Pesky Toenail Fungus
Have you ever taken your nail polish off and noticed discoloration on your toenail? Or caught a glimpse at a friend or family member’s toenails and wondered how they got that way? Or noticed that your toenails over the past few years have become increasingly thickened, discolored or even lifting off the underlying nailbed.
Toenail fungus is increasingly common (men>women). Approximately 10% of Americans, 20% over 60 years old and up to 50% over 70 years old are estimated to have affected toenails. Both fingernails and toenails are susceptible to the infection.
Who gets toenail fungus? You are at increased risk of developing fungus if you have Diabetes, vascular problems and/or impaired immunity. Approximately 1/3 of Diabetics have toenail fungus. Other contributing factors include family history, smoking, heavy perspiration or humid work environment, wearing socks and shoes that prevent ventilation, previous injury to nail or skin, history of foot fungus, tight footwear and/or exercises causing repetitive minor trauma.
Most of the time toenail fungus is symptom free. In some instances however it can cause pain and difficulty walking. Living in Florida wearing sandals and going barefoot is very common. Many people may feel self-conscious. Severe cases may lead to opening in the skin and infection.
Will it go away? Toenail fungus is notoriously difficult to cure and rarely goes away on its own. Standard treatments are only moderately effective and, even when they work, the fungus may return. Which treatment you choose depends on the severity of the condition, the cost and other medical conditions you may have. There are many topical products out on the market including nail lacquers and polish that you can apply for 6-12 months. There are few side effects however these products have a low cure rate. Another option are antifungal medications such as (Lamisil/terbinafine) which are more effective than topical polish. Lamisil kills the fungus directly rather than halting its growth. Though more effective it still has potential side effects, including stomach upset, rash, headaches and, rarely, liver damage (thus, periodic blood tests are usually advised).It can also interact with other drugs. New laser treatments have recently gained popularity and FDA approval for treatment. These have shown greater cure rates however be ready to pay top dollar for treatment.
What about alternative remedies? Many natural remedies have also been popularized including tea tree oil, olive oil, vitamin E, Campho-Phenique, oil of bitter orange and Listerine. There is little or no evidence that any are effective. Vicks VapoRub has also been commonly used and 1 study does suggest possible benefit.
If you have toenail fungus that is causing pain or other problems, see your primary care provider, dermatologist or podiatrist. With all treatments described above, you must be patient as the nails as to grow out before you can tell whether the fungus has resolved which can take several months.