Safe And Effective Treatments For Nail Fungus Infections For The Elderly
The elderly have poorer response to onychomycosis therapies compared to other age groups. Oral anti-fungal medicines have a high rate of success in curing nail fungus infections, but that rate reduces in older people. This may be because the medications they are taking for other conditions are rendering the anti-fungal treatments ineffective.
It could also be the other way around: the effectiveness of the medicines they take for their other health problems can be reduced, and this makes it more dangerous. This is why oral medicines for nail fungus infections are usually not prescribed to older patients.
It is crucial that the toenail fungus treatments for the elderly are not just effective, but completely safe as well. It could be oral treatments, but these should have been prescribed by a qualified physician.
Other treatments that have lesser risks than oral medications include topical ointments, surgery, essential oils and other alternatives, and laser therapy. Medicated nail lacquers are also an option for patients with mild cases of nail fungal infection or superficial white onychomycosis. These treatments have varying effectiveness, depending on the condition of the nail fungus infection.
Although some people recommend essential oils for treating nail fungi, essential oils alone have poor success rate. With few cases of exceptions, essential oils are said to be safe for most people, including the elderly.
What Causes Toenail Fungus
Everyone naturally has some amount of fungi in the body. An overgrowth of fungi, however, can cause painful, unattractive, annoying infections. Fungi thrives in warm, moist environments. But while poor hygiene is highly likely to cause toenail fungus, a diet that feeds fungi can make it worse. It also makes some people more prone than others to develop the infection.
Signs And Symptoms Of Foot Fungus
Itchy skin is an early sign of foot fungus, or scaly, peeling skin, or tiny blisters on the skin that will pop at times, says Sundling. The skin tends to break out in the shape of a moccasin, or the area of the foot that a moccasin would cover. You dont see foot fungus on the top of the foot very often. Its common to get a fungal infection between the toes as well, she adds.
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How Did I Get Toenail Fungus
Toenail fungus usually enters the nail bed when there has been an injury to the area, such as a crack or a split.
Once the fungus enters, the warm, dark environment that it finds in shoes and socks allow it to grow and spread. The fungus starts by growing under the nail bed, making it very difficult to reach with any sort of medication.
The standard treatment usually involves prescription medication or partial or full removal of the toenail.
The fungus first appears as a black spot on the toenail. This spot can start to grow and your nail can start changing color as it progresses.
If you let it go, your nail may thicken, change color further, and even produce a foul odor . It is best to deal with the early signs before it turns into something really serious.
One of the main causes of toenail fungus is poor hygiene, and the chances of getting toenail fungus increase with age men being more likely to get it over women.
This could be due to many factors, but most likely because men typically dont take care of their foot/nail hygiene as much as women do.
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.
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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.
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A Pharmacist Can Help With Fungal Nail Infections
Speak to a pharmacist if the look of your nail bothers you or it’s painful.
They may suggest:
- antifungal nail cream it can take up to 12 months to cure the infection and does not always work
- nail-softening cream it’s used for 2 weeks to soften the nail so the infected part can be scraped off
The infection is cured when you see healthy nail growing back at the base.
Causes Of Toenail Fungus
Well, essentially its an imbalance of bad bacteria to good bacteria in your body. Just like with other health conditions that stem from gut-related problems, when you dont have enough good bacteria living within your gut, you wind up developing high levels of yeast and fungus in your body that can show up on your skin.
Besides poor gut health, other risk factors that can tip the scale in terms of an infection forming include:
- Having athletes foot
- Wearing dirty or tight shoes
- Skin conditions, such as psoriasis
- Circulation problems in the legs, from existing conditions like diabetes or artery disease
- A weakened immune system
- Genetic predisposition
In particular, fungal nail infections can be caused by three different types of fungus, either by themselves or in combination:
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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:
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Amorolfine
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Efinaconazole
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Tavaborole
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.
The FDA has approved the following systemic medicines to treat nail fungus:
-
Fluconazole
-
Itraconazole
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Terbinafine
Risk Factors Of Toenail Fungus
Some factors can make you more susceptible to this infection or can exacerbate the condition. These include:
- Partaking in sporting activities such as running or swimming
- History of fungal infection anywhere on the body
- Preexisting conditions such as diabetes, psoriasis, blood circulation problems, and other immunocompromising ailments
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Potential Safe Uses For Bleach
The myth that bleach could treat toenail fungus may be less related to topical applications and more about using bleach to clean other items that could potentially infect the toenails, such as nail clippers or files.
Shoes and socks exposed to toenail fungus can be washed with bleach. Follow the bleach products directions for your washer and laundry load size. You can also use bleach-based solutions to clean areas where fungus may grow in your home, such as your shower tiles, bath mats, or floor.
Now that you know bleach isnt an effective toenail fungus treatment, lets look at some options that are.
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.
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Ask About Antifungal Pills
If topical treatment isnt doing the trick, your doctor may prescribe one of the following antifungal pills:
- Fluconazole
- Itraconazole
- Terbinafine
How to use it: Antifungal pills work faster than medicine applied to the nails, the AAD says, but you should still expect a few months of consistent use, per your doctors instructions.
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Terbinafine For Toenail Fungus Treatment
The best pill for toenail fungus is terbinafine. Evidence suggests it works better than the alternatives with the fewest side effects. Terbinafine results in resolution of toenail fungus 76% of the time. Common side effects may include headaches, skin rash, and vomiting. It is taken once a day for 6 to 12 weeks.
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What About Using Hydrogen Peroxide At Home
Hydrogen peroxide is credited with strong antifungal and antiseptic properties that can help eliminate toenail fungus, but it is very harsh at its original consistency.
Directly applying it to your skin or nail can cause extreme dryness, stinging, and irritation. So, it is recommended that you mix it with water to dilute its potency before topical use. Itâs highly recommended to consult your doctor before trying this potentially useful but somewhat risky remedy.
What Is The Most Effective Treatment For Toenail Fungus
The most effective toenail fungus treatment for you will largely depend on your symptoms and situation. Your provider will consider several factors before recommending a treatment plan thats customized to you.
Overall, oral antifungal medications may offer the most treatment potential. Pairing oral drugs with topical antifungal medication may make treatment more effective.
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Prevention And Treatment Of Toenail Fungus
Once its taken hold, toenail fungus can be hard to kick. Here are some techniques for the prevention and treatment of toenail fungus.
Anyone who enjoys wearing open-toed sandals in the summer knows how good it feels to have healthy-looking toenails. But good looks arent the only reason to keep your toenails in top shape. Fungal infections of the toenails also known as onychomycosis don’t go away on their own, and if left untreated, the fungus will spread and can eventually destroy the nail.
If you have comprised blood flow, theres even more reason to safeguard your toenails, since youll have trouble healing, says Ami Sheth, a doctor of podiatric medicine in Los Gatos, California, and a spokesperson for the American Podiatric Medical Association. And once you have a wound, you can get fungal skin infections, which can lead to a subsequent bacterial infection if the skin breaks down, notes Dr. Sheth.
However, because toenail fungal infections are typically painless, people are often unaware that they have a problem unless they are inspecting their feet regularly.
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Is Toenail Fungus Really Such A Problem
If youre thinking you can just live with it, we dont advise letting toenail fungus go untreated. Its an insidious problem, and without treatment, you have to deal with the discomfort of the nail as well as feeling self-conscious about its unsightliness.
If you let a nail fungus infection go for too long, several problems emerge. The infected nail can become misshapen and increasingly separated from your nail bed. Itching and pain are unpleasant side effects if theyre too severe, you can have trouble wearing shoes or walking.
You need to be especially attentive to treating toenail fungus if your immune system is compromised. If youre living with diabetes, its critical not to ignore the fungus. Even a mild infection like this can snowball into something more serious, like cellulitis, a severe bacterial skin infection.
Another problem is that untreated fungus eventually can spread to either neighboring toenails or to the skin of your foot, causing athletes foot. Possibly the worst outcome of untreated nail fungus is needing to have your nail surgically removed.
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Toenail Fungus Treatment Complications
Here are some things to think about when deciding on a nail fungus treatment.
If you have a disease like diabetes, your doctor will make sure you treat nail fungus. This illness often makes you more likely to have other problems from minor foot issues.
You may not be able to take antifungal pills because of side effects or because they donât work well with other drugs you take. If that’s the case, try a product that goes onto your nail. Your doctor will call this a topical treatment.
Be patient. Your nails may not look “normal” after treatment. It can take as long as a year to 18 months for your nail to grow out a fungus.
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.
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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.
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.
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How To Cure Nail Fungus
This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a board certified Family Nurse Practitioner and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support , Emergency Medicine, Advanced Cardiac Life Support , Team Building, and Critical Care Nursing. She received her Master of Science in Nursing from the University of Tennessee in 2006. This article has been viewed 331,808 times.
Onychomycosis, or nail fungus, is a common infection that affects toenails and, less frequently, fingernails. It is caused by a group of fungus called dermatophytes, which thrives in warm, moist environments, like your shoes. If you suspect you have a nail infection, try to treat it quickly and routinely, as the fungus will continue to come back if allowed to take hold.