Dr. Kyoung Min Han is a podiatrist (foot and ankle specialist) practicing in Southern California. Dr. Han completed her undergraduate education at the University of California, San Diego, and went on to the New York College of Podiatric Medicine to pursue her medical training. She returned to her native Southern California to complete a three-year foot and ankle surgical residency, followed by subspecialty training in a sports medicine fellowship.
Unfortunately, athlete’s foot is highly contagious and the fungus can easily spread to the toes and toenails, causing infections. There are more than three million cases of toenail fungus in the US every year. Not all toenail infections are from athlete’s foot or even from a fungus; some are caused by yeast or mold. These are much harder to cure than fungal infections.
The vesiculobullous type of athlete's foot is less common and is usually caused by T. mentagrophytes and is characterized by a sudden outbreak of itchy blisters and vesicles on an erythematous base, usually appearing on the sole of the foot. This subtype of athlete's foot is often complicated by secondary bacterial infection by Streptococcus pyogenes or Staphylococcus aureus.
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Walking barefoot in public places: Sure, taking your shoes off may feel great but it can also lead to toenail fungus. Toenail fungus starts when moisture gets trapped under the nail. This can easily happen when you walk barefoot.It is also easy to pick up toenail fungus from walking in public places as fungus can survive for up to 6 months on surfaces. The most common public places where you can pick up toenail fungus include swimming pools and public showers. Protect yourself by wearing sandals in public pool areas and public showers.
One way to contract athlete's foot is to get a fungal infection somewhere else on the body first. The fungi causing athlete's foot may spread from other areas of the body to the feet, usually by touching or scratching the affected area, thereby getting the fungus on the fingers, and then touching or scratching the feet. While the fungus remains the same, the name of the condition changes based on where on the body the infection is located. For example, the infection is known as tinea corporis ("ringworm") when the torso or limbs are affected or tinea cruris (jock itch or dhobi itch) when the groin is affected. Clothes (or shoes), body heat, and sweat can keep the skin warm and moist, just the environment the fungus needs to thrive.
Toe infections sound scary, but they’re infections of the nails, most commonly caused by ingrown toenails. The toenail grows into the side of the toe, into the soft tissue there, and the skin begins to grow over it. It can get infected very quickly and is most commonly seen in big toes. This condition is painful, and an infection can be a serious problem.
Ciclopirox (Penlac) topical solution 8% is a medical nail lacquer that has been approved to treat finger or toenail fungus that does not involve the white portion of the nail (lunula) in people with normal immune systems. In one study, ciclopirox got rid of the fungus 22% of the time. The medication is applied to affected nails once daily for up to one year. The lacquer must be wiped clean with alcohol once a week.
^ Jump up to: a b American Academy of Dermatology (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Dermatology, retrieved 5 December 2013. Which cites:*Roberts DT, Taylor WD, Boyle J (2003). "Guidelines for treatment of onychomycosis" (PDF). The British Journal of Dermatology. 148 (3): 402–410. doi:10.1046/j.1365-2133.2003.05242.x. PMID 12653730.
Fungal nail infections can be difficult to treat. Talk with your doctor if self-care strategies and over-the-counter (nonprescription) products haven't helped. 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 your nail condition improves, repeat infections are common.
Since some people are simply more prone to fungal infections, they are also prone to repeated infection. Preventive measures include keeping your feet clean and dry, avoiding prolonged moist environments, using socks in airport security lines, removing shoes, and allowing the feet skin to "breathe," avoiding walking barefoot, especially in public areas like swimming pools and gyms, avoiding contact with known infected people, and avoiding soaking and contaminated tool usage at nail salons. Weekly applications of a topical antifungal foot cream or sprinkling of antifungal foot powder (Zeasorb Foot Powder) into shoes may also be helpful.
Athlete’s foot infections can be mild or severe. Some clear up quickly, and others last a long time. Athlete’s foot infections generally respond well to antifungal treatment. However, sometimes fungal infections are difficult to eliminate. Long-term treatment with antifungal medications may be necessary to keep athlete’s foot infections from returning.
Fungal nails (onychomycosis) may be caused by many species of fungi, but the most common is Trichophyton rubrum. Distal subungal onychomycosis starts as a discolored area at the nail's corner and slowly spread toward the cuticle. In proximal subungal onychomycosis, the infection starts at the cuticle and spreads toward the nail tip. Yeast onychomycosis is caused by Candida and may be the most common cause of fungal fingernail.
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). 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.
Oral/combination therapy. Some studies have shown that taking antifungal pills and applying antifungals to your nails can be more effective than using either treatment alone. Oral medications can typically treat toenail fungus in three months. In stubborn cases, topical and oral medications may be combined to provide the best possible treatment. Oral medications must be prescribed by your physician or health care practitioner.
Readily available over-the-counter treatments work well for most nail-bed infections, especially early cases. An advanced toenail fungus infection may require a podiatrist’s intervention. To counteract a serious infection, medical professionals may utilize prescription topical medications, oral medications, and even laser therapy. Some cases best respond to combination therapy.
Creams and other topical medications have traditionally been less effective against nail fungus than oral medications. This is because nails are too hard for external applications to penetrate. It is also cumbersome to adhere to topical medication regimens. Oftentimes, these medications require daily applications for a period of time up to one year to see results. One of the major advantages of topical treatment is the minimal risk for serious side effects and drug interactions compared to oral therapy.
Excellent product. It worked beyond expectations. When I bought it, I was trying to make up for the lack of an appoinment opening with my dermatologist. It took 2 weeks to be seen, so in the meantime, I applied it according to the recommended use. So when I went to my appointment, the doctor had to look at my before pictures. He told me I didn't have fungus. I had to convince him that I need prescription fungus medication. Super effective, beyond expectations.
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.