What are they?
Discolored, thickened, or misshapen nails aren’t always caused by fungal infections. They can also result from trauma, congenital (birth) abnormalities, or other factors such as drug use, high fever, and circulatory issues. Fungal nail infections are diagnosed through clinical cultures and identification of the fungus. Typically, a fungal nail infection presents as a thickened, yellowish-brown nail plate. The infection often begins at the tip of the toenail and gradually affects the rest of the nail. Most fungal nail infections are asymptomatic or cause minimal discomfort, making them more of a cosmetic issue for many people. While fungal nails are not considered contagious between individuals, it can be perplexing when the infection spreads from one toe to another.
How do you treat them?
There are many treatment options for fungal nails, reflecting the variety of the condition itself. Oral medications are available, but they are costly, require long-term use, and can pose risks to the liver. Before starting oral treatment, a nail culture should be performed to confirm the presence of a fungal infection. Liver function tests are recommended before beginning medication and again at six weeks. Local treatments, such as trimming and periodic care, are generally only temporary measures, similar to using a tissue for a cold. Although these treatments can prevent the condition from worsening, they do not offer a long-term solution. Various topical medications, available both over-the-counter and by prescription, can be effective, with many patients opting for topical treatments over oral medications.
Another treatment approach involves surgically removing the affected nail plate to allow better access for topical treatments and medications to the underlying infection. This method often results in more effective treatment. Other, less commonly used treatments are also available. Ultimately, the choice of treatment should be based on the severity of the infection and the patient’s preferences. Fungus nails can be challenging to diagnose and treat, and ongoing advancements in medication may improve management options in the future.
