FUNGUS NAILS
Fungus infection of the nails of the foot can begin at any
time of life. It is more
common as we get older or the feet have been traumatized by sports or work
stresses. This slow-growing,
non-dangerous condition affects the nail beds underneath the toenails.
There is thickening, discoloration and crumbling of the nail.
There may also be a foul odor coming from the affected nail and
nail bed. Fungus nails are
caused by the same organisms that cause skin fungus (athlete’s foot).
Treatment varies with the extent of the infection and the length of time
present. Since nails grow at
the rate of 1/8” per month, it often takes a long time to see
improvement, and reinfection may occur.
Fungus grows in a dark, warm, moist environment.
It is important to treat the condition by changing the environment
for the foot within the shoe.
DO:
Fungus:
Fungus infections of
the
foot & nails spread in warm
moist
areas. “Athlete’s foot”
makes skin itchy
& scaly,
nails thick and white.
There may also be some cases where oral anti-fungal medication is used.
There will be special instructions for you and a prescription
issued.
Oral Antifungals: Oral
antifungals are 75-80% effective for treatment of most nail fungi.
The two most commonly prescribed are Sporanox (itraconozole) and
Lamisil (terbinafine hydrochloride) which have completely replaced
Fulvicin (Girscofulvin, no longer the drug of choice because it must be
taken 9-10 months of complete nail growth, with frequent recurrences) and
Nizoral (oral ketonazole) because of low effectiveness and frequent side
effects.
Both Sporanox and Lamisil need to be taken for three
months; Sporanox is usually prescribed as a pulsed dosage, 2 to 4 tablets
per day for one week, nothing for three weeks, repeated each month for a
total of three months; Lamisil is prescribed to be taken one tablet daily
for 90 days. Both drugs are
expensive ($6-$8/pill) and are usually not covered by insurance plans
because they consider the condition primarily “cosmetic,” both drugs
have cross sensitivity with other systemic medications, and both drugs can
cause liver or cardiac problems, so it is recommended to have monthly
blood tests while taking these drugs.
If you are inclined to consider taking these drugs, weigh the
benefits vs. risks. Talk this over with your Podiatrist.
In nail fungal conditions, it is important to realize that it is a long
process toward clearing of the infection.
In many cases, we cannot completely rid the nail bed of the fungus
and the goal is to prevent any further destruction or spreading.
When the doctor’s instructions are closely followed and regular
office care is provided, 80% of patients with this common nail condition
can be greatly helped.
Nail fungus grows in the bed of the toenail where there is poor
circulation. The fungus feeds
on dry, scaly, cracked skin. When
cutting your own toenails or when having a pedicure, do not damage (dig,
push back) the cuticle which is a natural protection to the invasion of
fungi.
Over-the-counter antiseptics such as Tea Tree Oil, Fungi-nail, and
Fungoid tincture are helpful in preventing fungus growth.
The Internet has testimonials and reports on the effectiveness of
regular use of Vicks Vaporub™ or mild bleach solutions (1/2 cup/quart of
water) to help resist fungus. Do not use detergents or cleaning solutions such as Lysol
which irritate tissues.
Topical prescriptions are effective when applied according to strict
guidelines. Nonyx gel and
Penlac nail lacquer are approved by the FDA, requiring a doctor’s
prescription, and need to be applied twice daily.
Nail polish and especially nail polish removers work against topical
treatments. The polish
removers, especially petroleum products, take away the natural resistance
of the nail and nail bed to disease.
All content © 2002 Dr. Harry Hlavac
All rights reserved. |
