A band of tissue called the plantar fascia runs along the bottom of the foot. It pulls on the heel when you walk -- and it works best with the proper arch in your foot. Walking barefoot, or in flimsy shoes without sufficient arch support, can overstretch, tear, or inflame the plantar fascia. This common condition can cause intense heel pain, and resting the feet only provides temporary relief.
If the fungal nail infection is severe, tablets can be used in combination with nail polish or cream. For example, if the nail is very thick, urea cream can be used (in addition to taking tablets) to gradually remove or partially file off the affected nail. Combining these treatments may also be an option if there are large collections of fungi beneath the nail. Another option for severe fungal nail infections is professional medical footcare. If the nail is filed off, it’s important to ensure good hygiene and disinfect the area, because the removed nail tissue could contain infectious fungal spores.
Oral medications include terbinafine (76% effective), itraconazole (60% effective) and fluconazole (48% effective). They share characteristics that enhance their effectiveness: prompt penetration of the nail and nail bed, and persistence in the nail for months after discontinuation of therapy. Ketoconazole by mouth is not recommended due to side effects. Oral terbinafine is better tolerated than itraconazole. For superficial white onychomycosis, systemic rather than topical antifungal therapy is advised.
The causative pathogens of onychomycosis are all in the fungus kingdom and include dermatophytes, Candida (yeasts), and nondermatophytic molds. Dermatophytes are the fungi most commonly responsible for onychomycosis in the temperate western countries; while Candida and nondermatophytic molds are more frequently involved in the tropics and subtropics with a hot and humid climate.
Onychomycosis – commonly known as toenail fungus – is characterized by inflammation, pain, and swelling of the toe, as well as yellowing, thickening, and crumbling of the nail itself. Toenail fungus can be the result of abnormal pH of the skin, continuous exposure to moisture, wearing synthetic socks, compromised immune system, sweat build-up in shoes, poor foot hygiene, or weak circulation such as that caused by diabetes.
Flip-flops offer very little protection. The risk of getting splinters or other foot injuries is higher when the feet are so exposed. People with diabetes should not wear flip-flops, because simple cuts and scrapes can lead to serious complications. In addition, many flip-flops provide no arch support. Like ballet flats, they can aggravate plantar fasciitis and cause problems with the knees, hips, or back.
Topical treatment (polish or cream) isn’t likely to get rid of a fungal nail infection. Treatment with tablets is considerably more effective and takes less time. But some people can’t take tablets because of the very rare, yet serious risks. How you feel about the pros and cons of the different treatment options is a personal matter. You can also discuss the options with your doctor.
For fungus infection, there are plenty of options. Many medications are available, including miconazole (Micatin, Zeasorb powder), econazole (Spectazole), clotrimazole (Lotrimin), terbinafine (Lamisil), naftifine (Naftin), butenafine (Mentax), ciclopirox (Loprox), ketoconazole (Nizoral), efinaconazole (Jublia), luliconazole (Luzu), sertaconazole (Ertaczo), sulconazole (Exelderm), and tolnaftate (Tinactin). Ask your health care professional or pharmacist for a recommendation. It is difficult to know which of these drugs is most effective since they have not been tested against each other. Cost is probably the most significant differentiating factor, and many are available without a prescription. Treatment for athlete's foot should generally be continued for four weeks or at least one week after all of the skin symptoms have cleared.
White superficial onychomycosis (WSO) is caused by fungal invasion of the superficial layers of the nail plate to form "white islands" on the plate. It accounts for around 10 percent of onychomycosis cases. In some cases, WSO is a misdiagnosis of "keratin granulations" which are not a fungus, but a reaction to nail polish that can cause the nails to have a chalky white appearance. A laboratory test should be performed to confirm.
Keeping socks and shoes clean (using bleach in the wash) is one way to prevent fungi from taking hold and spreading. Avoiding the sharing of boots and shoes is another way to prevent transmission. Athlete's foot can be transmitted by sharing footwear with an infected person. Hand-me-downs and purchasing used shoes are other forms of shoe-sharing. Not sharing also applies to towels, because, though less common, fungi can be passed along on towels, especially damp ones.
Use tea tree oil. Tea tree oil is a natural anti-fungal. One study showed that tea tree oil may be effective for nail fungus. 18% of patients who used tea tree oil twice daily for 24 weeks were cleared of the infection. To treat nail fungus with tea tree oil, use a 100% solution because lower concentrations have not been proven to be effective for this particular infection.
Many podiatrists now consider this an effective treatment, but because it’s new, there’s not enough concrete data to compare with other treatments. Dr. Hinkes raises another concern: “A clinical cure and a mycological cure are two different things. With the clinical cure, you look at the nail and it looks fine. It’s pink and shiny and smooth and it looks great. But if you sample the nail, you might find that there’s mold or fungus there, so it does not have what we call a mycological cure—mycology is the study of fungi.
Toenail injury: There are two types of injuries that can occur to your toenail. The first is acute trauma where the nail is impacted over and over again as in the case of a runner wearing shoes that don’t fit well. The other thing that can happen is blunt trauma where something falls on your toe such as a heavy object and causes an injury. This injury makes your toenail more susceptible to fungus. It is important in both cases to look after your toenails properly to avoid an infection.
Topical treatment is also usually recommended for children. One reason for this is that most oral medications aren’t suitable for children. Another reason is that children have thinner nails that grow more quickly, so it’s assumed that treatment with nail polish or creams is more likely to work in children than in adults. White superficial onychomycosis is also often treated with a nail polish or cream.
Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail.
Toenail fungus, also called onychomycosis, is a common fungal infection of your toenail. The most noticeable symptom is a white, brown, or yellow discoloration of one or more of your toenails. It may spread and cause the nails to thicken or crack. Sandal season or not, toenail fungus typically isn’t what you want to see when you look at your feet. Luckily there are many treatments you can try.