Caleb Foster
Fingernail fungus, or onychomycosis, is a fungal infection that causes the nail to become thick, discoloured, and brittle. It is usually treated with antifungal medications, which may be oral or topical, but in severe cases, doctors may recommend laser therapy or even surgery to remove the infected nail. Home remedies are not typically effective in treating fingernail fungus, and while nails usually grow back, it can take a significant amount of time—up to 18 months for a healthy nail to regrow.
| Characteristics | Values |
|---|---|
| Diagnosis | A dermatologist will examine the fingernails and toenails, checking for colour change, buildup, and other signs of nail fungus. They may take a sample from the nail by removing some buildup, clipping off a bit of the nail, or scraping the nail's surface to be examined under a microscope. |
| Treatment | Doctors may recommend antifungal medications in the form of oral tablets, topical paints, or creams and lotions. In severe cases, they may suggest combination therapies of both topical and oral antifungal medications. Other treatments include laser therapy, surgery to remove the infected nail, or non-surgical chemical removal. |
| Prevention | To prevent fungal nail infections, it is recommended to keep hands and feet clean and dry, trim nails short, and wear shoes or shower shoes in public places to avoid going barefoot. |
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What You'll Learn
Antifungal medications
Topical antifungal medications include ciclopirox nail lacquer, which is a prescription medication that treats nail fungus on both fingernails and toenails. It is important to remove any loose nails before applying the medication, and this trimming may need to be performed by a dermatologist. Topical medications can cause side effects such as redness, swelling, or a stinging and burning sensation.
Oral antifungal pills, such as itraconazole (Sporanox) and terbinafine (Lamisil), are prescribed for severe infections and taken for up to 12 weeks. These medications are not suitable for individuals with liver disease or heart problems and may interact with other medications.
While antifungal medications are effective, they require time to work. It can take 4 to 6 months for fingernails to grow back healthily, and in some cases, it may take up to 18 months for a complete recovery. It is important to consult a doctor to determine the most suitable treatment option, as certain medications may not be suitable for everyone.
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Laser therapy
There are several types of laser treatments available, including long-pulsed 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, short-pulsed 1064-nm Nd:CO2 lasers, and lasers with wavelengths of 870 nm, 930 nm, and 1320 nm. The specific wavelength of the laser is absorbed by the fungal cells, resulting in the generation of radical oxygen species that cause photoinactivation of the fungi. This high-energy laser treatment can be effective in killing the fungus and improving the appearance of the nail, but it is important to note that the FDA has not approved any laser to treat the infection itself.
While laser therapy shows promising results, it is important to acknowledge that it may be expensive and not covered by insurance. Furthermore, the American Academy of Dermatology Association (AAD) considers it an unproven therapy due to a lack of comprehensive research. More large-scale randomized controlled trials are needed to validate the effectiveness and safety of laser therapy and establish it as a standard treatment option for onychomycosis.
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Surgery
Surgical nail removal is an option for treating fungal nail infections. This procedure can be performed in a doctor's office or clinic, and does not require hospitalisation. Before the surgery, the patient is given an injection in the infected finger or toe to prevent pain. The doctor then uses a tool to loosen the skin around the nail and separate it from the skin. If only a part of the nail is infected, only the diseased part is removed.
If the patient wants to prevent the nail from growing back, the doctor can destroy the nail matrix by applying a chemical to the cuticle area after the nail plate is removed. An ointment is then applied to the wound, which is covered with gauze and tape. The patient should follow the doctor's instructions for wound care, or, if no instructions are given, general advice is to wash around the wound with clean water twice a day after the first 24 to 48 hours. It is recommended to avoid using hydrogen peroxide or alcohol, as these can slow healing.
After surgery, patients should take care to prevent further infection. This includes disinfecting bathroom tiles with bleach, wearing socks with shoes, and avoiding going barefoot, especially in public places. Shower shoes are recommended.
It is important to note that surgical nail removal may result in abnormal nail growth, with the new nail being odd in shape and appearance. The nail regrowth process can take a significant amount of time, with some sources stating that it can take more than a year for a new nail to grow, while others state that it can take 6 months or longer.
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Non-surgical chemical removal
Before starting the chemical treatment, your doctor may need to trim or clip the nail to remove any loose or infected parts. This step ensures that the chemical can reach all affected areas and may be done by the doctor or taught to the patient for at-home care. Additionally, patients may be instructed to remove previous coats of medication using rubbing alcohol.
One chemical treatment option is ciclopirox nail lacquer, a prescription medication applied once daily to the infected nails. It is important to cover not only the nail but also the surrounding skin for effective treatment. This treatment is suitable for individuals aged 12 years and older.
While mentholated salve and snakeroot extract are natural antifungal alternatives available over the counter, they are not as potent as prescription medications. These options may provide temporary relief, but the infection often returns, requiring a switch to a different treatment method.
It is worth noting that there are potential side effects to chemical treatments, including redness, swelling, stinging, and burning sensations. Additionally, it takes time for the nail to return to its normal state, even after successful treatment. On average, it takes 4 to 6 months for fingernails to recover, and in some cases, it can take up to 18 months for a healthy nail to regrow completely.
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Home remedies
Although there is no evidence that home remedies can completely cure a fungal nail infection, some treatments may help clear up symptoms. Here are some home remedies that may help:
Vicks VapoRub
Vicks VapoRub is a topical ointment that contains camphor, eucalyptus oil, and thymol, which have antifungal properties. A 2011 study found that Vicks VapoRub had a positive clinical effect in treating toenail fungus. To use this treatment, apply a small amount of VapoRub to the affected area at least once a day.
Oregano Oil
Oregano oil is a potent natural antifungal that contains thymol. It can be diluted and applied to the affected nails to help combat the fungus. However, it can cause side effects such as irritation or an allergic reaction.
Ozonized Oils
Ozonized oils, such as olive oil and sunflower oil, have been infused with the same gases present in the ozone layer and may have antifungal properties.
Listerine Mouthwash
The gold-coloured Listerine Original Antiseptic Mouthwash contains thymol, a plant compound with antifungal properties. To use this treatment, fill a basin with Listerine and soak your entire foot and nails in the liquid for 15 minutes, two to three times a week.
Coconut Oil
Coconut oil possesses antifungal and moisturizing properties. Applying it to affected nails can help soften and nourish them while combating the fungus. It can also be combined with garlic and olive oil to create a cream that can be applied to the affected area.
Tea Tree Oil
Tea tree oil is renowned for its antifungal properties and can be applied directly to affected nails to help combat the fungal invasion. However, it should be used with caution as it can cause irritation or an allergic reaction.
It is important to note that these remedies may not be suitable for everyone, and it is always recommended to consult a doctor or medical professional before starting any new treatment.
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Frequently asked questions
Symptoms of a fungal nail infection include thick, discoloured and brittle nails. The infection usually starts at the edge of the nail and spreads to the rest of the nail.
There are a variety of treatments available for fungal nail infections. Antifungal medications are available in the form of oral tablets or topical paints. In some cases, a doctor may recommend both topical and oral antifungal medications. Laser therapy is also an option if the infection doesn't clear up with medication alone. In severe cases, surgery may be required to remove the infected nail.
While there is no evidence that home remedies can fully clear up a fungal nail infection, mentholated salve and snakeroot extract have been shown to be effective for some people.
