“The medications we use to treat this are expensive and they are not benign,” cautioned Dr. Hinkes. “Lamisil is so powerful it stays in your body six months after you stop using it, and that’s one of the reasons why it works so well. So when we use these medicines, we have to be conscious that we may be affecting a person’s liver, because the liver is the organ that helps to detoxify the body and excretes that medicine.”
The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin underneath and around the nail can become inflamed and painful. There may also be white or yellow patches on the nailbed or scaly skin next to the nail,[6] and a foul smell.[7] There is usually no pain or other bodily symptoms, unless the disease is severe.[8] People with onychomycosis may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.[9]
Oral antifungal therapy has a high cure rate, depending on the medication. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back. Currently, an oral antifungal therapy is considered the best treatment for toenail fungus because of higher cure rates and shorter treatment duration compared to topical therapy.
Treating the feet is not always enough. Once socks or shoes are infested with fungi, wearing them again can reinfect (or further infect) the feet. Socks can be effectively cleaned in the wash by adding bleach or by washing in water 60° C (140° F).[32] Washing with bleach may help with shoes, but the only way to be absolutely certain that one cannot contract the disease again from a particular pair of shoes is to dispose of those shoes.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Many individuals with athlete's foot have no symptoms at all and do not even know they have an infection. Many may think they simply have dry skin on the soles of their feet. Common symptoms of athlete's foot typically include various degrees of itching, stinging, and burning. The skin may frequently peel, and in particularly severe cases, there may be some cracking, fissuring, pain, and itching in the toe webs. Occasionally, athlete's foot can blister.
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.
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Use tea tree oil. Tea tree oil is a natural anti-fungal. One study showed that tea tree oil may be effective for nail fungus. 18% of patients who used tea tree oil twice daily for 24 weeks were cleared of the infection.[13] To treat nail fungus with tea tree oil, use a 100% solution because lower concentrations have not been proven to be effective for this particular infection.[14]
If the diagnosis is uncertain, direct microscopy of a potassium hydroxide preparation of a skin scraping (known as a KOH test) can confirm the diagnosis of athlete's foot and help rule out other possible causes, such as candidiasis, pitted keratolysis, erythrasma, contact dermatitis, eczema, or psoriasis.[13][23][27] Dermatophytes known to cause athlete's foot will demonstrate multiple septate branching hyphae on microscopy.[13]
Modern medicine addresses toenail fungus with topical treatments, oral anti-fungal medicine, and in some cases surgical removal of the nail.  Side effects of these medications may possibly include trouble breathing, swelling of the mouth or face, hives, rashes, blisters, headaches, dizziness, nausea, loss of appetite, liver damage, weight gain, fatigue, heart problems, fever, diarrhea, and more pain – all just to get rid of fungus on your toenails.

Conventional treatment typically involves thoroughly washing the feet daily or twice daily, followed by the application of a topical medication. Because the outer skin layers are damaged and susceptible to reinfection, topical treatment generally continues until all layers of the skin are replaced, about 2–6 weeks after symptoms disappear. Keeping feet dry and practicing good hygiene (as described in the above section on prevention) is crucial for killing the fungus and preventing reinfection.
Garlic has antifungal properties useful to foot fungus treatment, thanks to its compounds such as allicin and ajoene. These natural compounds work to treat the toenail fungus. Mix crushed up garlic or garlic oil with white vinegar. Apply the mixture on and around the infected area and then cover it with a bandage. Leave the bandage on for a few hours. Repeat daily until the toenail fungus clears. Plus, learn about the other signs of disease your feet can reveal.
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.
Onychomycosis does not necessarily require treatment.[3] The antifungal medication, terbinafine, taken by mouth appears to be the most effective but is associated with liver problems.[2][4] Trimming the affected nails when on treatment also appears useful.[2] There is a ciclopirox containing nail polish, but it does not work as well.[2] The condition returns in up to half of cases following treatment.[2] Not using old shoes after treatment may decrease the risk of recurrence.[3]
Is it nail psoriasis or fungus? Is it nail psoriasis or fungus? Nail psoriasis is the result of a systemic condition in which the skin, and therefore also the nails, grow too fast. Nail fungus is the result of an infection, and it more common in the toenails. It is important to know the difference, so that effective treatment can be provided. Read now
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