Fungal nail infections are difficult to treat. The majority of patients seek treatment after having tried numerous home made remedies. Despite medical treatment, recurrences are common. There are many over the counter anti fungal products- but the majority of these are ineffective.
Oral medicationsThe best treatment for nail infections is oral therapy. The three commonly used anti fungals drugs used to treat nail infections include:
- Itraconazole (Sporanox)
- Fluconazole (Diflucan)
- Terbinafine (Lamisil)
The
medications have to be taken daily for at least 3-6 months and even longer. The approximate time to rid the nail infection is at least 3-4 months. The old infected nail usually falls off and a new nail free of the infection starts to grow.
The major problem with fungal nail infections is that despite adequate drug therapy, recurrence is common. IF the nails are re-exposed to the warm and humid condition, the fungus will start to grow back. These are usually avoided in patients with a history of liver problems such as hepatitis/cirrhosis and are not given to pregnant or nursing women.
These new internal treatments are very safe when monitored by the dermatologist.
The prolonged use of anti fungal drugs is also associated with some side effects which may include
- allergies
- skin rashes
- liver damage
Other treatment optionsAntifungal lacquer can be used for those individuals with a mild to moderate nail fungal infection. One may use a prescription lacquer called ciclopirox (Penlac). The topical anti fungal is painted on the infected nail once a day. Every 7 days, the lacquer is wiped off with alcohol and the treatments repeated. This treatment has to be carried out for at least a year to eradicate the nail infection. The success rates are very variable and less than 10% of individuals are able to cure the nail infection.
Topical medications. There are numerous topical anti fungal ointments available. However for the treatment of nail infections, these medications are not effective. They are best avoided because they do not do anything and are just an added expense. Topical anti fungals are often combined with oral drugs but generally do not add anything more to the therapy
Surgery: For those who do not have time or patience or like taking medications for months, the best and most effective treatment for a fungal nail infection is surgery. The surgery can be done in a physician's office. The surgery is done under local anesthesia. The entire nail is removed. The new nail generally is free from the infection but takes about a year to grow back
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