Nail Fungus
There are many causes of thickened and discolored nails. One is fungal infection.
How do we know it’s a fungal infection?
A typical fungal infection of the skin is caused by a dermatophyte (skin loving fungus). The most common being athlete’s foot – or “tinea pedis”. For the most part they do not cause any major medical issues unless someone is at risk for “superinfection” with bacteria (diabetics, immunosuppressed patients, etc.). Fungi live all around us, in our shoes, on our pets, on hard surfaces etc. Moist environments or breaks in the skin make getting a fungal infection more likely.
How did I get it?
Typically, a person will have athlete’s foot (tinea pedis) first. Then the fungus is around the feet and toes and moves underneath the nail.
How do you treat it?
Treatment varies depending on the patient’s risk factors. It is important to know that there is no 100% effective treatment. However, oral tablets – antifungal tablets – are the most successful. However, these can come risk for liver damage, albeit very rare. Below are a few options:
Oral tablets – Terbinafine, itraconazole, fluconazole
Topical lacquers (paint on) – ciclopirox, tavaborole, Eifinaconazole
Laser – 4-6 treatments, Low cure rate
Leave it alone – this is always an option
How do I prevent it?
Prevention is key. Consider anti-fungal foot powder in your shoes daily before putting them on or twice weekly application of anti-fungal cream for prevention. Most nail fungus starts as athlete’s foot. Preventing athletes foot will help prevent nail fungus after you are treated – or before it evens happens!
Source: American Academy of Dermatology (link - https://www.aad.org/public/diseases/a-z/nail-fungus-overview)
For Physicians only (or patients of Dr. Contestable) – “Fungus – Patient Handout”