Liam Carter
Toenail fungus, medically known as onychomycosis, is a widespread infection of the toenails. It occurs when fungi get between the nail and the nail bed, usually through a crack or cut in your toe. Walking barefoot, especially in wet public areas, increases your risk of contracting toenail fungus. To prevent this, it is recommended to wear well-fitted and breathable shoes and trim your nails straight across, leaving some white nail visible. If you are experiencing toenail fungus, it is important to address the underlying infection. Treatment options range from oral and topical medications to thinning and surgical removal of the nail.
| Characteristics | Values |
|---|---|
| Medical Term | Onychomycosis |
| Cause | Fungi get between the nail and nail bed through a crack or cut in the toe |
| Prevention | Keep nails short and straight across, leaving some white nail visible |
| Prevention | Avoid walking barefoot, especially in wet public areas |
| Prevention | Choose well-fitted and breathable shoes |
| Treatment | Oral antifungal drugs (e.g. itraconazole, terbinafine) |
| Treatment | Topical medications (creams or medicated nail polish) |
| Treatment | Thinning the nail |
| Treatment | Laser treatment |
| Treatment | Surgical removal of the nail |
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What You'll Learn
Preventing toenail fungus
Toenail fungus is a common infection that occurs when a fungus or yeast invades the toenail, causing the nail to become thickened, yellow, or brittle, and sometimes causing pain, redness, and swelling around the toenail. It thrives in warm, damp environments, making it important to keep your feet clean and dry. Here are some ways to prevent toenail fungus:
Keep Your Feet Clean and Dry
Wash your feet regularly with soap and water, paying special attention to the spaces between your toes. Dry your feet thoroughly afterward, including between your toes. Clean and dry feet and nails are less likely to pick up a fungus.
Wear Proper Footwear
Fungus thrives in warm, damp environments, so it's important to choose footwear that allows your feet to breathe. Opt for shoes made from breathable materials like leather or canvas, and choose socks made from natural fibers like cotton or wool that will absorb moisture and allow your feet to breathe. Avoid synthetic materials that can trap moisture. Additionally, wear flip-flops or shower shoes in public pools, locker rooms, and showers to prevent catching nail fungus from moist surfaces.
Practice Good Nail Hygiene
Keep your toenails trimmed short and straight across. File down any thickened or jagged nails, as these can trap moisture and lead to fungal growth. Avoid picking at your nails or the skin next to them. Clean and sterilize your nail clippers, files, and scissors after each use to prevent the spread of fungus.
Use Anti-Fungal Products
Use an anti-fungal cream or spray on your feet and between your toes to help protect against fungus. You can also use foot powder, such as medicated powder, to absorb moisture and protect against fungus.
Avoid Nail Polish and Artificial Nails
Nail polish and artificial nails can trap moisture, creating an ideal environment for fungus to grow. If you get pedicures, choose a reputable salon that sterilizes its tools, or bring your own sterilized tools.
By following these precautions, you can reduce your risk of developing toenail fungus and maintain healthy and fungus-free feet.
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Trimming nails properly
Toenail fungus, medically called onychomycosis, is a widespread infection that occurs when fungi get between the nail and the nail bed. Walking barefoot, especially in wet public areas, increases the risk of toenail fungus. To prevent this, it is important to trim your nails properly. Here are some tips for trimming your nails correctly to reduce the risk of fungal infections:
Firstly, when cutting your nails, always trim them straight across the nail. Avoid following the curve of the nail bed. Leaving some white nail visible is important; cutting nails too short exposes the vulnerable skin beneath, increasing the risk of infection.
It is also crucial to use proper tools when trimming your nails. Use a clean, sharp nail clipper specifically designed for toenails. Avoid using scissors, as they can lead to uneven cuts and increase the risk of ingrown toenails. Additionally, be gentle when trimming. Avoid cutting too close to the skin, and never cut into the corners of the nails, as this can lead to pain and potential infection.
Maintaining proper nail length is also essential. Keep your nails at a moderate length, not too long or too short. Nails that are too long can become breeding grounds for fungi, while nails that are too short, as mentioned earlier, can expose sensitive skin. Aim for a length that allows a small amount of white nail to be visible.
Finally, practice good hygiene when trimming your nails. Wash your hands and feet before and after trimming your nails. Ensure your nail clippers are clean and sterilised to prevent the spread of fungi. Regularly clean your nail care tools with rubbing alcohol or disinfectant to keep them free of any potential contaminants.
By following these tips for trimming your nails properly, you can help reduce the risk of toenail fungus and maintain healthy and well-groomed nails.
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Oral medications
Oral antifungal medications are an effective way to treat toenail fungus, also known as onychomycosis. This common condition can cause damage to the nail's structure and appearance, and in severe cases, can interfere with daily activities. Oral treatments are often preferred over topical treatments due to their shorter treatment times and higher cure rates.
There are three main groups of oral antifungal medications used to treat toenail fungus: griseofulvin, azoles (including itraconazole, fluconazole, albaconazole, posaconazole, and ravuconazole), and terbinafine. Both terbinafine and azoles have been found to be more effective than placebos in achieving a normal-looking nail and curing the infection.
Terbinafine is a prescription medication that comes in tablet or granule form and can be taken with or without food. For adults with onychomycosis, the recommended dosage is 250 milligrams once daily for 12 weeks. It is important to follow the instructions provided with the medication and consult a doctor if needed. To ensure the infection clears up completely, it is crucial to take the medication for the full duration of treatment, even if symptoms improve or disappear. As fungal infections can be slow to clear, this may involve taking the medication for several weeks or months.
Similar to terbinafine, azoles are also prescription medications. The specific type of azole, dosage, and duration of treatment will depend on the patient's individual circumstances and their doctor's recommendations. For example, itraconazole is typically taken for 12 weeks, while fluconazole is taken once a week for up to 9 months. It is important to note that elderly patients or those with liver, kidney, or heart problems may require additional caution when taking these medications.
While oral antifungal medications are generally safe and effective, it is always recommended to consult a healthcare professional before starting any new medication. They can help determine the most suitable treatment option based on individual needs and provide guidance on dosage, duration, and potential side effects.
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Topical medications
Topical treatments for toenail fungus include nail polish, cream, or tablets. While tablets are much more effective than topical treatments, they also have more side effects and are not suitable for children. Topical treatments are usually recommended for children because most oral medications are not suitable for them, and their thinner and faster-growing nails make it more likely that treatment with nail polish or creams will be effective.
Topical nail polishes include ciclopirox, which is water-soluble and applied daily. The remaining polish is removed with water before each new application. Another option is to use a treatment set that contains two creams and a nail scraper. The first cream contains urea, which softens the nail so it can be removed. The second cream contains bifonazole, which has an antifungal effect. For this treatment, the affected toe must first be soaked in warm water for ten minutes and then dried. After applying the urea-based cream to the nail, cover it with an adhesive bandage. Remove the bandage after 24 hours and soak the toe again in warm water.
Home remedies for toenail fungus include applying tea tree oil or vinegar, although there is a lack of evidence supporting their effectiveness. Vapor rub was found to be effective by more than half of the participants in a small study, and it worked almost as well as ciclopirox. Sodium bicarbonate has been shown to limit the growth of common fungi that cause skin and nail infections, and sunflower oil has been found to work against yeasts that cause foot fungus without any observed side effects.
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Surgical removal
Surgical nail removal is a procedure to consider when dealing with toenail fungus. It is often carried out when a large portion of the nail is diseased and damaged or if the nails are very painful. Before the procedure, your doctor will numb the area around the nail. Once the area is numb, the doctor will use special tools to remove the entire nail or just the infected piece, depending on the severity of the infection. In some severe cases, they may have to destroy the nail matrix, which is what makes your nail grow back.
After the procedure, an ointment is applied to the wound, and it is covered with gauze and tape. You will be given instructions by your doctor on how to care for your wound. Typically, you should wash around the wound with clean water twice a day for the first 24 to 48 hours. Avoid using hydrogen peroxide or alcohol, as these can slow the healing process. You may cover the wound with a thin layer of petroleum jelly and a non-stick bandage, reapplying the jelly and replacing the bandage as needed.
The wound should heal within a few weeks, and your doctor will advise when you can resume normal physical activity. Toenails can take 12 to 18 months to grow back, so you may be offered antifungal medication to apply to the nail bed to kill any remaining fungus.
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Frequently asked questions
Toenail fungus, or onychomycosis, presents as an infection between the nail and the nail bed. If you suspect you have toenail fungus, visit a doctor or podiatrist. They will take nail clippings and scrape debris from under your nail to determine the exact nature of the infection.
Toenail fungus occurs when fungi enter through a cut or crack in your toe. To prevent toenail fungus, avoid walking barefoot, especially in wet public areas such as pool decks or locker rooms. Keep your nails short and trim them straight across the nail, leaving some white nail visible.
Treatment options range from oral antifungal drugs, such as terbinafine (Lamisil) and itraconazole (Sporanox), to topical medications like nail creams or medicated nail polish. In severe cases, a podiatrist may recommend thinning or surgically removing the nail.
Oral antifungal medication typically needs to be taken for 10 to 12 weeks, and sometimes longer. Topical medications may need to be applied daily for eight months up to a year.
Oral antifungal drugs can have serious side effects. While they are the fastest way to treat nail fungus, it is important to discuss potential risks with your doctor before starting any medication.
