having a deformed nail or a nail disease
Best Treatment For Toenail Fungus
Fungal nail infections can be a stressful and recurring problem in some peoples lives. Fungal nail infections, referred to as onychomycosis in the medical community, affect as much as 10% of the general population. And the likelihood of experiencing fungal nail infections only increases with age with the chance of being affected rising to 50% for those over the age of 70.2
In addition to advanced age, there are several other factors that may make a person likely to experience toenail fungus. Medical factors include diabetes and other causes of poor blood flow to the toes and diseases and medications that affect the immune system. Lifestyle factors include living in a warm and humid climate, use of communal bathrooms and shower stalls, and injury to the nails.1,2
Those with fungal nail infections may notice brittle, yellow toe nails that are easily cracked. It can be quite a distressing problem to have. Fortunately, there are many treatments available to counter these infections.
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What Causes Toenail Fungus
What is toenail fungus and what causes it? Toenail fungus, also known as onychomycosis, is a type of fungal infection that specifically affects the nails. This fungus usually affects the toenails but can also affect the fingernails. A toenail fungus infection is caused by a group of fungi known as dermatophytes . Fingernails and toenails infected with fungus become brittle and can turn white, yellow or even black in color. The surrounding skin can also become infected, leading to pain and swelling. Sometimes, toenail fungus cultures are performed before initiating treatment for a toenail fungus infection.
Some Side Effects Can Be Serious The Following Symptoms Are Uncommon But If You Experience Any Of Them Call Your Doctor Immediately:
- irritation, itching, burning, blistering, swelling, or oozing at the place where you applied ciclopirox
- pain at the affected nail or surrounding area
- discoloration or change in shape of nail
Ciclopirox topical solution may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administrationâs MedWatch Adverse Event Reporting program online or by phone .
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How Is Toenail Fungus Treated
Toenail fungus is notoriously tricky to treat. You may need to treat tinea unguium for several months to get rid of the fungus. Still, toenail fungus often comes back.
A skin specialist or foot doctor can explain your treatment options. If you have a mild case that doesnt bother you, your healthcare provider may recommend no treatment.
Tinea unguium treatment options include:
Oral antifungal medication
You can take a prescribed oral antifungal medication to treat the fungus. Options include terbinafine , itraconazole or fluconazole . Youll need to take the medication every day for several months . Your healthcare provider may use blood tests to check for potential medication side effects. These medications can affect your liver and interact with other medications, so oral antifungals arent for everyone.
Topical medication
You can regularly apply a topical medication right onto your nail. The medication treats the fungus over time. Topical medications are most effective when paired with oral medications.
Laser treatments
Your healthcare provider will direct a high-tech laser beam and special lights at your toenail to treat the fungus. Lasers are U.S. Food and Drug Administration approved for temporary increase of clear nail in nail fungus, but theyre not a cure. Cure rates for laser treatment are lower than oral and topical mediations. Your healthcare provider wont typically use lasers as first-line treatments for nail fungus.
How Do Dermatologists Treat A Fungal Nail Infection
Treatment usually begins with your dermatologist trimming your infected nail, cutting back each infected nail to the place where it attaches to your finger or toe. Your dermatologist may also scrape away debris under the nail. This helps get rid of some fungus.
To completely get rid of the infection, most people also need one or more of the following treatments:
Medicine you apply to the nail: If you have a mild infection, a medicine that you apply to your nails may get rid of the infection. This treatment helps keep new fungus out while the nails grow. Fingernails typically grow out in four to six months. Toenails take longer, usually takes 12 to 18 months.
Probably the most difficult part of this treatment is remembering to use it as often as prescribed. Some treatments must be applied every day. Others you apply once a week. To get the best results, its essential that you apply these medicines exactly as directed.
The US Food and Drug Administration has approved the following medicines that you apply to the nail to treat nail fungus:
Side effects from these medicines are generally mild. Possible side effects include redness and swelling, an ingrown toenail, and stinging or burning when you apply the medicine. In clinical trials, none of these side effects caused patients to stop using the treatment.
Antifungal pills, however, can cause side effects. Your dermatologist will watch you closely. Youll also need to have blood tests every month to check for problems.
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