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.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
For this treatment, the affected toe or finger first has to be soaked in warm water for ten minutes and then dried. After that, the urea-based cream is applied to the nail, and the nail is covered with an adhesive bandage. After 24 hours, the bandage is removed and the toe or finger is held in warm water again. The softened layer of the nail is then scraped off using a spatula, the cream is applied again and the nail is covered with a new bandage. This treatment is carried out over 14 days. Once the infected part of the nail has been scraped away completely, the skin beneath is treated for another four weeks with a bifonazole cream.
Toenail fungus, also know as onychomcosis, is characterized by inflammation, thickening, swelling, yellowing, and pain of the toenail and toe. Another symptom is crumbling of the toenail. It’s caused by an abnormal PH of the skin, which can happen because of poor hygiene, a bad immune system, exposure to high levels of moisture, and/or poor circulation. These toenail fungus treatments will prevent or get rid of the problem.
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.
Ultra-high heels force the feet into a position that puts stress on the ball of the foot. At this critical joint, the long metatarsal bones meet the pea-shaped sesamoid bones, and the toe bones (phalanges). Too much pressure can inflame these bones or the nerves that surround them. Chronic stress to the foot bones can even lead to hairline fractures.
Español: eliminar los hongos en los pies, Deutsch: Fußpilz loswerden, Português: Acabar com Micoses nos Pés, Italiano: Liberarsi dei Funghi ai Piedi, Français: se débarrasser d’une mycose des pieds, Nederlands: Voetschimmel verhelpen, 中文: 摆脱足廯的困扰, Русский: вылечить грибок стопы, Čeština: Jak se zbavit plísně nohou, Bahasa Indonesia: Menghilangkan Jamur Kaki, العربية: التخلّص من فطريات القدمين, Tiếng Việt: Chữa Nấm Bàn chân, 한국어: 무좀 제거하는 법
^ 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.
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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.
Trichophyton rubrum is the most common dermatophyte involved in onychomycosis. Other dermatophytes that may be involved are T. interdigitale, Epidermophyton floccosum, T. violaceum, Microsporum gypseum, T. tonsurans, and T. soudanense. A common outdated name that may still be reported by medical laboratories is Trichophyton mentagrophytes for T. interdigitale. The name T. mentagrophytes is now restricted to the agent of favus skin infection of the mouse; though this fungus may be transmitted from mice and their danders to humans, it generally infects skin and not nails.
Topical antifungal agents can be used but are often ineffective. Oral terbinafine is considered to be the first-line treatment for confirmed onychomycosis; the treatment course is generally 6 weeks for fingernails and 12 weeks for toenails.9 Azoles can also be used. Surgical debridement or removal of the affected nail is also a consideration for cases that are resistant to antifungals, and laser treatments for onychomycosis appear to be a promising area for future study.10
Use soap and water to wash your feet, and dry well, including between toes. Trim your toenails -- straight across -- to keep them shorter than the end of your toe. Make sure the tools you use are clean, too. Wash clippers and files with soap and water, then wipe with rubbing alcohol. You might be tempted to cover up discolored nails with polish, but don't. Your nail bed can't "breathe," which keeps fungus from going away.