“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.”
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.
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.
In some cases of suspected nail fungus there is actually no fungal infection, but only nail deformity. A 2003 source gives a figure of 50% whereas a more recent source claims that fungus is present in 65 to 95 percent of cases. Avoiding use of oral antifungal therapy (e.g. terbinafine) in persons without a confirmed infection is a particular concern because of the possible side effects of that treatment. However, according to a 2015 study, the cost in the United States of testing with the periodic acid–Schiff stain (PAS) was about $148. Even if the cheaper KOH test is used first and the PAS test is used only if the KOH test is negative, there is a good chance that the PAS will be done (because of either a true or a false negative with the KOH test). But the terbinafine treatment only cost $10 (plus an additional $43 for liver function tests). In conclusion the authors say that terbinafine has a relatively benign adverse effect profile, with liver damage very rare, so it makes more sense cost-wise for the dermatologist to prescribe the treatment without doing the PAS test. (Another option would be to prescribe the treatment only if the potassium hydroxide test is positive, but it gives a false negative in about 20% of cases of fungal infection.) On the other hand, as of 2015 the price of topical (non-oral) treatment with efinaconazole was $2307 per nail, so testing is recommended before prescribing it.
There are many possible causes of foot rashes. Additional causes include irritant or contact dermatitis, allergic rashes from shoes or other creams, pompholyx (dyshidrotic eczema), psoriasis, yeast infections, and bacterial infections (gram negative toe web infection and erythrasma). Since these conditions are often indistinguishable on superficial visual examination, it is important for your doctor to do his best to identify the precise cause. Since fungal infections are potentially curable, it is important not to miss this diagnosis.
Starts at the base of the nail and raises the nail up: This is called "proximal subungual onychomycosis." This is the least common type of fungal nail. It is similar to the distal type, but it starts at the cuticle (base of the nail) and slowly spreads toward the nail tip. This type almost always occurs in people with a damaged immune system. It is rare to see debris under the tip of the nail with this condition, unlike distal subungual onychomycosis. The most common cause is T. rubrum and non-dermatophyte molds.
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.
Athlete's foot was first medically described in 1908. Globally, athlete's foot affects about 15% of the population. Males are more often affected than females. It occurs most frequently in older children or younger adults. Historically it is believed to have been a rare condition, that became more frequent in the 1900s due to the greater use of shoes, health clubs, war, and travel.