Nail fungus IntroductionAn infection of nail fungus (onychomycosis) occurs when fungi infect one or more of your nails. Onychomycosis (on-i-ko-mi-KO-sis) usually begins as a white or yellow spot under the tip of your fingernail or toenail. As the nail fungus spreads deeper into your nail, it may cause your nail to discolor, thicken and develop crumbling edges — an unsightly and potentially painful problem.Infections of nail fungus account for about half of all nail disorders. These infections usually develop on nails continually exposed to warm, moist environments, such as sweaty shoes or shower floors. Nail fungus isn’t the same as athlete’s foot, which primarily affects the skin of the feet, but at times the two may coexist and can be caused by the same type of fungus.An infection with nail fungus may be difficult to treat, and infections may recur. But medications are available to help clear up nail fungus permanently.Treatment Nail fungus can be difficult to treat, and repeated infections are common. Over-the-counter antifungal nail creams and ointments are available, but they aren’t very effective. Fortunately, other nonsurgical treatments have been introduced during the last 10 years.Oral medicationsTo treat nail fungus, your doctor may prescribe an oral antifungal medication, such as:Itraconazole (Sporanox) Fluconazole (Diflucan) Terbinafine (Lamisil) These medications help a new nail grow free of infection, slowly replacing the infected portion of your nail. You typically take these medications for six to 12 weeks but won’t see the end result of treatment until the nail grows back completely. It may take four to 12 months to eliminate an infection. Recurrent infections are possible, especially if you continue to expose your nails to warm, moist conditions. Antifungal drugs may also cause side effects ranging from skin rashes to liver damage. Doctors may not recommend them for people with liver disease or congestive heart failure or for those taking certain medications.Other treatment optionsYour doctor may also suggest these treatments:Antifungal lacquer. If you have a mild to moderate infection of nail fungus, your doctor may prefer to prescribe an antifungal nail polish. The Food and Drug Administration has approved a topical antifungal lacquer called ciclopirox (Penlac), which you paint onto your infected nails and surrounding skin once a day. After seven days, you wipe the piled-on layers clean with alcohol and begin fresh applications. Daily use of Penlac for up to one year or longer has been shown to help clear nail fungal infections, but researchers found that it cured the infections in less than 10 percent of people using it. Topical medications. Your doctor may also opt for other topical antifungal medications, such as econazole nitrate (Spectazole). In some cases, you may be advised to use these creams with an over-the-counter lotion containing urea to help speed up absorption. Topical medications usually don’t provide a cure but may be used in conjunction with oral medications. If your nail infection is severe or extremely painful, your doctor may suggest removing your nail. A new nail will usually grow in its place....
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