Jo has been an ITU nurse at the London North West NHS Trust for 14 years. She obtained her RN at University College London Hospital.
Spring is in the air and we are looking forward to a long hot summer. It's time to dig out those sexy shoes and sandals, time to uncover and show off those gorgeous legs; but wait, what is going on with those toenails? Yikes!! It's the dreaded nail fungal infection and it is not a pretty sight.
While not life-threatening, fungal nail infections or onychomycosis can be unsightly and embarrassing, it can also have an adverse effect on our quality of life. People who suffer from fungal nail infection will often avoid activities such as swimming and other sports that may require the use of a communal changing room.
What Is Fungal Nail Infection?
Fungal nail infection is one of the most commonly occurring dermatological conditions. Studies show around three in every hundred people in the UK are affected by fungal nail infection and up to 20% of American adults are suffering from this condition.
The incidence of fungal nail infection appears to be increasing; this is thought to be as a result of factors such as increasing prevalence of diabetes in the population, more frequent incidence of immunosuppression and an aging population. Fungal infection is responsible for about fifty percent of all nail problems.
The condition usually affects adults; becoming more common as we get older. It is four times more likely to occur in the toenails than fingernails. Fungal infection of the nail can involve all or part of the nail, including the plate, bed, and root. While the condition is not hereditary, it may occur in members of the same family at the same time, because it can be transferred from one person to another.
Symptoms of Fungal Nail Infection
The most common symptoms of fungal nail infection are in the appearance of the nail. Nails become thickened and discolored, appearing white, yellow, black or green. As the disease progresses, the nail can become brittle and crumbly with pieces of nail breaking off and the shape distorted. In some cases, it can fall away from the nail bed completely.
The fungal infection is often initially painless, and generally, do not cause further complications. However, If left untreated, although rare, it can cause pain, the skin underneath and around the nail bed can become inflamed with yellow patches or scaly skin.
What Are the Causes of Nail Fungus
Several types of fungus can cause fungal nail infection. Athlete's foot is a fungal skin infection that affects the skin between the toes, causing it to become red, flaky and itchy, spreading to the toenails.
Candida is a yeast that can cause infection of the skin around the nails, particularly the fingernail. Candida yeast infection is commonly found in occupations that require frequent hand washing, or where the hands are in water a lot. Fungi thrive in warm moist environment, some of the factors that can increase the risk of fungal nail infection are:
- Wearing shoes that cause hot sweaty feet, such as trainers, or being in a humid environment
- Regular damage to the nail or skin
- Ill health or particular health condition such as diabetes or psoriasis
- A weakened Immune system
- Poor general health
- Using artificial nails
- Nail damage
- Consistent nail biting
- Living in warm, humid climate
Toenail Fungus Treatments
Treatment is not always needed if the infection is mild, but if left untreated, the infection can spread to other nails. Clipping of the affected nails may be tested to find out the exact cause of the disease and to rule out other conditions.
The removal of fungal nail infection should be done in a way that is safe, effective and permanent. The condition can be treated and eventually cured. However, some types of treatment can take several months to work. The main treatment options are anti-fungal tablets or anti-fungal nail paint.
Anti-fungal tablet treatment is very successful; it allows the medication to reach the nails through the bloodstream. The most commonly prescribed oral medications for fungal nail infection is the first line of treatment drugs, terbinafine (Lamisil), and itraconazole (Sporanox). Although these drugs can be useful, there is a potential for minor to serious side effects, and even when the treatment works, the infection may return. Fluconazole (Diflucan) has been recommended by The British Association of Dermatologist as a potentially useful alternative in patients who are unable to tolerate terbinafine or itraconazole.
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In patients where the infection has been treated successfully with anti-fungal tablets,15% to 20% gets another infection in the next year. Out of 100 people, who take the oral medication, 15 to 20 will get another infection in the next year and 80 to 85 will not.
Side effects include:
- Liver and kidney failure
- Weakening of the heart's ability to contract effectively, leading to heart failure
- Cause dangerous side effects when combined with many different common medicines
- During treatment with oral anti-fungal medication
- Loss of sense of taste
Medication may have to be taken for several months to ensure that the infection has completely cleared.
Stopping the treatment too early may result in the infection returning, oral medication has the added advantage of treating any other fungal skin infections, such as athlete's foot, simultaneously. For those who prefer not to take oral medication, anti-fungal nail paint may be used instead.
Anti-Fungal Nail Paint
Instead of taking oral medication to treat fungal nail infection, an anti-fungal preparation can be painted directly on the affected nail. When applied as a nail varnish, the drug kills the fungus that is causing the infection. The anti-fungal drug stops the fungus growing; Fungus should eventually die off to allow the growth of a new healthy nail. Unfortunately, there hasn't been much research available in the UK on anti-fungal nail paint.
Currently available oral medication for nail fungus is thought to have a cure rate of around 40%. Topical treatments such as nail paint are considered safer than oral therapy but have a lower cure rate. However, there is now a third option, Laser Therapy.
Cold Laser/Low-Level Laser Therapy
Low-level, cold laser therapy is described as cold because it does not rely on heat; it is said to be the most effective, fastest most advanced and safest treatment for fungal nail infection. Laser treatment is new and controversial, and the result varies in clinical practice, but there has been no adverse reaction or side effect.
Laser treatment involves the shining of a light beam through the affected nail, the beam of light kills fungus by reacting with the cell wall but leaves surrounding healthy tissue unharmed.
Laser treatment is offered by specialist clinics and can be rather pricey since this treatment is considered to be aesthetic; health insurance plans do not cover it. However, laser treatment is said to have no side effects; there are no age or health restrictions or limitations.
The procedure has a success rate of over 80%. Following laser treatment patient should notice results within 2 to 4 months, depending on how quickly their nails grow.
The new clear nail will appear as the infected portion grows out. It takes about 8 to 12 months for the nail to grow completely out.
In extreme cases, surgical removal of the affected nail may be necessary.
User Survey Comparison of the Top 5 Rated OTC Topical Treatments for Nail Fungus
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Home Treatment For Nail Fungal Infection
Many people swear by various home treatment for fungal nail infection, here are some that are tried and tested:
- Tea Tree Oil: This oil is extracted from the Australian tree, Melaleuca alternifolia. The oil is known to be effective in treating viral, yeast, bacteria and fungal infection. The oil can be easily applied to the infected nail using a cotton ball. A few drops of tea tree oil added to the bath water can be beneficial for feet and skin care. Before commencing treatment, it is advisable to get a diagnosis from a doctor or healthcare provider.
- Vinegar: With its antiseptic and acidity properties, white vinegar creates an environment where fungi are unable to grow and thrive.
- Coconut Oil: Studies have found evidence of the healing properties of coconut oil for skin conditions. Coconut oil is abundant in lauric acid that contains antiviral, anti-fungal, anti-inflammatory and antibacterial properties
- Oil of Oregano: Studies have shown that oil of oregano can fight Candida infections without any side effect.
- Neem Oil: This oil has an anti-fungal action and enhances the look of brittle fingernails with its moisturizing and nourishing properties.
- Sea Salt: Salt is inexpensive way to treat fungal nail infection.
- Baking Soda: Baking soda is highly alkaline and can help to balance the pH levels to inhibit the growth of bacteria and fungi.
- Lemongrass Oil: This oil has both antibacterial and anti-fungal properties.
- Vicks VapoRub: This is both safe and cost-effective. In a pilot study by The Journal of the American Board of Family Medicine, Vicks VapoRub was found to have a positive effect in the treatment of onychomycosis, a fungal infection of the nail.
It is always advisable to talk with your doctor or healthcare provider prior to taking medication or trying new treatments, especially if you are pregnant or have diabetes.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 Jo Alexis-Hagues
Jo Alexis-Hagues (author) from Lincolnshire, U.K on April 22, 2013:
Skye, it's good to know that the home remedies actually works!.. although it takes time, there is light at the end of the tunnel. Nail polish sounds good; but maybe not all the time, as you said; it makes it more difficult to get to the root of the problem. Thank you for the visit and great comment, much appreciated.
My best to you, love Jo.
skye2day from Rocky Mountains on April 22, 2013:
Jo Great tips, well written and organized. I always feel for nail fungus people more so men because it is not likely they will paint their toes. I paint mine and use natural remedies so far nasty fungus is under control. Thank God for the polish. Although I know if the infection is bad polish avails the toe very little. Your a great writer girl. Wow. Very good. Love, Skye
Jo Alexis-Hagues (author) from Lincolnshire, U.K on April 17, 2013:
Hi Pamela, thank you for checking this out, it's good to know that the tea tree oil actually does the job.
I think you may be right about Florida, fungi loves the warm humidity. Thank you again for stopping by, and for the comment.
My best to you.
Pamela Oglesby from Sunny Florida on April 17, 2013:
You have covered all the bases with this excellent article. I started to have a problem, maybe because I live in FL, but I caught it early. Anyway, I used tea tree oil and it was gone in no time.
Jo Alexis-Hagues (author) from Lincolnshire, U.K on April 05, 2013:
DDE, It's always good to be prepared, even if it is not currently a problem it's good to have the information. Thank you for taking a look, much appreciated.
Devika Primić from Dubrovnik, Croatia on April 05, 2013:
Nail infection looks dreadful but you put out important information on such issues, a well-presented hub with and is useful to anyone.
Jo Alexis-Hagues (author) from Lincolnshire, U.K on April 04, 2013:
rajan, I hope your son will be able to find something here to help, always good to catch infection early, but it takes some time before the results are evident. Many thanks for checking this out, always appreciated.
Rajan Singh Jolly from From Mumbai, presently in Jalandhar, INDIA. on April 04, 2013:
Jo, my son has fungus infection of the big toenail. I'm going to ask him to try out these remedies.
Voted up and useful.