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.
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Nail Fungus: Polish Cream Or Tablets
Nail fungus can be very persistent. Topical treatment with nail polish may take up to one year. Tablets for treating fungal nail infections usually have to be taken for several weeks or months. They are much more effective than topical treatments, but they have more side effects.
Brittle nails and a whitish-yellowish or brownish discoloration are typical signs of nail fungus. The nails may also become thicker and change shape. The affected part of the nail sometimes detaches from the nail bed. The treatment options for nail fungus include nail polishes and creams as well as tablets. Nail polishes and creams are available in pharmacies without a prescription.
When To Call A Doctor For Severe Nail Fungal Infection
Nail fungal infections can be treated without going to the doctor. They can be successfully and easily cured with over-the-counter medications. Many topical ointments, though, get a bad rap because they are thought to be ineffective in treating nail fungus. However, newer topical solutions that have 10% undecylenic acid and nail-penetrating essential oils are proven to provide effective, safe, and fast cure.
For severe cases of nail fungal infections, its best to see a doctor for best possible treatments. These include worst case scenarios of onychomycosis, in which patients deal with discomfort or increased pain and swelling, other infections, red streaks extending from the area, discharge of pus, and fever with no other cause.
Its also best to go to a doctor if the fungal infection appears to be spreading to the surrounding skin. Other people also seek a doctors advice even if their nail condition is a moderate case because the appearance of the infected nail bothers them.
A general practitioner may be able to handle nail fungal infection cases. However, it is recommended to seek a dermatologist to pinpoint the problem. A dermatologist can give proper diagnosis on skin and nail conditions, and therefore will be able to identify the fungal infection and what type it is.
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What Are The Symptoms Of Fungal Nail Infection
Often the only symptom is difficulty trimming your nails but other symptoms of fungal nail infections are:
- The nail gets thicker.
- Change in colour of some or all of your nail turns yellow, white, blue, purple or black.
- The skin near the nail may itch, or crack.
- Pain around the nail area which can make it uncomfortable to walk or exercise or put on shoes.
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How To Treat Fungal Nail Effectively
Owing to the high recurrence rate of fungal nail infections, pharmacy professionals should be able to advise patients on effective treatment and preventative and appropriate self-care strategies to avoid re-infection.
Fungal nail infection is a mycotic infection caused by fungal invasion of the nail structure and is one of the most common nail disorders, representing half of nail abnormalities in adults. Its prevalence in Europe is around 4.3% over all age groups and 15.5% of all nail dystrophies in children. OM is more commonly diagnosed in men and older people, affecting 2050% of people aged over 60 years. An increased incidence among older people may be attributed to multiple factors, including reduced peripheral circulation, diabetes, inactivity, relative immunosuppression, and reduced nail growth and quality. Toenails are affected more commonly than fingernails.
This article will cover the causes, types and treatment of OM, practical information to help guide patient consultations and when to refer to podiatry.
What Is The Treatment For Fungal Nails
Oral antifungal therapy has a high cure rate, depending on the medication. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back. Currently, an oral antifungal therapy is considered the best treatment for toenail fungus because of higher cure rates and shorter treatment duration compared to topical therapy.
Prescription oral medications that are effective against nail fungus include the following:
There are several innovative treatments that are still being tested:
- Laser therapy or uses application of light-activated agents onto the nail followed by shining light of a proper wavelength on the nail.
- Use of electrical current to help absorption of topical antifungal medications into the nail: This is also called iontophoresis.
- Use of a special nail lacquer that changes the micro-climate of the nail to make it inhospitable for the fungus to grow: If this works, it may be an inexpensive way to treat this problem in the future.
One way to definitively get rid of toenail fungus is by surgery. Surgical treatment of onychomycosis involves nail removal. However, this often only provides temporary relief, and recurrence is common unless additional antifungal medication is simultaneously used. However, surgical removal may be warranted when the affected nail is associated with other factors such as trauma and or infection.
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Devices Used To Treat Onychomycosis
Recently, non-drug treatment has been developed to treat onychomycosis thus avoiding the side effects and risks of oral antifungal drugs.
Lasers emitting infrared radiation are thought to kill fungi by the production of heat within the infected tissue. Laser treatment is reported to safely eradicate nail fungi with one to three, almost painless, sessions. Several lasers have been approved for this purpose by the FDA and other regulatory authorities. However, high-quality studies of efficacy are lacking, and existing studies indicate that laser treatment is less medically effective than topical or oral antifungal agents.
- Nd:YAG continuous, long or short-pulsed lasers
- Ti:Sapphire modelocked laser
- Diode laser
using the application of 5-aminolevulinic acid or methyl aminolevulinate followed by exposure to red light has also been reported to be successful in small numbers of patients, whose nails were presoftened or medically avulsed using 40% urea ointment for a week or so.
Iontophoresis and ultrasound are under investigation as devices used to enhance the delivery of antifungal drugs to the nail plate.
Fungal Nail Infection Complications
It can take a year or more for your nails to look like they did before the infection. And you may continue to have problems:
- The fungus can come back.
- Your nails may be permanently discolored or misshapen.
- The infection may spread to other parts of your body.
Itâs especially important to take care of a fungal nail infection if you have diabetes. Youâre at greater risk of getting a serious skin infection.
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Fungal Nail Infection Treatment
See your doctor if you think you have nail fungus. It can be tough to get rid of, and youâre more likely to have success with a prescription. Treatments include:
- Oral antifungals. The doctor may give you a pill to kill fungus in your whole body. This is usually the best way to get rid of a nail infection. Treatment may last 2 months for an infection in your fingernails, or 3 months if itâs in your toenails.
- Topical antifungals. You rub or brush these medicines onto your nails. They may work for a mild infection, but they canât get deep enough into the nail to cure a more serious one. You might use a topical treatment in combination with a pill.
- Surgery. If other treatments donât work, the doctor may need to remove your nail entirely and let a healthy one grow back in its place. The new nail could also get infected.
- Laser or photodynamic therapy. Doctors are studying newer treatments that use special light to try to kill the fungus.
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.
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Using Baking Soda For Acrylic Fungus
For many years, baking soda has been an effective treatment for nail fungus, even if it is caused by the acrylic nails.
All you have to do is make a hand or foot soak mixed with a tablespoon of baking soda. It will gradually heal the nail fungus. The estimated healing time with the baking soda is almost 7 months.
If you find the nail fungus treatment with baking soda tough, think of using the baking soda paste. Mix the baking soda with an essential oil like the snakeroot extract, or any other ionized oil, and apply it twice a day.
Another amazing thing to treat nail fungus is putting a few pinches of baking soda in the gloves, and killing the already present fungus spores.
Treatments For Fungal Nail Infections
Treatment isnt always needed for a mild fungal nail infection because its unlikely to cause any further problems and you may feel its 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 youre bothered by the appearance of the affected nail, or its causing problems such as pain and discomfort. Theyll 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 theyre 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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Treatment With Topical Creams
Topical creams are the most famous treatment for every nail and skin infections. They are effective but not completely. We cannot claim the topical creams as the best solution for nail fungal infection.
You can use the topical creams, when your diet is under check. Proper diet is extremely important for fast results. Otherwise, any probiotic supplement can also help along with the topical creams.
The best time to use topical creams for nail fungus, is the time you feel a slight redness or pain. The best topical creams for nail fungus will take almost 48 weeks. Users may feel it difficult to use topical creams.
The main side effects of topical creams are burning, and a slight itching, which is really uncomfortable for a lot of women.
Distal And Lateral Subungual Onychomycosis:
Distal and lateral subungual onychomycosis are seen in majority of cases and is almost always due to dermatophyte infection. It affects the hyponychium, often at the lateral edges initially, and spreads proximally along the nail bed resulting in subungual hyperkeratosis and onycholysis although the nail plate is not initially affected. Distal and lateral subungual onychomycosis may be confined to one side of the nail or spread sideways to involve the whole of the nail bed, and progresses relentlessly until it reaches the posterior nail fold. Eventually the nail plate becomes friable and may break up, often due to trauma, although nail destruction may be related to invasion of the plate by dermatophytes that have keratolytic properties. Examination of the surrounding skin will nearly always reveal evidence of tinea pedis. Toenail infection is an almost inevitable precursor of fingernail dermatophytosis, which has a similar clinical appearance although nail thickening is not as common.
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Verywell Health / Sabrina Jiang
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. But if left untreated, the fungus can grow severely by hardening the nails and spreading to other toes.
The fungus often begins in the form of athlete’s foot between the toes or on the soles of the feet. At this stage, the fungal infection is easier to treat with over-the-counter medication. But Shari Lipner, MD, a board-certified dermatologist at New York-Presbyterian Hospital/Weill Cornell Medicine, told Verywell Health toenail fungus can be difficult to treat because of how slow the nails grow. The more severe the toenail fungus, the thicker the nail, and the more nails involved makes it that much harder to treat the nails even with effective therapies, she says.
Diagnosing the fungal infection early is key to make treatments effective. Dr. Lipner recommends visiting a board-certified dermatologist to properly treat the infection if it grows to be too severe.
Here are a few of the best over-the-counter toenail fungus treatments on the market.
Living With A Nail Fungal Infection
If you have a nail fungal infection, some things can help:
- Keep your nails cut short and file down any thick areas.
- Dont use the same nail trimmer and file on healthy nails and infected nails. If you have your nails professionally manicured, bring your own nail file and trimmer from home.
- Wear waterproof gloves for wet work . Wear 100% cotton gloves for dry work.
- Wear socks made of wicking material . This pulls moisture away from the skin. Change your socks when they are damp from sweat or if your feet get wet. Put on clean, dry socks every day. Put over-the-counter antifungal foot powder inside your socks to keep your feet dry.
- Wear shoes with good support and a wide toe area. Dont wear pointed shoes that press your toes together.
- Avoid walking barefoot in public areas, such as locker rooms.
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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.
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Treating With Apple Cider Vinegar
Fungus grows with a protective layer on it. The apple cider vinegar is known for its membrane killing property.
It will directly erase the protection the nail fungus have developed, and will eventually cause it to die. The ACV can take almost 5 months to show some obvious results.
All you have to do is make a dilute solution of apple cider vinegar and water. Now apply it twice a day. You need to do it regularly, without any break for satisfying results.
Another way to use it is soaking your nails in a mixture of apple cider vinegar and let it stay there for almost 15 minutes twice a day. During vacations it can help a lot but for regular working days, you can have the solution in a spray bottle.
Check in detail about how to efficiently use Apple cider vinegar for nail fungus.
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