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Nail Fungus

Nail Fungal Infection
  • Most common disease of the nails.
  • Both fingernails and toenails are susceptible to fungal infection.
  • Most commonly occurs in toenails.

Symptoms of Nail Fungus
  • Fungal infection of nails causes thickened, brittle, distorted, dull, darker or yellowish color nails.
  • Infected nails separate from the nail bed.
  • Pain in toes and finger tips.
Risk factors for fungal infection of nails
  • Diminished blood circulation
  • Slow growing nails
  • Family history
  • Excessive sweating
  • Humid or moist work environment
  • Wearing socks and shoes for long hours
  • Walking barefoot in damp public places (swimming pools, gyms and shower rooms)
  • Previous nail injury
  • Diabetes
  • Tight footwear with crowding of toes
Nail Fungus Treatment
Antifungal medications as advised by dermatologist

Fingernail fungus cure
  • Terbinafine 250mg/day, 6 weeks
  • Terbinafine 250mg BD for 7days/month, 2-3 months
  • Itraconazole 400mg/day for 7 days/month, 2-3 months

Toenail fungus cure
  • Terbinafine 250mg/day, 12weeks
  • Terbinafine 250mg BD for 7days/month,3-4 months
  • Itraconazole 400mg/day for 7 days/month, 3-4 months
Topical treatment for nail fungus
  • Amorolfine 5% nail lacquer once a week applied after abrading the nail
  • Ciclopyroxolamine 8% nail lacquer applied daily

Avulsion of nail or removal of infected areas
How to prevent nail fungus?
  • Certain areas should be avoided or used with caution- shower floors, locker rooms and swimming pools
  • Nail polish and acrylic nails make the nails less breathable and susceptible to fungal infections
  • Avoid tight non breathing shoes
  • Daily washing of feet and drying between the toes
Conditions which can be mistaken for fungus nails
  • Lines and ridges- considered normal, may worsen in pregnancy
  • Senile nails-nails thicken, become brittle in elderly
  • Red or black nails- due to collection of blood under the nail, usually due to trauma
  • Pitted nails-occur in Psoriasis
  • Chronic nail trauma
  • Yellow nails due to absorption of pigments like iron oxide from the nail polishes
Is nail fungus contagious?
It is not highly contagious, fungal infection can only be transmitted through constant intimate contact

What is prognosis of nail fungal infection?
  • Curing fungal nails can be difficult. Treatment can take up to 18 months
  • Relapse and re-infection are common 
  • Trying to remove or modify risk factors is important