Fungal Toenails

Fungal toenails is also known as Onychomycosis.  It is an infection of the nail, the nail bed, matrix (where nail grows) or plate.  Fungal nail infections account for 1/3 of all fungal skin infections and 1/2 of all nail disease.

• Fungal infections can cause nail to become thick, discolored, brittle and painful.  A fungal nail can be more than just a cosmetic problem because the pain involved may lead to impaired mobility.  Fungal infections of the nail can spread to other areas of the body and other people.
• Fungus likes to grow in warm moist environments like sneakers and locker rooms.
• Fungus is more common in men than women.  Toenail fungus is also more common in individuals over 60 years of age.  Patient with diabetes, peripheral vascular disease or immune compromised have higher incidence.
• There are many different types of fungus, yeasts and molds that can infect the nail.
• The nail can be infected only at the tip, the surface or entire nail.
• Trauma to nail bed or matrix can result in a fungal nail infection.

Precautions

• Practice good foot hygiene.  Keep feet clean and dry.
• Change shoes regularly.
• Wear cotton or synthetic moisture wicking socks.
• Protect feet in public showers, pool and gym floors.
• Avoid pedicures.  If you must go have the salon buff and paint your nails only.
• Never allow your cuticle to be pushed.  Make sure the instruments have been sterilized.  Also make sure the emery board new.

Treatment

There are many treatment options for fungal toenails.  Some work better than others. Some are safer than others.

Homeopathic Treatment

• Vicks vapor rub.
• Tea tree oil.
• Extract of oregano oil.
• Vinegar

Homeopathic treatments may improve the appearance of the nail but rarely effective in curing the infection.

Over the counter products for fungal nails

• The over the counter medications used in the treatment of fungal nails also yield poor results.

Prescription Topical Antifungals

• Ciclodan
• Penlac

FDA approved topical antifungals for mild to moderate nail infections.  Very safe but must be used for extended periods of time with varying results. Prescription Oral antifungals

• Lamisil
• Spornox
• Diflucan
• Grispeg

Oral medications used in the treatment of fungal toenails are very effective.  Due to potential side effects blood work will be required prior to starting treatment and during treatment.  There are also potential drug interactions associated with the use of these medications.

Laser therapy

Laser therapy for fungal nails is FDA approved.  Unfortunately, there are not any randomized studies with controlled subjects to determine the actual success rate.  The treatment is not covered by insurance and can be quite costly.

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