Toenail Fungus and How to Treat It

Toenail fungus (Onychomycosis) can be unsightly and a source for potential embarrassment. The nail will become thickened, disfigured, discolored (typically yellow, brown, and in some cases white), brittle, and/or unhealthy in appearance.

Toenail fungus, like any fungus (for example Athlete’s foot) prefers certain environments. Damp, moist, and dark environments are the most common. So sweaty socks or shoes, showers, or gym lockers will have a greater likelihood of catching or worsening the toenail fungus. Some people are more prone to developing nail fungus, just like some people may be more likely to get cavities even though they may brush their teeth as frequently as someone who doesn’t get as many cavities. In addition, some medical conditions may increase the chance that someone develops nail fungus. Either way, it is best to consult a professional regarding risk factors and realistic treatment options.

The most common treatments consist of topical medication, oral medication (a pill), and cutting away the diseased, infected nail. The fungus will usually start at the end of the nail and work its way to the base of the nail. The fungus typically lives under the nail where it is able to grow and expand until it affects the entire thickness of the nail itself. For this reason, treatment is typically challenging and requires patience to allow any given treatment option the opportunity to work. Just like you should brush your teeth after every meal, floss, as well as get periodic dental cleanings in order to prevent cavities, nail fungus requires consistent regular maintenance to cure the nail fungus but also to prevent a re-occurrence of the fungus infection.

1) Topical medication – There are several topical medications available, ranging from prescription medications that have been scientifically studied, to over the counter medications, to homeopathic remedies. Certainly the prescription medication has more Fungus Clear evidence to support its effectiveness, but some naturally occurring substances, like tea tree oil have been used with modest success. Over the counter treatments are not likely to improve severe conditions, and typically are not effective except in very mild and early stages of the fungus infection. These medications are much better at prevention of recurrence of nail fungus rather than actual cure or treatment of active infections. Even the prescription medication may not be sufficient to cure advanced cases.

2) Oral medication – The most common pill used to treat nail fungus is Lamisil (terbinafine), however there are other medications available. Because of the potent nature of these medications, blood work may be required, especially if one is also taking a medication to reduce or control cholesterol levels. Oral medication is required for moderate to severe cases.

3) Cutting out the bad nail – In order for any medication treatment to be successful, removing fungus that is already present in the nail is necessary. This may require cutting out a small section of bad nail in mild to moderate cases, to removing the entire nail in severe cases. Failure to remove the infected nail significantly reduces the chance that treatment will be successful.

4) Combination therapy – In many instances, the best course of action is to combine two or all three of the above treatment options to get rid of the fungus.

5) Permanent removal – If attempts to remove the nail fungus have failed, or if the fungus infection is severe and/or has been present for a long period of time, the best solution to rid oneself of the nail infection is to permanently remove the nail itself. This will require you to see a specialist, usually your podiatrist. Contrary to what many people may think, there is a minimal amount of discomfort, and the long term appearance of the toe without any nail is usually more aesthetically appealing compared to the nail fungus.


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