When To Refer To Podiatry
Before initiating topical or oral therapy, patients should ideally be referred to a podiatrist for nail trimming and debridement. This assists with removing as much fungus as possible and improves topical drug penetration. Debridement alone cannot be recommended for the treatment of OM patients using a combination of debridement and topical nail lacquer have shown a significant improvement in mycological cure compared with debridement only. Patients with nail trauma owing to footwear, dystrophic toenails affecting other toes or who describe discomfort when walking owing to thickened toenails should also be referred.
When there is treatment failure with topical, oral and combination therapies, a podiatrist may be able to carry out a chemical or surgical nail avulsion .
If there is doubt over the original diagnosis, or where no improvement has been seen with treatment, pharmacists should refer patients to a podiatrist or their GP.
Supported by RB
RB provided financial support in the production of this content.
The authors were paid by The Pharmaceutical Journal to write this article and full editorial control was maintained by the journal at all times.
Can I Wear Nail Polish If I Have Toenail Fungus
You may feel tempted to cover up a discolored toenail with nail polish. If you are using a topical antifungal, you probably should not use polish. Some providers may tell you not to wear it in any case. Polish traps in moisture from the nailbed . Because fungi thrive in moist environments, wearing nail polish may make a fungal infection worse. However, the nail continues to grow with or without polish.
Change Your Socks And Shoes
Sweaty, warm socks are a breeding ground for fungus. Wearing the same socks over multiple days encourages any small spores you may have picked up to grow.
Never wear socks for more than one day. Dont wear socks at night. Instead, allow your feet to breathe. Spray your shoes with an antifungal spray regularly.
Follow these tips, and even if you do pick up some spores, you may prevent them from growing.
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When Should I Call The Doctor
In rare cases, toenail fungus can cause an infection called cellulitis. Without prompt treatment, cellulitis may pose a serious danger to your health.
You should seek treatment guidance from a trusted healthcare provider if you have:
- Circulation problems.
- Redness, pain or pus near the toenail.
- Weakened immune system.
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Additional reporting for this story by Jennifer Nied
For over 10 years, Jennifer Nied has reviewed products, interviewed experts, scrutinized ingredients, and pored over research studies and claims, to help readers like you understand what works for your specific conditions. Every product in this piece was selected taking into account recommendations from doctors, published research, and real customer reviews.
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How Long Can Toenail Fungus Live In Shoes
Fungus can live in shoes for 6 months to even yearsin spore form. Fungus needs dark, warmth and moist environments to live andgrow. Shoes provide this and due to some shoe construction, often have placesto hide within the shoes. Make sure to thoroughly disinfect shoes beforepacking them up for the following season of use or if you have receivedhand-me-downs or second hand store finds.
Help Us Help You Get The Treatment You Need
Because of coronavirus , it can be hard to know what to do if you’re unwell. It’s important to get medical help if you think you need it.
- For help from a GP use your GP surgery’s website, use an online service or app, or call the surgery.
- For urgent medical help use the NHS 111 online service, or call 111 if you’re unable to get help online.
- For life-threatening emergencies call 999 for an ambulance.
If you’re advised to go to hospital, it’s important to go.
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What Causes Toenail Fungus And How To Prevent It
Unfortunately, the warm and moist environment inside your shoe can make you vulnerable to fungal infections. When these occur on the toenail, doctors call the condition onychomycosis. Fungal skin infections commonly called athletes foot can often affect the foot as well.
One of the you get a fungal toenail infection is when fungus invades small cracks in your toenail. Some people are at greater risk for this occurring, including those with:
- circulation problems, especially related to the feet
- history of injury, surgery, or damage to the nail
- impacted immune system function
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How Do Dermatologists Diagnose Nail Fungus
To find out if a patient has nail fungus, a dermatologist examines your nails and nearby skin. Its important to check the skin because the fungus can spread. You may already have a skin infection caused by fungus like athletes foot.
To get rid of the infection, you will need to treat all infected areas.
Before giving you the diagnosis, your dermatologist may also take some samples. Collecting a bit of debris from beneath a nail, trimming off part your nail, or scraping off a bit of skin can be very helpful. In a lab, these samples can be examined under a microscope to find out whats causing the problem.
Are you hiding an infected nail with nail polish?
Be sure to ask your dermatologist if you can wear nail polish while treating nail fungus.
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When Are The Different Treatments Considered
Most doctors recommend treating nail fungus with nail polish or cream if
- not much more than half of the nail is affected by the fungus,
- the base of the nail is not infected, and
- only some nails are affected.
Topical treatment is also usually recommended for children. One reason for this is that most oral medications arent suitable for children. Another reason is that children have thinner nails that grow more quickly, so its assumed that treatment with nail polish or creams is more likely to work in children than in adults. White superficial onychomycosis is also often treated with a nail polish or cream.
If several nails are infected by the fungus, or if the infection has spread out more on the affected nails, its usually necessary to take oral medication. And if the infection started at the base of the nail, its highly likely that only tablets will help.
How Effective Are Tablets In Treating Nail Fungus
Tablets for the treatment of nail fungus have been tested in several studies. All participants had an infection on their toenails caused by a skin fungus. Overall, the study results showed that tablets are considerably more effective than nail polishes or creams.
One year after a three-month treatment with terbinafine:
- About 17 out of 100 people who didnt have this treatment no longer had a detectable fungal nail infection.
- About 76 out of 100 people who had this treatment no longer had a detectable fungal nail infection.
In other words, the treatment with terbinafine got rid of the fungal infection in about 59 out of 100 people.
Itraconazole also proved to be effective. After one year,
- 7 out of 100 people who didnt have this treatment no longer had a detectable fungal nail infection.
- About 43 out of 100 people who had this treatment no longer had a detectable fungal nail infection.
In other words, the treatment with itraconazole got rid of the fungal infection in about 36 out of 100 people.
Some studies directly compared itraconazole and terbinafine with each other. They confirm that terbinafine is somewhat more effective than itraconazole.
Treatment with breaks is thought to be about as effective as continuous treatment. But that has only been looked into in a few studies.
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What Other Conditions Can Be Mistaken For Fungal Nails
Here are some other conditions you may have instead of fungal nails:
Remedies And Treatments For Toenail Fungus
Antifungal remedies help to stop the growth of the fungus. Over-the-counter options do not claim to cure toenail fungus, but they can help to improve the look of the affected nail. These products do not work as well as prescription medications. To cure toenail fungus, a remedy has to penetrate the nail and nail bed. Most over-the-counter remedies for nail fungus are topical and do not penetrate deeply enough.
Trim, Buff, and Thin the Affected Nail
Keeping your nails trim, buffed, and clean helps to prevent the spread of the fungus to other nails. Additionally, buffing the nail can allow topical antifungals to penetrate more deeply. Make sure to wash your hands promptly after touching the affected nail, especially before touching other nails.
Vicks VapoRub is a product marketed for people with coughs. However, it may also be effective against toenail fungus. One small study showed that after applying it topically each day for 48 weeks, 27.8% of participants fully cured their nail fungus â and 55.6% of participants saw partial improvement. However, more study is needed.
Tea Tree Oil
Tea tree oil comes from the Australian tea tree. It is an essential oil traditionally used as an antibacterial and antifungal treatment. Early research shows that it may help with nail fungus when used topically. However, more research is needed. If you do use tea tree oil for toenail fungus, only use it topically.
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Keratin Buildup Under Toenails Causes: How To Get Rid Of It
Keratin is a type of protein which is found in hair, nail and the outer layer of skin. This fibrous protein keeps the nail strong and hard. However, at the same time a buildup of keratin under the nail can make the nail discolored and brittle and distorted. Keratin buildup can occur in fingernail as well as toenail. Though keratin is a hard material it can become soft under the nail when it comes in contact with moisture constantly.
Because of excess of buildup, in worst scenario the nail may get separated from the nail bed.
The best way to prevent keratin buildup is to prevent fungal infection or trauma. Treatment depends on the underlying cause, for example regular topical application of anti fungal cream will help to combat fungus in nail and thus get rid of excess of keratin.
When To See A Doctor About Toenail Fungus
If you are experiencing persistent toenail fungus or pain is present, you may need to see a specialist. A dermatologist or podiatrist may be able to assess your symptoms and send a small sample of the affected toenail or flesh to a laboratory to be analyzed as there are various types of fungi and yeasts that cause onychomycosis. Knowing the specific cause of your foot fungus can help identify what route to take to treat your condition.
Nail changes can also be caused by underlying conditions, like psoriasis and diabetes, so its important to seek professional medical advice if your condition persists or worsens. Bacterial and fungal infection of skin in diabetes patients often result in hospital admissions, and in severe cases, can result in amputations. If you are at a higher risk for infection, you should skip home remedies and seek professional medical treatment.
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Best Ways To Treat A Nail Fungus
Nail fungus can cause thick, discolored nails, and, for some patients, it can even be painful. An Internet search will bring up plenty of ways to treat the condition, but which ones are best? Dermatologist Dr. Christopher Hull discusses what nail fungus actually is, why its so hard to get rid of, and which treatments work best.
Wash With Antifungal Cleanser
Antifungal washes, such as Nizoral, can help dry, scaly moccasin type foot fungus, Rodney says. Gently lather it onto the entire feet, let sit for 15 minutes, then rinse off with water, she adds. As it is a wash, the medication can penetrate through all the dry, scaly skin and easily get to the fungus.
Healthy Now Newsletter
Sometimes itÃ¢s possible to treat your toenail fungus at home. You can try:
- Over the counter antifungal creams or ointments. File or cut off any white markings on your nails. Soak your nails in water and dry off before you put on the medicated cream.
- Special nail care. If you keep your nails trimmed, it can reduce the pressure and pain you feel. You can also thin your nail bed by filing it down. This can help antifungal creams get to the problem easier.
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Home Remedies For Foot Fungus
There are many home remedies, both proven and unproven, for athletes foot, toenail fungus, and other foot problems. Soaking the foot in a diluted vinegar or bleach solution can help cure athletes foot. Use baking soda or cornstarch and sprinkle it on the feet to keep them dry or remove odor.
Anti-fungal products can do wonders for toenail fungus. Olive leaf extract is not only anti-fungal but also antibacterial. Orange oil, another anti-fungal ingredient, can be applied to the affected nails to cure toenail fungus. Lavender or oregano oil can also be used.
To treat ingrown toenails at home that are not infected or just barely affected, soak the foot in warm water and Epsom salts, wedge cotton or something else soft underneath the nail to prop it up, and add antibacterial cream.
The Danger Of Waiting To Treat The Fungus
The greatest danger of not treating the foot or toenail fungus is that it can spread to other parts of the body, such as the hands and groin.
If for some reason you cant treat your toenails or your feet right away, at least use an antifungal topical cream on the surrounding skin, Dr. Ng says. That will help keep it from spreading and keep the skin intact.
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Use A Foot Spray To Disinfect Shoes From Athletes Foot
Before wearing your shoes, ensure that you spray both your feet and your shoes with a foot spray. The foot spray should be one that contains a disinfectant in it to ensure that it is beneficial in killing the foot fungus.
Some foot sprays are scented to ensure that your feet and shoes not only are bacterial and fungus free but also ensure that your feet and shoes smell nice.
What Kills Nail Fungus Fast Everything You Need To Know About Nail Fungus
According to experts, fungal infection is responsible for a whopping 50% of all nail diseases. A 2014 research reported a 23% prevalence rate across Europe, 20% in East Asia, and 14% in North America. Every year, millions of dollars are spent on the treatment of nail fungus.
Nail fungus affects both the fingernails and the toenails but is more common with toenails. It starts as a rather subtle yellow or white spot beneath the tip of the nail. If not treated immediately, it worsens very fast hence causing nail discoloration, thickening, as well as crumbly nails. It is highly contagious, can quickly spread from nail to nail but there is no proof of spread between persons. Nail fungus makes the nail so ugly and can also be considerably painful. Nail fungus, especially toenail fungus, is notorious treatment may last several months yet the rate of recurrence is alarmingly high.
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What Are Treatments For Toenail Fungus
Do you need to treat your nail fungus? Maybe it doesnt hurt, and the yellow, thick nails dont bother you.
But nail fungus doesnt go away by itself. And if you dont treat it, theres a chance it could get worse. It could spread to other nails or through your body. It could cause pain when you walk.
There are a number of ways to take care of it, including:
Nonprescription options. You can buy antifungal creams, gels, and nail polish at the store and online without a prescription. You might want to try one of them first if the infection doesnt look bad. Some people also swear by home remedies like menthol rub, tea tree oil, mouthwash, or snakeroot extract but studies show mixed results.
Prescription polish and creams. Your foot doctor will likely trim your nail and file away its dead layers. They may also take a piece of your nail and send it to the lab to make sure itâs really a fungus and to find out what type it is.
The doctor might suggest an antifungal drug that you paint on your nails. This may work on its own, or they may suggest you take it with antifungal pills.
Prescription medications. One of several antifungal pills may help. They work, but it may take many months to do the job. They also come with side effects like nausea, vomiting, and headaches. They may cause liver damage too, so your doctor will watch you closely while you take them. Be sure to tell them about any other meds youâre taking some antifungal pills might not work well with them.