How Are Thick Toenails Treated
Although not all cases of toenail fungus need to be treated, thick toenails may be a sign that the fungus has gotten worse. Several methods are available to treat your toenails. You can try some home-based treatments first and then talk to your doctor about prescription-based options. Topical and oral medications are the mainstays of therapy.
What About The Cost Of Oral Medications For Fungal Nails
A further consideration is cost. Because newer oral antifungal agents are very expensive, some insurance companies balk at paying for what they consider a “cosmetic issue,” unless nail fungus causes pain or other functional symptoms. Terbinafine and fluconazole are now available as generic drugs and are quite inexpensive.
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.
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How Do You Get Rid Of Yellow Toenails
Applying a small amount of melted coconut oil can help heal thick yellow toenails. You can purchase over-the-counter antifungal nail creams and ointments. Be sure to clip and clean your nails before use to make sure the creams reach deeper layers. Laser therapy can be used to treat a fungal toenail infection.
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.
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What Is The Prognosis Of Fungal Nails
Curing fungal nails can be difficult and treatment can take up to 18 months. Relapse and reinfection are common. Trying to remove or modify your risk factors, if possible, is essential to preventing reinfection. People who have medical illnesses that predispose them to fungal nails can have an even more difficult time eradicating the fungus.
Shoewear And Loose Toenails
Another common scenario that causes a toenail to come loose is repeated trauma from shoe wear. This is often associated with running, extended periods of walking or hiking, or any endurance sport and is sometimes referred to as black toenail. In any case of trauma to a nail, the blood that builds up beneath the nail causes a red, purple, or black discoloration and is known as a subungual hematoma. Quite often, you will lose the nail as it grows out.
Repeated long-term rubbing of the toe against the tip of the shoe may result in the nail edge coming loose without any bleeding beneath the nail.
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Other Factors That Affect Regrowth
Other factors affect the speed of regrowth. For example, nails tend to grow slower in older adults and in colder climates. Nails grow faster in the summer.
In addition, nails on a dominant hand tend to grow faster than nails on a nondominant hand.
Its also been noted that trauma or an injury increases the rate of regrowth, due to an increase of blood flow to the injured area.
Overall health also has an impact on growth. Nail growth can slow down if youre sick or malnourished. And since hormones affect regrowth, your toenails and fingernails might grow quicker during pregnancy.
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.
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Manuka Honey For Nasty Nail Fungus
We thought we had heard just about every remedy ever tried for nail fungus.
Sam surprised us with something different:
Ive struggled with toenail fungus on my big toe for over five years. None of the remedies I tried really worked.
This spring I purchased a tube of medical grade Manuka honey ointment to have on hand for burns and scrapes. I started putting just a small dab on and under my toenail before I put my socks on every morning. I noticed a difference in about a week. A lot of the darkest color had disappeared.
Three months later, I can clearly see where my nail is growing out with no fungus. The honey is brown so it stains the nail, but thats a more than acceptable trade-off for me. Im guessing that after about five months of treatment, my nail will finally be back to normal.
Why Toenail Fungus Is So Stubborn
A fungal infection in your toenails is typically caused by a tiny organism called dermatophyte fungus. This type of fungus thrives in warm, moist environments think public swimming pools or locker rooms where it can be easily transferred between people.
Once you pick up the infection, it can spread fairly quickly, largely because you keep your feet inside shoes, creating the perfect environment for fungal growth.
Making matters worse, your toenails are fairly thick and made up of many layers, which means the fungus can set up shop deep within these layers, making it more difficult to target. In moderate-to-severe cases, the fungus can even get into the matrix of your nail, which means any new toenail growth is already infected.
Rounding out the list of hurdles is the fact that your toes dont benefit from great circulation, so your immune system is less likely to detect and fight off the foreign invaders.
What all of this amounts to is that many people think that a toe fungal infection is coming back when it never really went away in the first place.
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Trauma And Loose Nails
The other common cause of nail loosening is trauma. One common scenario is an object dropped on the tip of the toe or finger. Sometimes blunt-force trauma to a nail causes excessive bleeding beneath the nail that causes enough pressure to loosen the nailin some cases causing complete loss of the nail shortly after. Because the bone at the tip of the toe or finger, known as the distal phalanx, is very close in proximity to the nail, blunt toe or finger trauma can sometimes cause a bone fracture2.
It is best to seek medical care for nail trauma, especially if there is bleeding beneath the nail.
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.
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How Can I Prevent Toenail Fungus
Theres no way to guarantee that you wont get toenail fungus. But you can take several steps to help prevent it:
- Avoid going barefoot in communal areas such as hotel rooms / showers, public showers, locker rooms and swimming pools. Most people pick up fungus in these situations. It helps to wear flip flops in these public areas.
- If you have a family member with foot fungus or nail fungus, try to use different shower or wear flip flops in the shower to avoid coming in contact with it.
- Trauma due to accidental or aggressive clipping of the nails can turn into portals of entry for the fungus.
- Clean your nail trimmer before using it.
- Do not tear or rip your toenails on purpose.
- If you have diabetes, follow all foot care recommendations from your healthcare provider.
- Keep your feet dry. Make sure to fully dry your feet after a shower.
- Soak toenails in warm water before cutting them. Or you can cut your nails after a shower or bath.
- Trim toenails straight across .
- Wear shoes that fit correctly. They should not be too loose or tight around the toes.
What Should I Ask My Healthcare Provider About Toenail Fungus
If you have toenail fungus, you may find it helpful to ask your provider:
- What type of infection do I have?
- Do you recommend I treat it? Why or why not?
- How long will I need treatment?
- What steps can I take to stop it from coming back?
- Should I be aware of any potentially serious complications or treatment side effects?
A note from Cleveland Clinic
Toenail fungus is an incredibly common infection that can be difficult to treat. The condition usually isnt painful, but it may make you feel self-conscious about how your foot looks. If it bothers you, talk to your provider about your treatment options. A trained specialist can provide guidance on whats most likely to address your concerns while protecting your overall health.
Last reviewed by a Cleveland Clinic medical professional on 12/17/2020.
References
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Does Toenail Fungus Ever Go Away On Its Own
Onychomycosis even the name isnt all that attractive. But when it strikes your toenails, the effects can be downright unsightly. Toenail fungus is an incredibly common, and tenacious, condition to deal with. Once it takes hold, the fungal infection seemingly mocks your every effort at eradication, which is where we come in.
At Jeremy Moran: Foot & Ankle Specialist, our team of podiatric specialists understands the difficulty that this seemingly simple problem poses. A fungal infection in your toenails, though not dangerous, is an unwelcome guest that can take up residence and plague your toenails for months, and even years.
If youd like to explore how we help our patients in Tomball, Texas, wave goodbye to toenail fungus, once and for all, read on.
Signs And Symptoms Of A Fungal Nail Infection
A fungal nail infection may not cause any obvious symptoms at first.
As it progresses, the infection can cause:
- discolouration of the nail it may turn white, black, yellow or green
- thickening and distortion of the nail it may become an unusual shape or texture and be difficult to trim
- pain or discomfort particularly when using or placing pressure on the affected toe or finger
- brittle or crumbly nails pieces may break off and come away completely
Sometimes the skin nearby may also become infected and be itchy and cracked or red and swollen.
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When Should I Call The Doctor
In rare cases, toenail fungus can cause an infection called cellulitis. Without prompt treatment, cellulitis may pose a serious danger to your health.
You should seek treatment guidance from a trusted healthcare provider if you have:
- Circulation problems.
- Redness, pain or pus near the toenail.
- Weakened immune system.
Take It Slow And Steady
Thick fungal nails have a tendency to crumble, too. If you try to take off too much at once, the fragile nail might split and fracture in various ways you did not intend it to.
Clip only a small part of your nail at a time, starting at one corner and moving straight along the nail. Make sure these clips are relatively straight and uniform to try to avoid any jagged edges that could snag against socks.
Do not round your nails off at the corners, as this can increase the odds of ingrown toenails. Painful, inflamed, and potentially open skin is not something you want next to toenail fungus.
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Softening And Scraping Away The Nail
As it can take a long time for antifungal medication to work, some people may prefer to use a treatment that involves softening and removing infected parts of nail over a few weeks.
Treatment kits are available from pharmacies that contain a 40% urea paste, plasters and a scraping device. The paste softens the infected parts of the nail, allowing them to be scraped away so they can be gradually replaced with healthy nail.
To use the treatment:
What Are The Symptoms
The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured. The nail can turn white, black, yellow or green.
You will not usually feel any pain at first, but the nail can look ugly and, without treatment, there is a chance the infection will spread and lead to complications such as cellulitis.
Read more information about the symptoms of a fungal nail infection.
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What Are The Signs The Treatment Is Working
In some cases, you might not really see sure signs that the fungi are âdyingâ per se. But you might begin to see some subtle changes in the appearance of your infected nail.
If you see these signs, itâs a good thing, but donât optimistically stop treatment. Even if you have great physical changes, it doesnât mean the fungus is gone — keep on treating it as long as your doctor recommends.
Here are some positive initial signs your treatment is working:
Changes in color
Toenail fungus can cause the nail to become white, yellow, black, or brown. As the fungus diminishes, the discoloration of the nail might slowly dissipate. Over time, youâll see areas of discoloration get smaller and smaller.
If your toenail infection has caused your nails to become thick and raised off your nailbed, a sign of effective treatment is a decrease in nail thickness. However, this might not totally resolve until your nail regrows.
New nail growth is healthy
Over time the new growth will begin to show at the base of your nail. If the treatment is working, the new growth should be healthy and will likely look a little different from the upper part of the nail.
Clear delineation between new nail growth and infected nail
With time, this new growth will become longer and longer, making its way to the top of your nail. As this happens you might see a clear line between healthy new growth and the older infected nail.
Keep Your Fungal Nail Trimming Equipment Separate
Nail clippers and other equipment that comes in contact with fungal areas are not objects that should be used anywhere else, or for anyone else. Doing so invites a greater chance for a fungus to be carried from one set of nails to another.
This is not just a warning against sharing toenail trimmers between family members you should also not use that set of trimmers on your fingernails, either! It is quite possible for a fungal infection to be transferred from toenails to fingernails, and you cant exactly hide the latter in a pair of socks all day.
Similarly, only use proper trimming equipment on your toes. Using smaller fingernail clippers not only increases the risk of transferring the fungus if you slip up, they are likely also not going to work very well.
It is also wise to regularly disinfect your equipment, just in case. A soak of a few minutes in rubbing alcohol or diluted bleach will do the trickjust make sure to completely dry any metal parts to avoid rusting. Also make sure all nail debris and matter is cleaned off.
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What Happens To Your Fingernails When You Have Cancer
Many changes to nails that happen during cancer treatment can affect their appearance. For example, ridges or lines in your nails are not usually painful, but cause changes in how your nails look and feel. Once the treatment causing changes is done, the changes will usually go away over time as the nail grows out.