Nail fungus is also known as Onychomycosis. Nail fungus causes toe nails to become thick and discolored and may lift from the nail bed. The nails affected will have a yellow and white appearance. It often starts at the tip of the nail and progresses towards the base of the nail. As the infection progresses, the nail may become hard and brittle. Each time you trim your nails, the infection may cause the nail to break off into little pieces and have a crumbling effect.
Fungal nail infections can cause pain and discomfort due to the changing shape of the nail. When nails become thick due to a fungal infection, it may cause the nails to become ingrown. Thickening of the nails will also increase the pressure of the nail when wearing tight footwear such as heels or steel toed boots. With long periods of standing and walking, the increased pressure could cause injury to the nail bed and may result in a wound.
A variety of organisms can cause nail fungus but in most cases, it is caused by dermatophytes. Onychomycosis occurs in 10% of the general population but occurrence increases with age. The occurrence rate of people over 60 years of age is 20% and raises to 50% after age 70.
Topical – A variety of topical treatments can be used to treat nail fungus. The benefit of topical medications as opposed to oral anti-fungals are there are minimal side effects once the treatment has started. The medication only affects the nail which does not absorb into your blood stream. The goal of the topical treatment is for the medication to penetrate the nail to kill the fungus. Treatment time with topical treatment will take on average 9-12 months of daily use. Once topical treatment has started, the medication will try and kill the fungus living within the nail but will not be able to clear the nail of the fungus initially.
Treatment effectiveness will be seen over the next several months of daily use by monitoring the discoloration of the nail. Generally, very little change will be noticeable in the first 3 months of use. If you notice the discoloration is moving forward to the tip of the nail as the nail is growing out over the next several months, then the treatment is working.
Oral Treatment – There are several oral medications available for nail fungus. They work by destroying the nail infection from the base of the nail. Most oral medications must be taken daily for 3 months but it is highly recommended to do a liver function test before treatment and during treatment because these medications increases the risk of liver damage.
Why you should treat nail fungus
You should consider treating nail fungus as soon as possible because it can spread to other nails and become painful. If caught early on during the infection, treatment time is reduced. If the infection spreads to the base of the nail, treatment becomes more difficult to completely rid the entire nail of the fungal infection.
What we will do
When you come in for nail fungus, we will assess to see if the nail is truly a fungal infection. The nail specimen can be sent out to a lab to be tested. We will also assess the severity of the damage of the involved nails.
- Nails will be drilled and thinned out so topical medications can be used effectively on the nail (nails that are very thick will not absorb the medication properly and will make the treatment ineffective). Drilling of the nail is recommended every 1-2 months.
- Topical anti-fungal treatments will be prescribed. Most over the counter topical treatments for nail fungus is very weak. We will prescribe the most effective topical treatments for your infection.
- Discuss treatments for oral medications. A referral will be made to a family physician for oral treatment if needed.
- We will also treat any nail or skin conditions complicated by the nail fungus such as ingrown nails
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