Noah Sinclair
Fungal nail infections can be unsightly and embarrassing, and they won't clear up on their own. There are several treatment options available, depending on the severity of the infection. For mild cases, over-the-counter antifungal creams, mentholated salve, or natural antifungals like snakeroot extract can be effective. More severe cases may require prescription medication such as ciclopirox nail lacquer or even surgery to remove the nail. To prevent nail fungus, it's important to keep your hands and feet clean and dry, trim your nails short, and avoid walking barefoot in public places.
| Characteristics | Values |
|---|---|
| Diagnosis | A dermatologist can take a sample from a nail by removing some buildup, clipping off a bit of the nail, or scraping the nail's surface. This sample is then observed under a microscope to confirm the presence of nail fungus. |
| Treatment | Various treatments are available, including prescription medications, antifungal creams, mentholated salve, and snakeroot extract. In severe cases, surgical procedures such as nail avulsion or laser/light therapy may be recommended. |
| Prevention | Keep hands and feet clean and dry, trim nails short, wear shoes in public places, especially in locker rooms and pools, and change socks and shoes when feet get sweaty. |
| Post-Surgery Care | Keep the arm or leg elevated above the heart level for 48 hours to manage pain and swelling. Change bandages regularly, and follow your doctor's instructions for antifungal medicine application to the nail bed. |
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What You'll Learn
Surgery to remove the nail
Surgical nail removal is usually performed when a large portion of the nail is diseased and damaged or if the nails are very painful. It is considered a last resort when other treatments have failed to cure the infection. The procedure can be carried out in a doctor's office, and patients are awake during the surgery but will not feel any pain as the area around the nail is numbed, similar to how gums are numbed at the dentist.
The doctor will then use a tool to loosen the skin around the nail and separate it from the skin. If only part of the nail is infected, only the diseased part is removed. If the patient wants to avoid future infections, the doctor can destroy the nail matrix by applying a chemical to the cuticle area after the nail plate is removed. This procedure is called chemical avulsion. An ointment is applied to the wound, and it is covered with gauze and tape.
After the surgery, patients are advised to keep their arm or leg elevated above the level of their heart to help with pain management and reduce swelling. Bandages need to be changed regularly, and doctors may prescribe antifungal medicine to apply to the nail bed to kill any remaining fungus. The healing process can take at least two to three weeks, and the nail will regrow over 12 to 18 months.
It is important to note that nails with fungal infections should be treated promptly. Fungal nail infections can worsen over time, and hiding the infection will not make it go away. If the nail has turned brown or black, suddenly hurts, or pulls away from the nail bed, it is important to see a doctor as soon as possible.
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Prescription medication
If you have a fungal nail infection, it's important to see a doctor or dermatologist as soon as possible. They may prescribe stronger medication than what is available over the counter. Prescription medication is typically necessary if several nails are infected or if the infection has spread across the nail.
Topical prescription medications include efinaconazole 10% solution, which is approved for treating toenail fungus in patients aged six and older. Another option is ciclopirox nail lacquer, which is used to treat nail fungus in people aged 12 and older. It's important to remove any loose nail before applying this medication, and to remove previous coats of the medication with rubbing alcohol once every seven days.
If the infection is severe, oral medication in the form of tablets may be prescribed. These are typically taken for several weeks or months and are more effective than topical treatments, but they also have more side effects. Examples of oral medication include terbinafine and itraconazole. Terbinafine is prescribed to treat adults with nail fungus on their fingernails and toenails. It is taken as a daily pill for six weeks when treating fingernails, and 12 weeks for toenails. Itraconazole is also prescribed to treat nail fungus in adults and can treat both toenails and fingernails. It is not suitable for pregnant women, however, as it can harm the baby, and it may also interact with other medications.
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Over-the-counter antifungals
When shopping for an over-the-counter antifungal, it's important to understand the difference between products that improve nail appearance and those that actively fight fungal infections. Most over-the-counter antifungals are geared toward softening the nail with ingredients like urea, lactic acid, or salicylic acid. These can be helpful for people with painful or brittle nails, but they won't cure the infection itself.
For real antifungal activity, look for ingredients like tolnaftate, an FDA-approved antifungal, or clotrimazole, a broad-spectrum antifungal often used in OTC creams to stop fungal growth at the source. Clotrimazole is not ideal for treating fungus buried deep within thickened toenails, however, and works best on the skin, such as the soles, between the toes, or around the nail.
In addition to over-the-counter antifungals, mentholated salves and snakeroot extract have also been shown to be effective in treating nail fungus.
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Mentholated salve
The key ingredients in mentholated salve are menthol, camphor, and eucalyptus oil. The menthol provides a cooling sensation that can temporarily relieve pain and discomfort. Additionally, the emollient base of the salve, often petrolatum, helps to soften the nail, allowing other antifungal medications to penetrate more effectively. Eucalyptus oil also contributes mild antifungal properties to the mix.
To use mentholated salve for nail fungus, start by ensuring that your affected nail is clean and dry. Then, apply a small amount of the salve to the nail daily. Continue applying the salve for several weeks or even months, monitoring the nail to gauge improvement. It's important to note that mentholated salve may not eliminate the infection on its own, so combining it with other antifungal treatments could be beneficial.
If you are experiencing nail fungus, it is recommended to consult a dermatologist or podiatrist, especially if your nail has turned brown or black, is causing pain, or has separated from the nail bed. They can help determine the best course of treatment, which may include prescription topical or oral antifungal medications, nail trimming, or, in severe cases, nail avulsion to surgically or chemically remove the infected nail.
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Preventative measures
Preventing nail fungus is better than treating it, as treatment can take about a year and often requires prescription medication. Here are some preventative measures to stop nail fungus from occurring or reoccurring:
Keep Nails Short and Clean
Keep your nails short and straight across. This helps prevent fungi and other germs from collecting under your nails. Avoid biting your nails, as this can create an opening for fungus to enter. It is also important to keep your nails clean. Scrub your nails with soap and water to help defend against infection, especially after physical activity or other reasons that cause sweaty and moist feet.
Keep Feet Clean, Dry, and Covered
Wash your feet daily with soap and water, and dry them thoroughly, especially between the toes. Fungi thrive in warm, damp places, so it is important to keep your feet dry. Wear moisture-wicking socks and breathable shoes, such as those made of leather, canvas, or mesh. These materials allow for airflow and help prevent your feet from sweating. Change your socks often, especially after exercising, and give your shoes 24 hours to dry before wearing them again.
Disinfect Tools and Choose a Clean Salon
Disinfect your nail clippers, files, and scissors after each use. If you have nail fungus, disinfect with a bleach and water solution. If you do not have nail fungus, use 70% rubbing alcohol. Never share nail-grooming tools, as nail fungus spreads easily from person to person. If you get a pedicure, choose a licensed and well-kept salon that sterilizes its tools.
Protect Against Injury and Avoid Public Areas
When you injure your nail bed or the skin around your nails, it creates an opening for fungus. Protect your feet from potential exposure to toenail fungus by wearing shower shoes or flip-flops in public areas like pools, gyms, and locker rooms.
Strengthen Your Immune System
A strong immune system can help fight off infections, including toenail fungus. Maintain a healthy diet, exercise regularly, and consider taking supplements to support your immune health.
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Frequently asked questions
There are several over-the-counter treatments for nail fungus that can be purchased at a local drugstore, such as antifungal creams and lotions, mentholated salve, and snakeroot extract.
See a doctor if your nail has turned brown or black, if it suddenly hurts, or if it pulls away from the nail bed. Diabetics should see a doctor at the first sign of discolouration in their toenails.
A dermatologist may take a nail sample by removing some buildup, clipping off a bit of the nail, or scraping the nail's surface to examine under a microscope. They can also prescribe stronger medications, such as ciclopirox nail lacquer for mild infections.
Nail surgery is an option for removing nail fungus when other treatments have failed. It involves numbing the area around the nail and using special tools to remove the infected piece or the entire nail. After the surgery, it is important to keep the arm or leg elevated to manage pain and swelling.
