In normal, healthy people, fungal infections of the nails are most commonly caused by fungus that is caught from moist, wet areas. Communal showers, such as those at a gym or swimming pools, are common sources. Going to nail salons that use inadequate sanitization of instruments (such as clippers, filers, and foot tubs) in addition to living with family members who have fungal nails are also risk factors. Athletes have been proven to be more susceptible to nail fungus. This is presumed to be due to the wearing of tight-fitting, sweaty shoes associated with repetitive trauma to the toenails. Having athlete's foot makes it more likely that the fungus will infect your toenails. Repetitive trauma also weakens the nail, which makes the nail more susceptible to fungal infection.
For more severe cases, oral antifungal medications might be required. These include fluconazole (an antifungal agent also commonly used to treat thrush), terbinafine (a broad-spectrum antifungal) and griseofulvin (usually used for skin infections). The latter is a very old drug and carries the risk of causing damage to the liver. Terbinafine is most effective and therefore is the preferred oral treatment. A 12-week course cures 70-80% of cases by causing the fungi’s cells to leak and die. It can, however, cause gastrointestinal side effects and depression.
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
For fungus infection, there are plenty of options. Many medications are available, including miconazole (Micatin, Zeasorb powder), econazole (Spectazole), clotrimazole (Lotrimin), terbinafine (Lamisil), naftifine (Naftin), butenafine (Mentax), ciclopirox (Loprox), ketoconazole (Nizoral), efinaconazole (Jublia), luliconazole (Luzu), sertaconazole (Ertaczo), sulconazole (Exelderm), and tolnaftate (Tinactin). Ask your health care professional or pharmacist for a recommendation. It is difficult to know which of these drugs is most effective since they have not been tested against each other. Cost is probably the most significant differentiating factor, and many are available without a prescription. Treatment for athlete's foot should generally be continued for four weeks or at least one week after all of the skin symptoms have cleared.
Because fungus needs an acidic environment to flourish, alkaline baking soda actually prevents toenail fungus from spreading by creating an uninhabitable environment for it. Borax is a naturally occurring mineral that is also a powerful fungicide. These two combined create a remedy that can cure nail fungus fast. Mix equal parts borax powder and baking soda with just enough water to form a paste. Wet feet and gently rub the mixture onto infected nails. Do this twice daily and continue for at least two weeks after fungus appears to have cleared up.
Making a few simple lifestyle changes can help prevent a fungal infection of the nails. Taking good care of your nails by keeping them well trimmed and clean is a good way to prevent infections. You should also avoid injuring the skin around your nails. If you’re going to have damp or wet hands for an extended amount of time, you may want to wear rubber gloves.
You may use other antifungal treatments, such as antifungal nail lacquer or topical solutions. These treatments are brushed onto the nail in the same way that you would apply nail polish. Depending on the type of fungus causing the infection, as well as the extent of the infection, you may have to use these medications for several months. Topical solutions are not generally effective in curing toenail fungal infections.
Removal of the nail can reduce symptoms rapidly, but regrowth of the nail can take one year during which time local treatment for fungus can be used. Oral medications include terbinafine (Lamisil), itraconazole (Sporanox), and griseofulvin (Fulvicin). Treatment regimens vary and can last between six weeks and one year. Side effects of systemic treatment include gastrointestinal disorders, liver toxicity, skin rash and other hypersensitivities. These medications should not be taken during pregnancy or if there is a chance you will become pregnant because of effects on the fetus.
Fungal athlete's foot may cause a rash on one or both feet and even involve the hand. A "two feet and one hand" pattern is a very common presentation of athlete's foot, especially in men. Hand fungal infections are called tinea manuum. Fungal athlete's foot may also be seen along with ringworm of the groin (especially in men) or hand(s). It is helpful to examine the feet whenever there is a fungal groin rash called tinea cruris, or jock itch. It is important to treat all areas of fungal infection at one time to avoid reinfection. Simply treating the soles and ignoring the concurrent fungal infection of toenails may result in recurrences of athlete's foot.