Sophia Delgado
Fungal nail infections are characterized by thick, discoloured, and brittle nails that are easy to break. They can affect both toenails and fingernails, but are more common in toenails. While it is not a serious condition, it can take a long time to treat and may require medical attention. Treatment options range from over-the-counter antifungal creams and gels to prescription medications and, in severe cases, surgical nail removal. In some cases, trimming or cutting away the infected part of the nail may be recommended to facilitate treatment and reduce the amount of fungus present. This procedure should be performed by a medical professional to ensure safety and effectiveness.
| Characteristics | Values |
|---|---|
| What is a fungal nail infection? | A fungal nail infection is when the nail becomes thick, discoloured, and easy to break. |
| What causes it? | Fungal nail infections are caused by fungi that cause athlete's foot. This fungi can multiply in warm, dark, and moist places like the feet. |
| Who is at risk? | Anyone can get a fungal nail infection, but you may be more at risk if you have a weakened immune system, athlete's foot, blood circulation problems, a nail injury, or a nail surgery. Older adults and people with diabetes are also more susceptible to complications. |
| How is it diagnosed? | A healthcare provider will typically diagnose a fungal nail infection by examining the nail and asking about symptoms. They may also take a nail clipping to examine under a microscope or send it to a lab for testing. |
| What treatments are available? | Treatments for fungal nail infections include antifungal pills, creams, gels, sprays, patches, and prescription medications. In some cases, the infected nail may need to be removed surgically or non-surgically. |
| How can it be prevented? | To prevent fungal nail infections, it is important to practice good foot and nail hygiene, including washing and drying the feet, trimming nails straight across, and avoiding walking barefoot in public spaces. |
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What You'll Learn
Antifungal pills are more effective than creams and gels
Fungal nail infections are characterised by thick, discoloured, and brittle nails. While it is not a serious condition, it can take a long time to treat. The infection usually affects the toenails, but it can also develop on the fingernails.
There are various treatments available for nail fungus, including oral and topical antifungals, which are the primary treatment methods. Oral antifungals, or antifungal pills, have been found to be more effective than topical treatments, such as creams and gels. Antifungal pills like itraconazole (Sporanox) and terbinafine (Lamisil) have high success rates in treating nail fungus. Terbinafine is generally taken for 6 weeks for fingernail infections and 12 weeks for toenail infections, with a daily dosage of one 250 mg tablet. Itraconazole is taken for 12 weeks, with a daily dosage of one 200 mg tablet. However, it is important to note that these medications can have side effects and may interact with other medications. For example, terbinafine can affect the liver, while itraconazole can cause headaches, dizziness, stomach and bowel problems, and rashes, as well as interact with cholesterol-reducing and blood-sugar-lowering medications. Therefore, it is crucial to consult a doctor before taking any antifungal pills.
Topical treatments for nail fungus include antifungal creams, gels, sprays, patches, and nail polishes. These treatments are available over the counter or by prescription, depending on their strength. While topical treatments are a good option for mild toenail fungus, they may not be effective for moderate to severe cases. It is important to follow the instructions for these treatments carefully, such as filing or cutting off any white markings on the nails and soaking the nails in water before applying the medication. Topical treatments may also require regular nail cutting and thinning during the course of treatment.
In some cases, surgical or nonsurgical removal of the infected nail may be recommended, especially if the infection is deep and long-standing. Nonsurgical removal involves applying a urea ointment to the nail, softening the nail bed, and then cutting away the diseased part of the nail. This process can take about 10 days. Surgical removal of the nail may also be an option, depending on the severity of the infection.
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Surgical and non-surgical nail removal
It is not advisable to attempt to cut away a nail infected with fungus yourself. A pharmacist can help advise on treatment for a fungal nail infection, and you should speak to a doctor if the nail is painful. Surgical nail removal is an option for severe or recurring fungal nail infections, especially if a large portion of the nail is diseased and damaged or if the nail is very painful. This procedure is typically carried out in a doctor's office under a local anaesthetic. The doctor will loosen the skin around the nail and separate the nail from the skin, removing either the entire nail or only the diseased part. 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 procedure, an ointment is applied to the wound, which is then dressed with gauze and tape. The patient should then follow their doctor's aftercare instructions, or, if none were given, wash the wound with clean water twice a day after the first 24 to 48 hours.
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OTC antifungal treatments
It is not advisable to cut away a nail infected with fungus, as this can cause the skin around it to become painful and swollen. Instead, consult a doctor or pharmacist, who may recommend over-the-counter (OTC) antifungal treatments, such as creams, gels, sprays, and patches. These treatments are most effective for mild toenail fungus, and may not be potent enough to cure moderate or severe cases.
Antifungal creams can be used in conjunction with other measures to prevent the spread of the infection. This includes maintaining good foot hygiene by washing and drying the feet regularly, wearing appropriate footwear, and keeping toenails short and straight across. It is also important to treat any athlete's foot, as this can worsen or lead to fungal nail infections.
In addition to OTC antifungal creams, gels, and nail polishes, home remedies such as Vicks VapoRub, tea tree oil, apple cider vinegar, oregano oil, Listerine, baking soda, epsom salts, garlic, or coconut oil may help with mild toenail fungus. However, it is important to consult a doctor for more severe infections, as oral medications or prescription drugs may be necessary.
Overall, while OTC antifungal treatments can be a good first option for mild toenail fungus, they may not be sufficient for more severe cases, and it is important to consult a medical professional for advice and treatment options.
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Preventing toenail fungus
Toenail fungus is a common issue, affecting around 12% of people in the United States each year. It can cause the nail to become thickened, yellow, brittle, and cracked, and may lead to pain, redness, and swelling. The fungus thrives in warm, moist environments, so keeping your feet clean and dry is essential for prevention. Here are some detailed tips to help you prevent toenail fungus:
Keep Your Feet Clean and Dry
Wash your feet daily with soap and water, paying special attention to the spaces between your toes. Be sure to dry your feet thoroughly, including the areas between your toes, after washing. Clean and dry feet are less likely to harbour fungus.
Choose the Right Footwear and Socks
Fungus thrives in warm, damp environments, so avoid tight-fitting shoes and socks that trap moisture. Opt for shoes made from breathable materials like leather, and choose socks made from natural fibres such as cotton or wool. Synthetic fibres designed for wicking can also help pull moisture away from your feet. Additionally, avoid going barefoot in public places, especially showers and pools, as toenail fungus can spread easily. Wear flip-flops or shower shoes in these areas to protect your feet.
Practice Good Nail Hygiene
Keep your toenails trimmed and short. Cut them straight across, avoiding rounded edges that can dig into the sides of your toes. Long nails provide the perfect breeding ground for fungus. Avoid picking at your nails or the skin next to them. If you share nail care tools, ensure they are disinfected before and after use. It is also important to clean and sterilize your personal nail tools, such as clippers, files, and scissors, after each use.
Avoid Nail Polish and Fake Nails
Nail polish and fake nails can trap moisture, creating an ideal environment for fungus to grow. If you choose to get a pedicure, select a licensed and well-kept salon that sterilizes their tools after each use. You may also consider bringing your own sterilized tools to reduce the risk of infection.
Use Anti-Fungal Products
Apply over-the-counter or prescription anti-fungal creams or sprays to your feet and between your toes. Tea tree oil is a natural alternative that has been shown to cure toenail fungus in some cases and improve nail appearance and symptoms. However, always consult with a doctor or podiatrist if you suspect a toenail fungus infection, especially if home remedies do not provide improvement after a few months.
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Nail abrasion, trimming, and debridement
Fungal nail infections are characterised by thick, discoloured, and brittle nails that are easy to break. They can affect both toenails and fingernails, but toenails are more commonly affected. The infection usually starts at the edge of the nail and spreads to the rest of it, causing the nail to turn white or yellow and crumble or break easily.
Nail abrasion is a medical procedure performed by a dermatologist, which involves scraping or filing the surface of the infected nail. This method is particularly useful for treating white superficial onychomycosis, a type of nail fungus that develops on top of the nail. It is important to note that nail abrasion should not be attempted at home, as it requires experience, practice, and the right tools to be performed safely.
Nail trimming is a simple procedure where a dermatologist trims away any infected portions of the nail. This method helps to reduce the amount of fungus present and makes it easier for other treatments to work effectively.
Nail debridement is another medical procedure performed by a dermatologist to specifically reduce nail thickness, which is a common symptom of nail fungus. Thicker nails can hinder the treatment process, so reducing thickness can aid in the overall treatment of the infection.
It is important to note that self-care at home is crucial in preventing and managing nail fungus. This includes proper nail trimming techniques, such as cutting nails straight across without rounding the edges and keeping toenails shorter than the end of the toes. Soaking nails in warm water before cutting them can also help. Additionally, maintaining good foot hygiene, wearing appropriate footwear, and sanitising nail tools are essential preventive measures.
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Frequently asked questions
A fungal nail infection is when the nail becomes thick, discoloured, and brittle. It can affect both toenails and fingernails, but toenails are more commonly affected.
Over-the-counter antifungal creams, gels, nail polishes, and home remedies can be used to treat mild toenail fungus. Prescription medications, such as terbinafine, are more effective for moderate to severe cases.
Cutting away the diseased part of the nail can help make it easier for treatments to work and reduce the amount of fungus present. However, nail trimming should be done by a medical professional as it requires experience and the right tools to do safely.
To prevent fungal nail infections, keep your feet clean and dry, wear shoes in communal spaces, and avoid sharing nail tools or walking barefoot in public areas. Trim your nails straight across and keep them shorter than the end of your toes.
