Nail Fungus

             Nail fungus is an infection of a toe nail or fingernail by a fungus.  Common symptoms of nail fungus include a yellowing of the nail, a change in the shape of the nail, a lack of shine to the nail, thickening of the nail, or a brittle, crumbly, or ragged nail. 

            Nail fungus is most easily treated at the first sign of infection, before it spreads to the entire nail, and can take a long time to cure.  It is best to see your doctor as soon as possible, especially if you have diabetes or high blood sugar.

            The fungi that cause nail fungus prefer warm, damp places.  For this reason, toe nail fungus is more common than fingernail fungus. This is because many people wear shoes that completely cover their feet and trap moisture.  People who wear enclosed shoes, shoes and socks with poor ventilation, or who spend a lot of time in warm, humid environments may be more likely to develop nail fungus.  Other risk factors include walking barefoot in damp public places, like gyms, locker or dormitory showers, or pools.  You have a higher risk of developing nail fungus if you have a skin condition called psoriasis, a fungal infection of the foot (athlete's foot, or tinea pedis), or have diabetes, circulation problems, or problems with your immune system. People with diabetes, circulation problems, or problems with their immune system should see a doctor immediately if they have or notice nail fungus.

            There are several medications available to treat nail fungus.  Two medications are taken by mouth, called Lamisil (or terbinafine) and Sporanox (or itraconazole).  These medications kill the fungus living in and under your nail, allowing new, healthy nail to grow.  But, they take time to work.  A typical course of treatment is six to twelve weeks.  The full effect of the medication won't be seen until new, healthy nail grows out.  These medications are often used for people with diabetes or problems with their immune system, people with a high risk for a skin infection called cellulitis, or have pain because of the nail fungus.  These medications may cause liver damage.  Your doctor may not recommend them for you if you have certain liver problems, congestive heart failure, or are taking certain medications.

            Other treatments for nail fungus include medicated nail polish.  Penlac (or ciclopirox) is a ready-made medicated nail polish.  Specially-made nail lacquer is available form compounding pharmacies, using antifungal drugs such as fluconazole, itraconazole, and ketoconazole.  These medications kill the fungi that cause nail fungus like the medications taken by mouth.  The nail lacquer is applied once a day, usually at bed time, to the top of the infected nail, the surrounding area of the finger, and under the nail if possible.  Treatment can last for up to six months.  The patient must trim their infected nails regularly to help the medication work. 

            If your nail fungus is very bad or painful, your doctor may suggest removing the nail surgically.   A new nail will grow back in its place.

            Proper nail care is very important while you are treating your nail fungus.  Keep your nails cool and dry as much as possible.  If you toe nails are affected, wear sandals or go barefoot when possible.  Change your socks daily.  Wear clothing made of cotton or other natural, breathable fibers, instead of non-breathable synthetics. 

            Home remedies for nail fungus are popular, but there is no evidence that they work.  Soaking the infected nail in vinegar or bleach, or rubbing Vicks Vaporub into the infected nails are popular, but haven't been proven to get rid of the nail fungus.  If you prefer to treat your nail fungus with home remedies, it is a good idea to speak to your doctor first.