The newer drugs are unlikely to cause any liver problems in patients without known liver disease. Blood tests are not needed for once-weekly treatment with fluconazole (Diflucan); however, people taking longer courses often have their liver function tested before starting the medicine and then retested during the course of treatment. It is important to notify the doctor of all side effects while on the medication. You should tell your doctor of all current medications to prevent potential serious drug interactions.
Swelling and redness of the skin around the nail is called paronychia. This is an infection of the skin at the bottom of the nail (cuticle). If the infection is acute (has a rapid onset), it is usually caused by bacteria. It may respond to warm soaks but will often need to be drained by a doctor. A chronic paronychia occurs when a cuticle becomes inflamed or irritated over time. Sometimes, yeast will take advantage of the damaged skin and infect the area as well. Therapy begins with keeping the skin dry and out of water. If the problem continues, a physician should be consulted. Antibiotics are not often used but may be necessary in severe infection.
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]

Nail fungus, or onychomycosis, is a common skin condition where a fungus infects a part of the nail including the bed, matrix, or plate.[1] Nail fungus can result in cosmetic concerns, pain, and discomfort as well as end up affecting your everyday activities. If it is a severe infection, it may cause permanent damage to your nails or may spread beyond your nails.[2] If you know you have toenail fungus, you can follow a few simple steps to get rid of it and return your toenail to its former health.
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]
A 2003 survey of diseases of the foot in 16 European countries found onychomycosis to be the most frequent fungal foot infection and estimates its prevalence at 27%.[32][33] Prevalence was observed to increase with age. In Canada, the prevalence was estimated to be 6.48%.[34] Onychomycosis affects approximately one-third of diabetics[35] and is 56% more frequent in people suffering from psoriasis.[36]
Globally, fungal infections affect about 15% of the population and affects one out of five adults.[2][21] Athlete's foot is common in individuals who wear unventilated (occlusive) footwear, such as rubber boots or vinyl shoes.[21][23] Countries and regions where going barefoot is more common experience much lower rates of athlete's foot than do populations which habitually wear shoes; as a result, the disease has been called "a penalty of civilization".[35] Studies have demonstrated that men are infected 2–4 times more often than women.[2]
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.
The ease with which the fungus spreads to other areas of the body (on one's fingers) poses another complication. When the fungus is spread to other parts of the body, it can easily be spread back to the feet after the feet have been treated. And because the condition is called something else in each place it takes hold (e.g., tinea corporis (ringworm) or tinea cruris (jock itch), persons infected may not be aware it is the same disease.
When visiting a doctor, the basic diagnosis procedure applies. This includes checking the patient's medical history and medical record for risk factors,[11] a medical interview during which the doctor asks questions (such as about itching and scratching), and a physical examination.[11] Athlete's foot can usually be diagnosed by visual inspection of the skin and by identifying less obvious symptoms such as itching of the affected area.
The fungi (molds) that cause athlete's foot require warmth and moisture to survive and grow. There is an increased risk of infection with exposure to warm, moist environments (e.g., occlusive footwear—shoes or boots that enclose the feet) and in shared humid environments such as communal showers, shared pools, and treatment tubs.[17] Chlorine bleach is a disinfectant and common household cleaner that kills mold. Cleaning surfaces with a chlorine bleach solution prevents the disease from spreading from subsequent contact. Cleaning bathtubs, showers, bathroom floors, sinks, and counters with bleach helps prevent the spread of the disease, including reinfection.
Fungus can infect the skin and nails of your feet. A fungal infection of the skin is also known as Athlete’s Foot, which causes itching, burning, and flaking. This infection can spread to the toenails if it’s not treated. Both types of foot fungus are extremely contagious, both in your own body as well as to other people through contact. Therefore, it’s essential to treat the infection and prevent its recurrence.
Baking soda has the ability to dry up the excess moisture on your toes, and it will help neutralize foot odor and act as a toenail fungus treatment. Create a paste using baking soda and water and apply it to the toenail. Let it soak for 10 minutes and then rinse off. You can also create a foot bath by mixing a bucket of water with baking soda and letting your entire foot soak. Check out these other effective home remedies for smelly feet.
No one knows where a specific person catches the fungus, as it is everywhere. However, since the fungus does thrive in warm moist areas (like sweaty feet), there are certain areas one should avoid or use with caution. Shower floors, locker rooms, and swimming pools are suspected of being sources of the fungus, although there are no studies proving this fact. Nail polish and acrylic nails also make the nail less "breathable" and make the nail more susceptible to fungal infection. Fungi are everywhere -- in the air, the dust, and the soil. Hygienic measures such as spraying socks and footgear sound sensible, and perhaps these measures can even help a little bit. However, avoiding tight, nonbreathing shoes or steering clear of athletic facility floors may very well be the best prevention available. Daily washing of the feet and drying between the toes can help to prevent nail fungus. The fungi carried on the coats of pets, like cats and dogs, don't often cause nail fungus. Wearing white socks does not help.
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.
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.
The ease with which the fungus spreads to other areas of the body (on one's fingers) poses another complication. When the fungus is spread to other parts of the body, it can easily be spread back to the feet after the feet have been treated. And because the condition is called something else in each place it takes hold (e.g., tinea corporis (ringworm) or tinea cruris (jock itch), persons infected may not be aware it is the same disease.
Nail-bed fungus is also called onychomycosis. It can affect anyone regardless of age, gender and hygiene and is spread by direct contact with skin or with infected surfaces. Common places you may be exposed to fungus are at nail salons, as well as showers at hotels, pools, nail salons, and gyms where you go barefoot. Housemates and family members with a fungal infection may also spread their condition.

When the skin is injured damaged, the natural protective skin barrier is broken. Bacteria and yeasts can then invade the broken skin. Bacteria can cause a bad smell. Bacterial infection of the skin and resulting inflammation is known as cellulitis. This is especially likely to occur in individuals with diabetes, chronic leg swelling, who have had veins removed (such as for heart bypass surgery), or in the elderly. Bacterial skin infections also occur more frequently in patients with impaired immune systems.
Oral medications include terbinafine (76% effective), itraconazole (60% effective) and fluconazole (48% effective).[2] They share characteristics that enhance their effectiveness: prompt penetration of the nail and nail bed,[23] and persistence in the nail for months after discontinuation of therapy.[24] Ketoconazole by mouth is not recommended due to side effects.[25] Oral terbinafine is better tolerated than itraconazole.[26] For superficial white onychomycosis, systemic rather than topical antifungal therapy is advised.[27]
As both an antiseptic and fungicidal remedy, tea tree oil is a great remedy for onychomycosis.  First clean areas on and around the infection with rubbing alcohol then apply undiluted 100% pure tea tree oil (such as this Plant Therapy Tea Tree Oil) directly to the affected nails and let it soak in.  After about ten minutes, gently scrub the nail with a soft bristle toothbrush.  When applying tea tree oil directly to skin, consider mixing the oil one-to-one with an all-natural carrier, like olive or almond oil.  Repeat daily until the new healthy nail grows out completely, then continue treatment for two to three more weeks to prevent regrowth.
The newer drugs are unlikely to cause any liver problems in patients without known liver disease. Blood tests are not needed for once-weekly treatment with fluconazole (Diflucan); however, people taking longer courses often have their liver function tested before starting the medicine and then retested during the course of treatment. It is important to notify the doctor of all side effects while on the medication. You should tell your doctor of all current medications to prevent potential serious drug interactions.
The most reliable way to diagnose athlete’s foot is to correctly identify its cause. Fungal athlete's foot is relatively straightforward to diagnose and treat. Visualization of the fungus in skin scrapings removed from the affected areas of the feet is a painless and cost-effective method for diagnosis. Rarely, it is necessary to identify fungi in portions of skin removed during a biopsy. If no fungus is found, other causes of athlete's foot must be investigated.

There are several preventive foot hygiene measures that can prevent athlete's foot and reduce recurrence. Some of these include keeping the feet dry, clipping toenails short; using a separate nail clipper for infected toenails; using socks made from well-ventilated cotton or synthetic moisture wicking materials (to soak moisture away from the skin to help keep it dry); avoiding tight-fitting footwear, changing socks frequently; and wearing sandals while walking through communal areas such as gym showers and locker rooms.[8][13][28]
Satchell, A. C., Saurajen, A., Bell, C., & Barnetson, R. StC. (2002, July 19). Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: A randomized, placebo-controlled, blinded study [Abstract]. Australasian Journal of Dermatology, 43(3), 175–178. Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.1440-0960.2002.00590.x/full
If common remedies do not offer relief within three to four months of consistent use, or if the discomfort worsens, contact your doctor. Extreme infections may require the temporary surgical removal of the nail. A replacement nail will usually grow. As the new nail regrows, it is good practice to treat it with an antifungal cream to prevent reinfection.
Nail fungus is usually harmless. But many people find discolored or thickened nails unpleasant to look at and want to get rid of the fungus as soon as possible. Fungal nail infections can also spread, and may infect other people. Regardless of the treatment you choose, it will take a while until the nail looks normal again. It’s especially important to be patient where toenails are concerned. It can take a year for a healthy big toenail to grow back. Nail fungus can sometimes be very persistent despite treatment. It can also come back after successful treatment.
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