Toenail fungus is more common than fingernail fungus and it takes time for the complete cure of toenail fungus. It is easy to get toenail fungus as wearing tight shoes for a long time can make your feet sweat and reduce the ventilation, this promotes the fungal growth. Fingers are often not covered for a longer time therefore; fingernail fungal infections are quite less.
If one of your toenails or a few appears broken, discolored or have white color patches on the nail this might be a fungal infection. You should consult without delay because early treatment of fungal infection can be eliminated completely within a short period. (3)
The organisms that cause fungal infections of toe are:
- Dermatophytes are the commonest organism and this include Epidermophyton, Microsporum, and Trichophyton species.
- The dermatophyte Trichophyton rubrum – it’s the commonest organism to cause fungal toenail infection. This dermatophyte gives rise to distal lateral subungual onychomycosis and proximal subungual onychomycosis.
- The dermatophyte Trichophyton mentagrophytes is rare. It causes white superficial onychomycosis.
- Yeast (Candida species) commonly causes chronic mucocutaneous candidiasis. They count for about 8% of the cases(1)
- Molds also cause 2% of nail fungal infections
How To Cope With Toenail Fungus & How To Prevent It?
Topical Treatment: Topical treatment is given if you have a mild toenail fungal infection. The topical treatment needs to be applied to the nail most probably a year to cure the infection. The drugs that are used as topical treatment are amorolfine, ciclopirox, efinaconazole, and tavaborole. This treatment will treat the current infection and prevent further fungal infection in the nail until it grows. Typically toenails take about 12-18 months to grow back completely therefore, longer treatment is needed for toenails. The success rate of topical treatment alone is about 15-30%. Side effects are usually mild, some of the side effects that can occur are redness, swelling or burning sensation when applied.
Oral Medication. Oral medication is prescribed for more severe infections of toenail fungus. The drugs that are used as oral antifungals are fluconazole, griseofulvin, itraconazole, and terbinafine. Oral drugs are very effective than topical medication to treat toenail fungus. The period of treatment depends on the fungal infection and oral drugs prescribed. Usually, it takes about 3-18 months for complete cure of toenail fungal infection. The side effects of oral drugs are more, severe allergic reactions, liver problems and drug interactions are some of the common side effects.(1)
Combined Therapy. Oral medication and topical medication can be combined to get a more positive outcome quickly.
Nail Removal. If none of the above treatment work and if the toenail fungus infection is deep then the nail needs to be removed completely in order to get rid of the fungal infection completely. The nail can be removed either chemically or surgically; after removal of the nail topical treatment can be applied directly to the affected parts of the toenail. (2)
Prevention Of Toenail Fungal Infections
There is a higher recurrence rate even after complete treatment with toenail fungal infection. Therefore, prevention methods are important to reduce recurrence rates of toenail fungus.
- Wear special socks that absorb moisture and try to change socks during the day if you are wearing socks for a long time. When washing spray antifungals to the socks and wash them separately.
- Wash your shoes properly and allow it to dry completely. Have several pairs of shoes.
- Wear well-fitting breathable, wide-toe shoes.
- Practice good hygienic methods, maintain good foot hygiene.
- Do not walk bare feet in shower areas, locker rooms and near swimming pools.
- Take your antifungal drugs and apply topical antifungals as prescribed. (4)
Toenail fungus are common and most people suffer from it. Treatment options are a topical treatment, oral medications, and removal of the nail. Topical and oral medication can be combined for a faster outcome. There is a higher recurrence rate with toenail infections therefore; prevention methods need to be practice properly to reduce recurrence rates. Also, the treatment needs to be continued for the prescribed period of time as instructed.
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