There Is A Wide Range Of Options With Varying Success Rates
Other than keeping your toenails trimmed and perhaps painted, you may not pay much attention to them unless a problem develops. Healthy toenails are pink, shiny and smooth, but a fungal infection can cause them to become discolored, thick, brittle and even painful.
Toenail fungal infection, known as onychomycosis, is a common but challenging condition toenail fungus treatments include a wide range of options with varying success rates.
Causes of toenail fungus
Fungal nail infections are usually caused by fungi called dermatophytes that infect the skin beneath the nail yeast is another common culprit. Toenails are especially vulnerable to infection when your bare feet contact damp surfaces such as showers, swimming pools and locker rooms. If you have athletes foot, the infection can spread to the nails.
Wearing closed shoes such as athletic shoes for extended periods also can contribute to infection if your shoes and/or socks are damp from perspiration or heat. Moreover, if your shoes fit snugly enough to put pressure on your toes, they can damage the nail bed, making it more susceptible to infection.
People with chronic diseases, such as diabetes or circulatory problems, also may be more prone to toenail infections.
Symptoms of toenail fungus
Toenail fungus symptoms can develop slowly over time and may go unnoticed at first. Symptoms can include:
Toenail fungus treatments
When to see a doctor for toenail fungus
Preventing toenail fungus
Doctors Weigh Best Treatments
The best treatment for fungal nail infections is a prescription that your dermatologist can prescribe that you take every day for two-to-three months. The pill is not for everyone, since oral antifungals can interact with other medications and can affect the liver.
Fortunately if you dont want to or cant take a pill, there are topical solutions to treat nail fungus. Although topical medications are desirable because of the low risk of side effects and interaction with other medications, they have much longer treatment regimens. Generally, topical medications have a lower clearance rate compared to oral pills.
Newer topical antifungals including Efinaconazole and Tavaborole have better penetration of the nail plate and so they work better compared to older topical medications, says Dr. Ng. She says the topical medications work best if you only have partial nail involvement.
Lasers are approved by the FDA to temporarily increase the amount of clear nail. However, the cure rates are lower than oral medications and topical solutions.
Treatment For Athlete’s Foot From A Gp
The GP may:
- send a small scraping of skin from your feet to a laboratory to check you have athlete’s foot
- prescribe a steroid cream to use alongside antifungal cream
- prescribe antifungal tablets you might need to take these for several weeks
- refer you to a skin specialist for more tests and treatment if needed
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The combined ingredients work to dry out the fungus to prevent it from spreading. Benefits of the soak also include healing cracked feet and soothing aches.
This US-made product has no dyes or synthetic fragrances, making it a great all-natural solution. But results, depending on severity, might take longer to show when using the soak over prescription or over-the-counter treatments.
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Results can take several weeks
Only for toe and fingernail fungus
When To Visit The Dermatologist
Many over-the-counter foot powders, washes, sprays or creams are usually enough to treat foot fungus, Lain says, but in order to stop the infection from recurring its important to make changes. The infection will likely recur unless changes are made to daily activity: perhaps wearing open toe sandals instead of shoes, changing socks during the day if they get sweaty or adding in a drying powder to help reduce moisture.
If the infection doesnt improve or continues to spread after trying home remedies for foot fungus, Rodney says its time to visit your dermatologist.
If blisters develop or you notice that the infection has spread to your nails, dont delay, she adds. The longer you wait to treat the nail infection, the more difficult it becomes.
Next, read about what those white spots on your fingernails actually mean.
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What To Watch For When Taking Oral Medication For Toenail Fungus Treatment
All of the pills for toenail fungus can cause liver toxicity. This is rare and is reversible after the medication is stopped. Still, liver function blood testing will be done before you start your treatment and again midway through your treatment.
Medications like Terbinafine and Itraconazole can also interact with certain drugs. Your healthcare provider will look at your medication list to make sure there arent any drug interactions.
Home Remedies For Ingrown Toenails
There are also some simple home care tips to help you care for a toe that has an ingrown toenail. Heres what you can do:
- Soak your foot in clean warm water several times a day .
- Ensure your feet are dry except for when youre soaking them. Any moisture the rest of the day must be avoided.
- Wear open sandals to reduce pressure on the toenail until it heals.
- If you need to wear shoes, make sure they are roomy in the front so theres plenty of space around the toes.
- Simple over-the-counter painkillers like acetaminophen or ibuprofen can help ease the pain.
If you dont see any change in the condition or if the pain or symptoms seem to get worse, do get in touch with your doctor right away. Those with medical conditions like diabetes and vascular problems should be particularly careful and alert their doctor soon. If you have a badly infected toe, you might need a course of antibiotics prescribed by a doctor. If the problem is linked to a fungal infection, appropriate treatment will be suggested.
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Staying One Step Ahead Of Toenail Fungus
An established fungal infection is hard to eradicate, but you can stop its spread and improve your toenailâs appearance.
Toenail fungus isnât a pressing health problem. Yet a fungal infection can ruin the appearance of your nails and cause pain as it lifts the nail away from the nail bed. And fungal infections are notoriously difficult to get rid of. âYou may want to consider fungal toenail a condition to be managed rather than cured,â says Dr. James P. Ioli, chief of the podiatry service at Harvard-affiliated Brigham and Womenâs Hospital.
Dangers Of Traditional Treatment Options
Fungal nail infection is treatable with oral anti-fungal drugs, topical medications, surgery, or laser treatments. The problem with these modern treatments, however, is that they can sometimes cause complications. Depending on the chosen treatment, some of the possible side effects that may occur include skin rashes, blisters, loss of appetite, gastrointestinal issues, headaches, respiratory problems, abnormal nail growth, or liver damage.
Due to the many risks associated with modern treatments for fungal nail infection, many people are now opting for alternative remedies that are relatively safer. As an added bonus, its also possible to treat fungal nail infection using just a few basic ingredients one already has available at home.
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What Is The Outcome For Someone Who Has Nail Fungus
With treatment, many people can get rid of nail fungus. Even when the fungus clears, your nail may look unhealthy until the infected nail grows out. A fingernail grows out in 4 to 6 months and a toenail in 12 to 18 months.
To clear the fungus, its important to:
Use the treatment exactly as prescribed
Apply the medicine for as long as prescribed
Keep all follow-up appointments with your dermatologist
Nail fungus can be stubborn. If you had a severe infection, its possible to clear the infection. A healthy looking nail, however, may be unrealistic, but you can expect the nail to look better and feel more comfortable.
Even with clearing, nail fungus can return. Youll find steps to reduce your risk in Tips: 12 ways to prevent another nail infection.
ReferenceGold LFS and Rosen T. Onychomycosis: Diagnosis, treatment, and prevention strategies. Dermatology News . March 2016:2-15.
See A Dermatologist To Pinpoint The Problem
Foot fungus wont just go away on its own, Dr. Ng says. If you think you have foot or toenail fungus, see your dermatologist, she says. There are several tests that your dermatologist can perform to identify exactly whats going on.
Its important to be aware that there are other diseases which can cause nail changes, she says. For example, we do see things like squamous cell skin cancers in the nail beds and even melanomas, which have a brownish or blackish discoloration.
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How Do I Know If I Have Toenail Fungus
A toenail fungal infection has a slow, eroding effect on your toenail but usually takes a while to develop and spread so you might not notice it at first.
Here are some of the toenail symptoms you may encounter:
- Change in color often the toenail turns yellow, brown, white, or eve green
- Nails become thicksometimes so thick you cant get a toenail clipper to work
- Toenail shape becomes curved, twisted, or ingrown on the sides
- Initially, a white dot may show itself which then slowly grows larger
- Toenails become brittle and break easily, sometimes they seem to crumble or get chalky
- Toenails become flaky and break off
- Sometimes the toenail has a cottage-cheese type substance especially under the hard-outer shell
- Toenails may loosen and separate off the nail bed occasionally they may even fall of entirely
- You get pain around the toenail as the hard, curved nail digs down into the sides
- There is a bad-cheese smell coming from your toenails
- Eventually, the fungus spreads to your other toes and even out onto the skin on your feet
If left untreated, you can develop a secondary bacterial infection and even get ulcerations, which are extremely dangerous if you are diabetic or have poor circulation. For some people, toenail fungus has even ultimately led to the surgical amputation of toes or even leg amputations.
When Are Tablets Considered
Athlete’s foot is nearly always treated topically. Tablets are only considered if topical treatment isn’t successful. It may also be a good idea if the infection has spread to one or more toenails, or if the infection is very severe.
The tablets taken to treat athlete’s foot generally contain the active ingredients itraconazole or terbinafine. Itraconazole is usually taken once daily for four weeks . Terbinafine is typically taken once daily for two weeks . The treatment lasts longer if you also have a fungal nail infection. This is true for both medications.
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Other Options For Toenail Fungus Infections
Removal of the toenail is only used when just one nail is infected, but it does work. Light therapy and lasers are also being studied as possible toenail fungus treatments. Laser therapy has shown promise when combined with oral or topical antifungals. A multicenter trial investigating the efficacy of a device, the Pinpointe FootLaser, is currently underway, so stay tuned to that.
When Should I See A Podiatrist Or Foot Doctor
Fungi, yeast, and molds tend to spread over time if left untreated. The best thing to do is seek the help of an expert podiatrist to get a proper diagnosis, treatment, and preventive interventions for your condition.
Your podiatry specialist will perform a physical exam of your toenails and a medical history check to diagnose your condition. They might also do other tests to confirm their diagnosis, such as
- Microscopic examination of nail clippings or scrapings.
- Fungal culture
If you think you might have a fungal problem with your nails, then you should visit one of our many podiatric offices right away. Use our practice locator tool to find the doctors office closest to you.
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What Helps To Get Rid Of Athlete’s Foot
Athlete’s foot is very common and usually doesn’t cause any serious problems. But it can make skin itch, crack, and look unattractive. The fungus may spread to the nails, and sometimes to other areas of skin although that rarely happens. The infection can usually be treated effectively with over-the-counter creams, gels or sprays from the pharmacy.
Athlete’s foot fungi grow particularly well in the areas between our toes. It is often moist and warm there, and the skin on our feet also provides the fungus with nutrients to feed on. Topical treatment such as creams or gels can usually successfully get rid of the infection. It’s very rarely necessary to take tablets.
To prevent infection, it’ s a good idea to wear flip-flops at the swimming pool or in the sauna. If you already have athlete’s foot, you should change your socks and towels often, and wash them at 60 degrees Celsius or more. Paying close attention to hygiene also helps to stop others from being infected.
Treatment Options For Nail Fungus
Most of my conversation is usually discussing medical therapy, so things that are available by prescription only. And those come in two main forms, which are topical antifungal medications, and then oral antifungal medications. There are other surgical or procedural options, so you can remove nails as well. And then there’s starting to be more interest in technologies like lasers for nail fungus.
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What Causes Foot Fungus
The symptoms of nail fungus usually begin as a yellow or white spot appearing under the nail. As the fungus grows and deepens, it can cause yellow-brown or whitish discoloration. The affected nail may thicken and become brittle and crumbly. A distinctive foul smell can also emanate from the affected area.
This condition can spread across several nails. Although it is normally found on the toenails, nail fungus can also develop on the fingernails. If the fungus infects the area between the toes and skin of the foot, it is commonly known as athletes foot. Nail fungus is an unsightly and embarrassing ailment, which can also cause significant pain if left untreated. Unfortunately, nail fungus can be a difficult condition to remedy, as it will often return.
How To Apply Antifungal Cream
It will be detailed on the packaging of your antifungal cream and by the advice of your pharmacist, but antifungal cream is most commonly applied with clean hands in a thin layer over the affected area. This light application will most often be done a few times throughout the day, as recommended by both your doctor and that outlined on your medicated ointment. It is important to wash hands thoroughly before and after applying your antifungal cream.
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Tips For Keeping Toenail Fungus From Returning
Toenail fungus is a tough foe to battle. The sooner its found out, the easier it tends to be to treat. Unfortunately, most cases are not discovered until the fungus has had a good opportunity to entrench itself in your toenail.
Treatment has likely taken months, but youve reached that light at the end of the tunnel. The fungus has been declared eradicated and youre already growing new, clear toenails to replace the war-torn battlefields that once were. Well done!
Unfortunately, it can come back.
A fungal toenail infection is not like a cold. Having had it doesnt really mean your immune system is fully geared up to keep the same case from returning. And, like a cold, there is more than one type of nasty organism out there that can cause similar symptomsin this case, discolored, crumbling, thickened nails.
You know how bad it is. The last thing you want is to fight that battle over again, and people with diabetes should be especially careful of any type of infection. You also dont want anyone you live with to have to go through it, either!
So what can you do to prevent toenail fungus from coming back? Quite a lot.
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What Is Athlete’s Foot What Are Causes And Risk Factors Of Athlete’s Foot
Athlete’s foot is a term given to almost any inflammatory skin disease that affects the sole of the foot and the skin between the toes. It is usually scaly and maybe a red, raw-appearing eruption with weeping and oozing with small blisters. It affects the feet of athletes and non-athletes alike. Although it is frequently caused by a fungal infection, other causes may be indistinguishable without proper testing.
The medical name for fungal athlete’s foot is tinea pedis. There are a variety of fungi that cause athlete’s foot, and these can be contracted in many locations, including gyms, locker rooms, swimming pools, communal showers, nail salons, and contaminated socks and clothing. The fungi can also be spread directly from person to person by contact. Most people acquire fungus on the feet from walking barefoot in areas where someone else with an athlete’s foot has recently walked. Some people are simply more prone to this condition while others seem relatively resistant to it. Another colorful name for this condition is “jungle rot,” often used by members of the armed services serving in tropical climates.
Fungal infections are promoted by warmth and moisture. There is some speculation that before enclosed shoes became common, tinea pedis was less prevalent. Up to 70% of the population may develop athlete’s foot at some time. An infection by athlete’s foot fungi does not confer any resistance to subsequent infections.
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