A fungal toenail occurs when the nail is lifted from the underlying skin, allowing the fungus to get under the nail and grow, creating white, yellow, green, or even brown coloring. A fungal nail infection can arise from cutting the edges improperly, tight fitting shoes, trauma, or ingrown toenails.
Fungal toenails are often associated with other foot conditions such as:
Toenail fungus and the thick, discolored nails can be treated with a topical medication or oral anti-fungal medications or both. The oral medication is not dangerous, but is eliminated by the body through the liver. A check on other medications that can interact and history to rule out pre-existing liver problems are required. Liver testing performed 1 to 2 weeks after taking the medication.
A larger, softer shoe can relieve the direct or indirect pressure on toenails. Make sure that the shoe has enough room at the end about the width of your thumb and that the toe box (front of the shoe) is high enough to allow your toes to move freely.
Cutting the nail edges straight across without cutting the corners will prevent the skin at the edges from growing over the nail (becoming an ingrown toenail). Once the nail is ingrown, the painful edge(s) can be angled at the end by a professional to temporarily relieve the pressure and/or fungal infection.
There is an array of over the counter pads that can be placed between the toes or behind the painful nail edge to relieve the pain associated with ingrown toenails and fungal infections.
Anti-fungal medication can be applied directly to the nail (topical creams, gels, solutions). Oral anti-fungal medication will kill the fungus at the nail root, but laboratory tests are needed to assess liver function after administration to check for adverse reactions. The anti-fungal medication will usually take 6 to 9 months to push out the entire infected toenail and grow a clean, new toenail in its place.
In certain instances, the infected nail can be surgically removed to relieve the pressure and infected tissue. It is rare, but the new toenail can grow back normal or look better than before removal. Topical medication is then applied until the nail completely returns. If the nail thickness and pain persists, a chemical can be applied to the nail root and prevent the nail from returning. The skin under the toenail removed appears as a very thin nail when healed. It can be painted or have accessory nails adhered to it.
The procedure is performed in the office with local anesthetic or occasionally at an out-patient facility under sedation (e.g. young children, anxiety, bone infection). Full weight bearing is allowed immediately without restrictions.
You can get toenail fungus from many sources. The live and dormant varieties can be found on most warm, moist areas of the body. They only grow on or within toenails when there are similar places underneath or in cracks of the toenail that are warm and moist.
Medically, the most effective treatment for toenail fungus are the oral antifungal medications. They are metabolized and eliminated out of the body through the liver. Testing is still the standard of care, but liver enzyme elevations or any reactions are extremely rare. Not recommended for anyone with liver problems or taking medications that affect the liver.
If you leave toenail fungus untreated, it can infect the entire nail or even spread.
It is very rare for any fungus to get into your bloodstream. Unless a person is immunologically compromised and/or on high doses of immunosuppressive drugs, toenail fungus will grow only externally.
Toe fungus is not contagious in the general sense of catching it from someone else. The fungus cannot grow unless it has a damp place to hide, usually a nail that is detached or ‘lifted.’
“Everyone was very professional. Dr. Moore is a knowledgeable man and has a great bedside manner. I’ll be keeping him as my podiatrist. Feel comfortable going into an appointment with him.”
Our client approached our clinic with a fungal toenail infection and concerns about her thick, dark nail condition and wearing sandals.
I always instruct my patients that the thickness is from shoe pressure and may not go away with the Lamisil treatment, but the discoloring will go away. Her nails not only cleared up, but they were back to their thin soft shape after the treatment and wearing sensible shoes.
Don’t resign yourself to uncomfortable, painful fungal toenails. Contact Moore Ankle and Foot Specialists today and let’s get started on your treatment.
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