Do you have nails that are thick and difficult to trim? Do they have white or yellow discoloration?
If the answer to either of those questions is,’ yes’ then it is possible you have nail fungus. Nail fungal infections, known as onychomycosis, are extremely common. As people age, the odds steadily increase that a person will have fungus infection in one or more fingernails or toenails.
Nail Fungus Infection
With nail fungal infections, there are a variety of different changes in the nails that may occur. One of the most common changes is the thickening of the nail. This often starts out at the far outer edge of the nail, where the infection begins. Over time, it can worsen to the point of causing an extremely thick nail that is nearly impossible to trim, necessitating visits with a podiatrist for nail trimming and care. Color change in the nail itself may also signify a nail fungal infection. There can be a variety of colors in infected nails, with yellow and white coloration being the most common.
Nail fungal infections are more common in the toenails, and usually start off by impacting just a few nails. Gradually over months or years the infection can spread to more nails, and some individuals may also develop involvement in their fingernails.
Generally, this condition is harmless causing only cosmetic concern. However, with the difficulty in trimming the nails and on account of the undesirable nail appearance, many people do pursue treatment. In rare cases, nail fungus can distort nails causing pain, especially with walking. There are many different causes for an affected nail to have nail fungus. Each cause has a treatment of its own. Although many of the causes of a fungal nail infection are preventable, some risk factors increase the likelihood of developing one. For additional information on how to treat toenail fungus, consult with one of our dermatologists today.
Nail Fungus Treatments
Treatments for fungal nail infections can be divided up into two main categories—oral (taken by mouth) and topical treatments (applied directly to the nails). It is noteworthy that none of the treatments have a 100% success rate. In fact, some of the medications can at best cure roughly half of those undergoing treatment. In more severe or returning nail infections, nail removal may be recommended by your dermatologist.
For many years, oral medications have been utilized to treat various types of fungus, and though they can work they can also cause some notable side effects, particularly liver issues in rare cases. Sporanox (itraconazole) and Lamisil (terbinafine) are two of the most commonly used oral antifungal medications for nail fungus. Because they can rarely be harmful to liver, laboratory testing before and during treatment is generally needed. Over the years, we have used these medicines less and less frequently because applied treatments have come to market and have been gradually improving over time.
Applied topical medications offer the great advantage of being delivered directly to the problem areas, and avoiding our internal organs, therefore having the best safety profiles. Penlac (ciclopirox) was the first applied medication FDA-approved for nail fungus. Penlac is an antifungal nail polish that is painted onto the infected nails and surrounding skin once a day. Unfortunately, this medication is minimally effective, working just a bit better than placebo in studies. Recently a new applied medication known as Jublia (efinconazole) has been approved for use for nail fungus. Under the right circumstances, Jublia can have success rates to the older oral medications used for nail fungus.
Laser treatment for onychomycosis has gained interest recently. Long story short, there is not yet any great scientific evidence supporting the effectiveness of lasers for nail fungus. We hope this will come in time. As there is very limited information out there, this is not a treatment that we support in our practice at Advanced Dermatology of the Midlands.
Frequently we have patients ask us about homeopathic treatments for nail fungus. Home remedies ranging from apple cider vinegar to Vicks vapor rub and some other medicated over-the-counter products are touted by certain nonmedical individuals as effective for onychomycosis. Unfortunately, though some of these treatments might improve the appearance of the condition, there is no scientific evidence yet that they can cure nail fungus.
Most likely, it is not possible to completely prevent a person from acquiring nail fungus. Also, some of us are apparently more susceptible to fungus based on our immune systems. However, we have some useful tips for patients with nail fungus, especially those undergoing treatment, to reduce chances of the fungus spreading to other nails or coming back after they have completed successful treatment.
First and foremost, we recommend using at least 2 different sets of nail clippers. Use one set on your normal appearing nails and the other for the abnormal (infected) nails. Perhaps mark the nail clipper for the infected nails with a piece of black electrical tape. At Advanced Dermatology of the Midlands, we believe that the use of contaminated nail clippers may be one way that we possibly spread fungus from one nail to another, as well as to other people sharing our clippers. For this reason, consider using your own nail clippers and not sharing these with a family member.
Also, when at a public restroom facility or locker room, or even at a public pool, consider wearing water shoes or sandals to prevent direct contact between the floor and your feet & nails. Dry your feet thoroughly after a shower or when they get wet for other reasons. Zeasorb AF is an antifungal foot powder that we frequently have patients use in their socks and shoes daily to reduce chances of recurrence or reduce chances of nail fungus spreading onto skin of the feet and causing athlete’s foot (aka tinea pedis).
There are many potential sources of nail fungus throughout the environment. If you visit a nail salon, make sure that your salon cleans and disinfects all their instruments regularly.
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
The best dermatologists know that nail fungal infections are generally harmless and primarily of a cosmetic concern. However, with at least one newer applied treatment, many people can be treated safely and successfully for their nail fungus. Through our research division at Advanced Dermatology the Midlands, we are active in ongoing trials of innovative dermatology treatments. We hope to be involved in future breakthrough studies when it comes to the treatment of nail fungus. For advice, diagnosis, or treatment, reach out to us to schedule a consultation at 402-933-3770 or click here to fill out our contact form.