FUNGAL NAIL OVERVIEW Fungal nail infections are fairly common and usually not serious. However they can be quite unpleasant and unfortunately very difficult to treat. Conventional treatments only allow around a 70% success rate and often the infection reoccurs. The infection tends to develop slowly and causes the nail to become discoloured, thickened and distorted. The medical name for a fungal nail infection is onychomycosis.
Signs and symptoms of a fungal nail infection A fungal nail infection may not be obvious at first, but as it progresses the following may be experienced: • Discolouration of the nail – it may turn white, black, yellow or green • Thickening and distortion of the nail – it may become an unusual shape or texture and be difficult to trim • Pain or discomfort – particularly when using or placing pressure on the affected toe or finger • Brittle or crumbly nails – pieces may break off and come away completely • Sometimes the skin nearby may also become infected and be itchy and cracked or red and swollen.
How do I prevent fungal nail infections? To minimise your risk developing a fungal nail infection, the following measures may help: • Hands and feet should be kept clean and dry • Wear well-fitting shoes made of natural materials and clean cotton socks to allow your feet to breathe • Keep nails short – and don't share clippers or scissors with other people • Do not share towels or socks with other people, and ensure your towels are washed regularly • Do not walk barefoot in public pools, showers etc – special shower shoes are available to protect your feet or you could wear flip flops • Replace old footwear that could be contaminated with fungi • If you suspect you have Athletes Foot, treat this straight away so that it does not spread to your nails
What should I do if I believe I have a fungal nail infection? It is generally advisable to treat a fungal nail unless for example it is very mild and perhaps affects the ‘little toe’ only. If a fungal infection is allowed to progress the result will most likely be total nail destruction.
If you believe you may have a fungal nail infection, your first port of call is an appointment with your GP. He or she will take a clipping of your nail and send it away for testing. If the test comes back positive then the easiest, cheapest and most successful treatment is to obtain oral medication from your GP on prescription.
Antifungal Tablets Terbinafine and Itraconazole are the two medicines most commonly prescribed for fungal nail infections. These usually need to be taken once or twice a day for several months to ensure the infection has completely cleared up. If you stop taking the medication too early, the infection may return. These are prescribed by your GP and are not suitable for everyone and do come with some side effects. However if you are able to take these they are the EASIEST, CHEAPEST and MOST SUCCESSFUL TREATMENT OPTION.
Antifungal nail paint If you prefer not to take antifungal tablets, you could try antifungal nail paint instead. Nail paint isn't generally considered to be as effective as tablets because it can be difficult for it to reach the deeper layers of the nail. Howeve, it doesn't usually cause any side effects. Treatment needs to be continued for between 12 and 18 months. The medication is called Amorolfine and can be prescribed by your GP, and is also available over the counter at pharmacies. Brands include Loceryl Curanail
Nail Softening This is a relatively new treatment and may be worth a try as it shortens the treatment time. Over the counter medications such as Canespro contain a 40% urea solution which is applied to the fungal part of the nail. This softens the nail so that the fungal parts can be scraped away. After all fungal parts are removed (usually 2 to 3 weeks) return to the pharmacy and they should be able to provide a fungal cream or paint to continue with.
Laser Treatment This is a very new treatment and is available privately from some Podiatrists. It is very expensive and there is no data as yet to success rates.
Surgery Surgery to have the nail removed is available but generally only undertaken when the fungal nail is causing serious problems. The nail is removed under Local Anaesthetic, and then a regime of antifungal treatment is continued.
Other Over the Counter Treatments There are many treatments available from pharmacies in addition to the mainstream treatments already mentioned. However they are not considered the first line treatment of this condition.
Home Remedies Purely anecdotal, the use of either Tea Tree Oil or Vicks VapoRub is often seen as helping with fungal nail infections. However this is not backed up with clinical research. It is important to apply daily and file the affected part twice a week. Care must be taken not to allow any of the substances to touch the surrounding skin as it can cause dermatological problems. It is advised that you research these remedies prior to trying them.
How can Plymouth Foot Care help? We are always happy to discuss and offer advice on fungal nail infections. Should your GP require nail clippings we will be able to do this. We will cut a portion of your nail for you to take to your GP.
If your nail infection is confirmed then it is important to use the medication as prescribed. However periodically you may find that a visit to us for reduction of the fungal part of the nail may help your treatment regime. Additionally if the fungal infection has caused thickening of the nail we can thin your nails. Both these treatments will be undertaken with our medical drill and are painless.
If you purchase any treatments, always read the information sheet to ensure it is suitable for you to use..And if you have any concerns, always seek medical help