Description

Nail fungus is a common infection of the nail. It begins as a white or yellow-brown spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, nail may discolor, thicken and crumble at the edge. Nail fungus can affect several nails.

If your condition is mild and not bothering you, you may not need treatment. If your nail fungus is painful and has caused thickened nails, self-care steps and medications may help. But even if treatment is successful, nail fungus often comes back.

Nail fungus is also called onychomycosis (on-ih-koh-my-KOH-sis). When the fungus infects the areas between your toes and the skin of your feet is called athlete's foot (tinea pedis).

Symptoms

The symptoms of nail fungus include a nail or nails that are:

  • Thickened
  • Faded
  • Brittle, crumbly or ragged
  • Deformed
  • Separated from the nail bed
  • Smells bad

Nail fungus can affect fingernails, but it is more common in toenails.

When to see a doctor

You may want to see a doctor if self-care measures haven't helped and the nail becomes increasingly discolored, thickened or deformed. Also talk with your doctor if you have:

  • Diabetes and think you're developing nail fungus
  • Bleeding around the nails
  • Swelling, or pain around the nails
  • Difficulty walking

Causes

Nail fungus is caused by various fungal organisms (fungi). The most common is a type of so-called dermatophytes. Yeasts, bacteria and molds also can cause nail infections. The discoloration of a bacterial infection tends to be green or black.

The fungal infection of the feet (athlete's foot) can spread to the nail, and a fungal nail infection can spread to the feet. You can also get the infection through contact with areas where the fungi can grow, such as the tile floor in a gym shower or in the dark interior, sweaty, wet shoes.

Risk factors

Factors that may increase your risk of developing nail fungus are:

  • Age
  • The use of shoes that make your feet sweat a lot
  • After you have had athlete's foot in the past
  • Walking barefoot in damp public areas, such as pools, gyms and shower rooms
  • Having a minor skin or nail injury
  • Having a skin condition that affects the nails, such as psoriasis
  • Having diabetes, blood flow problems or a weakened immune system

Complications

A severe case of nail fungus can be painful and may cause permanent damage to the nails. And can lead to serious infections that spread beyond your feet if you have a weakened immune system due to medication, diabetes or other conditions.

Prevention

The following habits can help prevent nail fungus or reinfections and the athlete's foot, which can lead to nail fungus:

  • Keep nails clean and dry. Wash your hands and feet regularly. Wash your hands after touching an infected nail. Dry well, apply an antifungal foot powder and hydrate your nails. Consider applying a nail hardener, which could help to strengthen nails and cuticles.
  • Keep nails trimmed. Cut toenails straight, smooth the edges with a file and file down thickened areas. Disinfect clippers after each use. Let your nails grow long creates more places for the fungus to grow.
  • Use absorbent socks or change your socks throughout the day.
  • Choose shoes made of materials that breathe.
  • Dispose of old shoes or to treat them with disinfectants or antifungal powders.
  • Wearing shoes in the pool area and locker rooms.
  • Choose a beauty salon that uses sterilized utensils for each client. Or disinfect the tools that I use for home pedicures.
  • Give up nail Polish and artificial nails.
  • If you have athlete's foot, treatment with antifungal product.

Diagnosis

Your health care provider will examine your nails, and maybe take some nail clippings or scrape debris from under the nail. These samples are sent to a lab to identify the cause of your symptoms.

Other conditions, such as psoriasis, can mimic a fungal infection of the nail. Microorganisms such as yeast and bacteria also can infect nails. Knowing the cause of your infection helps determine the best treatment.

Treatment

Treatment for toenail fungus is not always necessary. And sometimes, self-care and otc products to remove the infection. Talk with your doctor if your condition does not improve. The treatment depends on the severity of your condition and the type of fungus causing it. It can take months to see results. And even if the nail condition improves, repeat infections are common.

Drugs

Your health care provider may prescribe antifungal medications you take by mouth (orally) or applied to the nail.

  • Oral antifungal drugs.These medications are often the first choice. One option is to itraconazole (Sporanox). These drugs help a new nail grow free of infection, slowly replacing the infected part. It is usually taken this type of medication a day for 6 to 12 weeks. But you won't see the end result of treatment until the nail grows back completely. It may take four months or more to remove an infection. The success of the treatment with these drugs appear to be lower in adults older than 65 years of age. Oral antifungal drugs may cause side effects such as skin rashes, and liver damage. Or can interfere with other prescription medications. You may need occasional blood tests to check how you are doing with these types of drugs. Health care providers may not recommend oral antifungal drugs for people with liver disease or congestive heart failure or those taking certain other medications.
  • Medicated nail Polish. Your health care provider may prescribe an antifungal nail Polish called ciclopirox (Penlac). The paint on your infected nails and surrounding skin once a day. After seven days, you wipe the piled-on layers clean with alcohol and begin fresh applications. You may need to use this type of nail Polish daily for almost a year.
  • Medicated nail crema.Su health care provider may prescribe an antifungal cream, such as efinaconazole (Jublia) and tavaborole (Kerydin). Rub this product into your infected nails after soaking. These creams may work better if you first thin the nails. This helps the medication get through the hard nail surface to the base of the mushroom. For nails, apply a lotion without a prescription that contain urea. Or your health care provider may thin the surface of the nail (debridement) with a file or other tool. Antifungal nail creams can cause side effects such as rashes on the skin.

Oral antifungal drugs. These medications are often the first choice. One option is to itraconazole (Sporanox). These drugs help a new nail grow free of infection, slowly replacing the infected part.

It is usually taken this type of medication a day for 6 to 12 weeks. But you won't see the end result of treatment until the nail grows back completely. It may take four months or more to remove an infection. The success of the treatment with these drugs appear to be lower in adults older than 65 years of age.

Oral antifungal drugs may cause side effects such as skin rashes, and liver damage. Or can interfere with other prescription medications. You may need occasional blood tests to check how you are doing with these types of drugs. Health care providers may not recommend oral antifungal drugs for people with liver disease or congestive heart failure or those taking certain other medications.

Medicated nail cream. Your health care provider may prescribe an antifungal cream, such as efinaconazole (Jublia) and tavaborole (Kerydin). Rub this product into your infected nails after soaking. These creams may work better if you first thin the nails. This helps the medication get through the hard nail surface to the base of the mushroom.

For nails, apply a lotion without a prescription that contain urea. Or your health care provider may thin the surface of the nail (debridement) with a file or other tool.

Antifungal nail creams can cause side effects such as rashes on the skin.

Surgery

Your health care provider might suggest a temporary removal of the nail to the antifungal drug may be applied directly to the infection under the nail.

The most effective but less used option is surgery to permanently remove the nail and its root.

Lifestyle and home remedies

Often, you can take care of a fungal nail infection at home:

  • Try the-counter antifungal nail creams and ointments. Several products are available to you, such as terbinafine (Lamisil). If you notice white spots on the surfaces of the nails, file the same, soak your nails in water, dry and apply the medicated cream or lotion. Even if this clears up your symptoms, it is common for the infection to come back.
  • Trim and thin the nails. This helps to reduce the pain, reduce the pressure on the nails. Also, if you do this before you apply an antifungal drug, the drug can reach the deeper layers of the nail.

Before trimming or using a nail file to get slim thick nails, soften them with urea-containing creams. See a health care provider for the care of your feet if you have a condition that causes poor blood flow to their feet.

Alternative medicine

Some research suggests that the nutritional supplement biotin might help strengthen weak or brittle nails. Talk with your health care provider if you have any questions or concerns about whether this is right for you.

Also, some studies show that tea tree oil has anti-fungal effects. It is often used to treat nail fungus.

Preparing for your appointment

It is likely to start by seeing your primary care provider. In some cases, when you call to schedule an appointment, you may be referred immediately to a doctor who specializes in skin diseases (dermatologist) or one that specializes in foot conditions (podiatrist).

Here are some steps you can take to prepare for your appointment:

  • List of symptoms, including any that may seem unrelated to fungi in the nails.
  • The list of personal information, including any major stresses or recent life changes.
  • List of all the medicines, vitamins, and supplements you are taking.
  • List of questions to ask your health care provider.

For the nail fungus, the questions may include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes for my symptoms or condition?
  • What tests do I need?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • It is a generic alternative available to the medicine you're prescribing?
  • Do you have any brochures or other printed material that I can take home? Do you recommend any of the web sites on the fungus of nails?
Symptoms and treatment of Nail fungus