Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed. This infection may cause a foul odor of the nails. The treatment is to trim the nail short every four weeks, don't clean it, polish if you want to hide the color, and wait two to three months. It is also advised to avoid soaking the nail in any sort of water (even if inside gloves) and to thoroughly dry the nail after bathing. If the problem continues, there are prescription treatments that your doctor may try.
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Nail infections occur more often in men than in women, and the infections are found in adults more often than in children. If you have family members who often get these types of fungal infections, you’re more likely to get them as well. Older adults are at the highest risk for getting fungal infections of the nails because they have poorer circulation and their nails grow more slowly and thicken as they age.
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.
Modern treatments made surgery a last resort. “Before we had these 21st century medications, we didn’t have a good choice in how to deal with toenail fungus,” said Dr. Hinkes. “Oftentimes patients would come in, and out of frustration and lack of any real significant clinical cure with medication, they would ask for their nails to be permanently removed.”
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.
Select shoes that fit right – Choosing the correct footwear is a must if you want to avoid toenail fungus. Shoes should not touch your toenails at all. Don’t jam your feet into shoes that are too big either – this will cause you to jam your toenail into the front of the shoe causing damage. According to the American Academy of Physicians, the best shoes have a wide toe box.
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.
Some methods of prevention include avoiding walking barefoot in public showers, keeping the toenails short, wearing big enough shoes, and changing socks daily. When infected, the feet should be kept dry and clean and wearing sandals may help. Treatment can be either with antifungal medication applied to the skin such as clotrimazole or for persistent infections antifungal medication that are taken by mouth such as terbinafine. The use of the cream is typically recommended for four weeks.
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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.
Before buying new shoes, have a professional measure the length and width of your feet at the end of the day, while you're standing. For unusually flat feet or high arches, an exam by a podiatrist may be warranted. These conditions can increase the risk of osteoarthritis. Early treatment and use of proper footwear may help to avoid unnecessary wear and tear on the joints of the foot.
Onychomycosis patients may need to learn new, healthier habits to stop the fungus growing back. These could include protecting toes from sources of infection, wearing correctly fitting footwear, laundering socks in hot water with disinfectant, wearing protective footwear at the pool and gym, keeping nails short, using open-toed footwear and wearing shoes made of breathable material.
Topical agents include ciclopirox nail paint, amorolfine, and efinaconazole. Some topical treatments need to be applied daily for prolonged periods (at least 1 year). Topical amorolfine is applied weekly. Topical ciclopirox results in a cure in 6% to 9% of cases; amorolfine might be more effective. Ciclopirox when used with terbinafine appears to be better than either agent alone.
Because fungal spores can remain viable for months in these environments, frequent exposure can increase the risk of infection (and re-infection). Fungal spores can be picked up in many ways – such as wearing shoes that harbour the organism, by walking barefoot in areas where the fungus is prevalent (especially public showers and locker rooms), by wearing wet shoes or socks for long periods, through previous injury to the toe or toenail that opens a path for easy entry of the fungus, or by wearing improperly-fitting shoes.
A number of different types of fungus can cause onychomycosis including dermatophytes and Fusarium. Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function. The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.