| |
| |
|
Medicine Information brought to you by discount drugs and med4.com |
|
|
|
Toenail Fungus: Treatment and Prevention
A thick, yellowish nail with splotchy white areas is a classic presentation for a fungal toenail. In the early stages the toenail is only slightly discolored, or slightly thickened. In the late stages the nail can become very thick and has a tendency to "grow up" more than in grows out. The nail will be very discolored, typically dark yellow-brown and will start to change shape and crumble. In some cases the nail becomes very loose and many will lose the nail, only for it to regrow with the fungus. The medical term for toenail fungus is "onychomycosis," pronounced on * EE * ko * my * ko * sis. The prevalence in America is about 2-3%, but some have reported it as high as 13%. Toenail fungus affects men twice as often as it affects women and the prevalence among elderly individuals and diabetics is 25%. In the 1800s, fungal toenails were very rare. The increased prevalence is linked to the increased exposure to fungus through the use of showering facilities in gyms, the use of hot tubs, saunas and public pool areas. There has also been an increase in the number of individuals participating in sporting activities and wearing occlusive footwear. More individuals have diabetes and there has been an overall increase in age of the general population, both of which are associated with a less than optimal immune system. It is no surprise that the risk factors for developing toenail fungus are increasing age, male gender, nail trauma, sweaty feet, poor circulation, poor hygiene, foot fungus and a compromised immune system. Athletes will also have a higher risk. There are a number of treatments for toenail fungus. The most aggressive and effective way to treat the fungus is with oral anti-fungal medications. The most common oral anti-fungal medications are Itraconazole (Sporonox ®) and Terbinafine (Lamisil ®). Both medications can be quite expensive as they need to be taken once daily for 3 months. The effectiveness of the medications ranges from 60 to 80%, with a recurrence rate of 15%. Lamisil® appears to be more effective and has fewer drug interactions than Sporonox®. With both medications there is a long list of benign side effects including nausea, vomiting, abdominal pain, diarrhea, rash, headache, taste disturbances and dizziness. Serious adverse events are very rare, less than 0.5%, but do include hepatitis and acute hepatic necrosis. There are many other options besides oral anti-fungal medications. Unfortunately, they are not very effective. The most effective topical medication is Ciclopirox (Penlac ®) lacquer. Some studies have shown cure rates up to 60%, but in my experience the effectiveness is about 10-15%. Side effects occur in less than 2% of patients and include burning and redness around the nail. This medication is only available by prescription and is also quite expensive. A few other prescription medications that help decrease the thickness of the fungal nails are Carmol® 40 and Keralac® Nail Gel. You should not expect to see complete cures with these products, but they can decrease the thickness and discoloration of the nail in some cases. There are many home remedies and over the counter products that you can purchase. Some home remedies that can be used include bleach, tea tree oil, grapeseed extract, and Vics VapoRub®. With any home remedy or non-prescription topical, you must understand that the effectiveness of the treatment is fairly low, less than 10%. If you do try one of these therapies make sure to use it every day. Roughen up the nail surface with a file and apply the medication with a q-tip. Bleach can cause skin irritation and some individuals have had skin reactions to the Vics VapoRub®. In general these treatments are considered very safe. Combination therapy can help increase the effectiveness of the treatment. If you choose to take an oral medication, make sure you use a topical anti-fungal agent as well. Nail removal is also an option. Once the nail is removed, the topicals can reach the nail bed and they become more effective. The nail will grow back in over a period of 8-10 months. Permanent nail removal is reserved for those with chronic ingrown nails, ulceration under the nails or pain from the fungal nails. The best form of treatment is prevention and preventing the fungus from spreading to other toenails may be the best treatment option. I recommend choosing a topical that you feel comfortable with and use it once a week. No matter which treatment option you choose, you should take the following steps to avoid re-infection. 1. Place an anti-fungal powder or spray in the shoes to help fight off the fungus. 2. Make sure you rotate your shoes often and keep them in a cool dry place. 3. Change your insoles frequently, and make sure they dry out between use. 4. Bleach out the shower on a weekly basis. 5. Wash your shower mat regularly in hot water. 6. If you belong to a gym or health club, wear sandals in the locker room and don't walk around barefoot. 7. Don't keep your shoes in the gym locker where they cannot dry out. 8. Make sure your athletic shoes fit well to prevent jamming at the toes. Jamming at the toes leads to microtrauma at the nails and increases the chance for fungal infection. 9. If your feet sweat excessively, try using an antiperspirant spray on your feet before your workout. 10. Cut your toenails straight across. Don't cut too short and cause breaks in the skin. This will increase the chance for fungal infection. Don't let the toenails grow too long or they will jam against the shoe and cause bleeding under the nail, again increasing the chance for fungal infection. The bottom line is that prevention is easier than treatment. Treating toenail fungus is very difficult and will take months regardless of the type of treatment you choose. If you have fungal toenails that cause pressure, pain or infection, consider talking to your doctor about prescription medications or nail removal. If your fungal toenails are only unsightly and don't cause any discomfort, consider topical therapy for treatment. The last option is to prevent the nails from becoming worse or becoming a problem. Try a weekly application of an over the counter topical along with methods to prevent re-infection. Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com/. To learn more about products for toenail fungus visit http://www.northcoastfootcare.com.
MORE RESOURCES:
Medicine - Google News |
|
|
|
RELATED ARTICLES
Environmental Medicine Our modern preservatives and other pollutants like yellow dye no. 5 have caused bodily responses which detract or impair the natural process of our system. Treating Neuromas - Ten Tips A neuroma is an inflamed nerve. In the foot, the most common place for a neuroma is between the third and fourth toes. Traditional Treatments for Back Pain... Which Ones Work and Which Ones Don't? When Dorothy followed the yellow brick road, she was told to do so by those who wanted her to get where she wanted go. Well as humans when we blindly follow recommendations even by individuals who have good intentions, it may not always be your best option. Catch The Wave There has never been a better opportunity for chiropractic medicine?and it's going to get even better!Living in Southern California the ocean waves and the surfing environment inspire you. You cannot help but draw the analogy of "catching the wave" during the most exciting time I have experienced in chiropractic medicine over the past 15 years. Be Informed About The Medications You Take The recent withdrawal of the prescription drugs Vioxx and Bextra have arthritis patients concerned about their health, lawyers busy with lawsuits, and Congress poring over thousands of pages of documents obtained from the manufacturer. The drugs, part of a family of medications known as COX-2 inhibitors, have recently been shown to increase the risk of heart attacks and strokes among users who take the drugs for long periods of time. Aleve, Vioxx, Celebrex, and Bextra: What You Need To Know About Arthritis Pain Medications Recent controversy about the safety of pain medications for arthritis has left patients and health care professionals alike confused about which medications are safe to use. In fact, a recent survey by the Boston-based Rippe Lifestyle Institute indicated that many people with arthritis are suffering unnecessarily because they have stopped or reduced their use of pain relievers due to confusion about which drugs are considered safe. Bextra Recall: Lawyer Says Help Is On The Way By now, you have probably heard of the prescription drug Bextra. You may not know, however, why that a recall is in order. Online Pharmacies and the FDA The FDA (Food and Drug Administration) is responsible for overseeing the testing, manufacturing, and distribution of prescription drugs in the United States.Drug companies in the United States operate in a free market and can charge whatever they want for their medications. rX My Heart and Hope to Die This must be a mistake! How could his drug costs rise from $150 a month to $1101 in just three weeks? My hands shook while I read the pharmacy bill.There was no mistake. Medical Malpractice Suits: Death By Medicine A recent report has found that Americans are more frightened of dying at the hands of their doctor than they are of a plane crash. The overwhelming majority of those who participated in the survey said that information about malpractice suits and medical errors would be the single most deciding factor in trusting a healthcare provider. Christopher Reeve To Have Promoted Basement Lab Chrisopher Reeve has died. But his vision of a "Cure" has not. Accutane Side Effects Lawyer: Hair Loss, Depression, Suicide You probably know the drug isotretinoin by its trade name, accutane. Accutane is a powerful drug often used to treat acne. At Last! Good News For Gout Sufferers! Gout, an arthritis affliction with its roots in antiquity, has not always been easy to treat. The traditional medicines employed for gout have been non-steroidal anti-inflammatory drugs (NSAIDS), colchicines, probenicid (Benemid), and allopurinol (Zyloprim). Considerations in Distance Education for the Medical Assistant Instructor Medical Assistant distance education is emerging to meet the demands of a new generation of students in the twenty first century. St. "Foot Pain Relief At Last!" "As an arthritis specialist, one area that I see people complain about more often than almost any other, is their feet." So says Dr. Generic Medicines Generic DrugsGeneric Online Pharmacies started making a big impact on the net since the mid to late 90's. This has allowed the prescription drug buyer to save hundreds with the click of a mouse. Lamisil Side Effects Lawyer: Lamisil Tablet While the recent Lamisil commercial featuring Digger, a disgusting cartoon fungus, is still fresh in our mind (who could forget the imagery of a toenail being pulled back and colorful germs crawling in?) it is a good time to look at the side effects of this seemingly innocuous drug. Despite the disturbing advertising campaign, who would have guessed that an antifungal tablet could have so many negative side effects?The drug comes in both cream and tablet form and is used to fight nail fungus, athlete's foot, jock itch, and ringworm. Relafen: A New Drug with an Old Danger Individuals who regularly take Relafen (nabumetone) or other anti-inflammatory medications, either for arthritis, joint pain, or other indications, should be aware of severe adverse health implications that can potentially result from prolonged use. Relafen is usually prescribed for osteoarthritis or rheumatoid arthritis to reduce pain, inflammation, and stiffness, but can also be prescribed for other purposes. Another Cold Sore! Why Me? An estimated 85 million Americans have acquired the herpes simplex (cold sore) virus. And the majority had received the virus before the age of 3. Benefits of a Virtual Top Doctor Consultant Looking for the best doctor to suite your medical needs can be a problem, especially if you don't have time and you need to research the doctor's credentials. Whether you're in urgent need of help, or just need a second opinion, I will show you how to access all the information you need - through the Internet's Virtual Top Doctor Consultant.
|
| home | site map |
| © 2006 |
