Liam Carter
Fingernail fungus is a common condition that can cause discolouration, thickening, and breakdown of the nail. It is caused by a fungal infection that spreads in and under the nail and can be challenging to treat. While there are various home remedies and over-the-counter treatments available, they are often ineffective in fully eliminating the fungus. Medical treatments, such as oral and topical antifungal medications, laser therapy, and nail removal, are the most effective methods to eradicate the infection. It is important to consult a doctor for proper diagnosis and treatment to ensure the best chance of success in treating fingernail fungus.
| Characteristics | Values |
|---|---|
| Diagnosis | Dermatologist examines nails and nearby skin; checks for skin infection; collects debris, nail or skin scrapings for examination under a microscope; performs a potassium hydroxide (KOH) smear or a fungal culture |
| Symptoms | White or yellow spots under nails; nail discolouration; nail thickening; nail crumbling; nail odour; pain when pressure is applied to the area |
| Treatment | Prescription antifungal medications (oral or topical); laser therapy; nail removal; alternative remedies such as Vicks VapoRub, oregano oil, ozonized oils |
| Prevention | Keep nails short and clean; practice good hand and foot hygiene; prevent athlete's foot; moisturise hands and feet to prevent skin cracks; sanitise nail tools and do not share them |
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What You'll Learn
Antifungal pills and creams
Antifungal medication is the primary treatment option for nail fungus. Oral antifungals are usually more effective than topical treatments, and they work more quickly. Oral antifungals are taken by mouth to kill the fungus in your whole body. Treatment for fingernail infections typically lasts for two months, while toenail infections usually require three months of treatment.
There are several oral antifungal medications available, including:
- Terbinafine: Treatment for fingernail infections takes six weeks, while toenail infections require 12 weeks of treatment. Individuals must take one 250-milligram tablet daily.
- Itraconazole: Treatment involves taking one 200-milligram capsule daily for 12 weeks for toenail infections.
Topical antifungals are also available, which are medicines that you rub or brush onto your nails. These treatments may work for mild infections, but they cannot penetrate deep enough into the nail to cure more severe infections. Topical treatments can be used in combination with oral antifungal pills for more effective results. Examples of topical antifungals include:
- Tavaborole: A 5% tavaborole topical solution applied to the affected nail.
- Efinaconazole: A 10% topical solution applied daily to any affected nails.
- Ciclopirox: An 8% nail lacquer applied once per day to affected nails. Treatment can last for up to 48 weeks.
In addition to oral and topical antifungals, there are over-the-counter treatment sets containing two types of creams and a nail scraper for the topical treatment of nail fungus. One cream contains urea, which softens the nail for removal, and the other has bifonazole, an antifungal agent. This treatment is carried out over 14 days, followed by four weeks of treating the skin beneath the nail with bifonazole cream.
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Laser and light treatments
There are several types of laser treatments available, including fractional CO2 lasers, which ablates the nail plate and potentially disrupts the growth of the fungus. Another type is the Nd:YAG class of solid-state lasers, which includes titanium (Ti):sapphire and erbium-based devices. These lasers deliver a substantial amount of energy per pulse while sparing the surrounding tissues from excessive heating due to their high thermal conductivity.
The number of sessions required for laser treatment can vary, and it may take about two months to notice the results. The cost of laser treatment can range from $200 to $700 per session, and it may not be covered by health insurance.
While laser treatment for nail fungus has been available since the 1980s, more research is needed to determine its safety and effectiveness for most people. Some studies have shown promising results, with a "complete cure" rate of 50% in one study using fractional CO2 lasers. However, the small sample size and lack of a control group limited the conclusions that could be drawn.
In addition to laser therapy, photodynamic therapy (PDT) is another light-based treatment for nail fungus. PDT uses a combination of light and a photosensitizing agent to kill the fungus. This treatment is still being studied, and more research is needed to determine its effectiveness and safety.
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Nail removal
Fungal nail infections can be stubborn and persistent. They can cause the nail to thicken, become misshapen, and turn white, yellow, green, or black. In some cases, the nail may crumble, emit a foul odour, or detach from the nail bed. If you suspect you have a fungal nail infection, it is important to consult a dermatologist or doctor for diagnosis and treatment.
If you have a severe fungal nail infection or if other treatments have been ineffective, your doctor may recommend removing the nail to eradicate the infection. This procedure can be performed in the doctor's office under local anaesthesia. The doctor will first inject your finger or toe to prevent pain, then use a tool to gently separate the nail from the surrounding skin. If only a portion of the nail is infected, the doctor may remove only the diseased part. However, if the infection is widespread or the nail is severely damaged, they may opt to remove the entire nail.
In some cases, to prevent the nail from growing back and reduce the risk of future infections, the doctor can destroy the nail matrix by applying a chemical to the cuticle area. This decision should be made in consultation with the patient, as the nail may not grow back or may grow back with an abnormal shape or appearance. After the procedure, an ointment is applied to the wound, which is then covered with gauze and tape.
It is important to follow your doctor's instructions for wound care to ensure proper healing. Typically, you should keep the wound clean and wash it with water twice a day, avoiding the use of hydrogen peroxide or alcohol, which can impede the healing process. The wound should heal within a few weeks, but it may take up to six months for a fingernail to grow back and 12 to 18 months for a toenail.
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Natural remedies
While it is always best to consult a doctor or dermatologist for a proper diagnosis and treatment plan, there are several natural remedies that can help treat a fungal nail infection.
Fungal nail infections occur when a fungus attacks a fingernail, toenail, or the skin under the nail, called the nail bed. Toenails are more commonly affected than fingernails because they grow slower, have less blood flow, and are often in dark, warm shoes or socks, which provide an ideal environment for fungi to grow.
- Mentholated salve: Research has shown that applying a mentholated salve to the nail every day can help get rid of a fungal infection.
- Snakeroot extract: Snakeroot is a natural antifungal from the sunflower family. It has been found to be as effective as some prescription antifungal creams.
- Tea tree oil: Tea tree oil is a natural antiseptic. Apply it to the affected nail twice a day. Do not ingest tea tree oil as it can be toxic.
- Listerine or vinegar: Some people find success by soaking the affected nail in Listerine or vinegar for five minutes a day to dry out the nail.
- Natural hygiene practices: Keep your hands and feet clean and dry, and your nails trimmed. Wash your hands and feet often with soap, ensuring you get between your fingers and toes. Keep your nails short and straight across. Avoid walking barefoot in public places, especially in places like gym showers, swimming pools, and locker rooms, where fungus spreads easily. Disinfect your bathroom tiles with bleach.
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Prevention
To prevent a fungal nail infection, practice good hygiene by washing your hands and feet often with soap and water. Be sure to dry your hands and feet thoroughly, paying special attention to the areas between your fingers and toes, as fungus thrives in dark, warm, and moist environments. Keep your nails short and straight across, avoiding any sharp corners that can catch on things.
If you visit places like gym showers, swimming pools, or locker rooms, where fungi can easily spread, consider wearing flip-flops or waterproof shoes to protect your feet. Avoid walking barefoot in these areas. If you have a skin infection, such as athlete's foot, be sure to treat it promptly, as the fungus can spread to your nails.
Keep your nail care tools clean and dry. Sterilize your nail clippers and nail files with rubbing alcohol or another disinfectant to prevent the spread of fungi. If you get manicures or pedicures, ensure the salon sterilizes their tools and uses clean instruments for each client. Bring your own tools if you're unsure about the salon's hygiene practices.
Choose breathable footwear made of materials like leather or canvas, and avoid wearing tight-fitting shoes that can trap moisture and create a favourable environment for fungi. Change your socks regularly, especially if your feet tend to sweat a lot. You can also apply antifungal powder to your feet to help keep them dry and reduce the risk of infection.
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Frequently asked questions
You may have a fungal nail infection if you notice white or yellow spots under your nails. This could spread and turn your whole nail white, yellow, green, or black. The nail may thicken and become difficult to trim. It may also start to curl up or down or loosen from the nail bed.
You should see a doctor or a dermatologist to get a prescription for antifungal medication. You can take this medication orally or apply it topically. In more severe cases, your doctor may recommend removing the nail to prevent the infection from spreading.
To prevent a fungal nail infection, practice good hand and foot hygiene. Keep your nails short, clean, and dry. Sanitize and do not share nail scissors and clippers.
There is currently no evidence that home remedies can fully cure a fungal nail infection. However, some home remedies can be used to complement medical treatments. For example, nail scraping with an over-the-counter kit can help remove an active infection, but it doesn't remove all of the fungus.
