Fungal Nails

  • Medical Author:
    Kyoung Min Han, DPM, AACFAS

    Dr. Kyoung Min Han is a podiatrist (foot and ankle specialist) practicing in Southern California. Dr. Han completed her undergraduate education at the University of California, San Diego, and went on to the New York College of Podiatric Medicine to pursue her medical training. She returned to her native Southern California to complete a three-year foot and ankle surgical residency, followed by subspecialty training in a sports medicine fellowship.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideNail Color and Texture: What Nails Say About Your Health

Nail Color and Texture: What Nails Say About Your Health

Is it possible to prevent the recurrence of nail fungus?

Tinea pedis, also known as athlete's foot or foot fungus, can cause recurrence of fungal nails. Therefore, it is important to manage this condition. One can apply over-the-counter (OTC) antifungal medicines such as clotrimazole (Lotrimin) or terbinafine (Lamisil) cream as directed to affected skin. Keeping footwear and socks clean can be helpful. You can also use portable UV light sanitizers to disinfect shoes.

Tips for prevention of fungal nails

Nail fungus causes only 50%-60% of abnormal-appearing nails. It can be hard to tell the difference between the different causes of discolored nails (even for doctors). Onychomycosis is often not treated. Reasons to receive treatment include

  1. diabetes,
  2. previous leg infection (cellulitis),
  3. if you have pain or discomfort from your nails, or
  4. you would like them treated for cosmetic reasons.

Treatment failures and recurrences are common.

Prevention is the key. The following preventive measures may be helpful:

  1. Keep your toenails short, and don't dig into the corners of your nails when cutting toenails.
  2. Keep feet clean, and dry them thoroughly.
  3. Wear dry socks and no tight shoes.
  4. Alternate your exercise shoes.
  5. Don't soak your hands in water or use harsh cleaners.
  6. Treat athlete's foot when it occurs.
Reviewed on 2/13/2017
References
REFERENCES:

Baran, R., R.J. Hay, and J.I. Garduno. "Review of Antifungal Therapy, Part II: Treatment Rationale, Including Specific Patient Populations." J Dermatolog Treat 19.3 (2008): 168-175.

Brillowska-Dabrowska, A., S.S. Nielsen, H.V. Nielsen, and M.C. Arendrup. "Optimized 5-Hour Multiplex PCR Test for the Detection of Tinea Unguium: Performance in a Routine PCR Laboratory." Med Mycol. 48.6 Sept. 2010: 828-831.

Bristow, I.R., and M.C. Spruce. "Fungal Foot Infection, Cellulitis and Diabetes: A Review." Diabet Med 26 (2009): 548.

de Berker, D. "Clinical Practice. Fungal Nail Disease." N Engl J Med. 360.20 May 14, 2009: 2108-2116.

Derby, R., P. Rohal, C. Jackson, et al. "Novel Treatment of Onychomycosis Using Over-the-Counter Mentholated Ointment: A Clinical Case Series." J Am Board Fam Med 24 (2011): 69.

Gaburri, D., J.M. Chebli, A. Zanine, A.C. Gamonal, and P.D. Gaburri. "Onychomycosis in Inflammatory Bowel Diseases." J Eur Acad Dermatol Venereol. 22.7 JulY 2008: 807-812.

Garcia-Doval, I., et al. "Clinical Diagnosis of Toenail Onychomycosis Is Possible in Some Patients: Cross-sectional Diagnostic Study and Development of a Diagnostic Rule." Br J Dermatol. 163.4 Oct. 2010: 743-751.

Ginarte, M., Garcia-Doval, I., et al. "Observer Agreement in Toenail Disorders: Implications for Diagnosis and Clinical Research." Br J Dermatol. 160.6 June 2009: 1315-1317.

Gupta, A.K., L.E. Lynch, N. Kogan, and E.A. Cooper. "The Use of an Intermittent Terbinafine Regimen for the Treatment of Dermatophyte Toenail Onychomycosis." J Eur Acad Dermatol Venereol. 23.3 Mar. 2009: 256-262.

Kondori, N., A.L. Abrahamsson, N. Ataollahy, and C. Wennerås. "Comparison of a New Commercial Test, Dermatophyte-PCR Kit, With Conventional Methods for Rapid Detection and Identification of Trichophyton rubrum in Nail Specimens." Med Mycol. 48.7 Nov. 2010: 1005-1008.

Litz, C.E., and R.Z. Cavagnolo. "Polymerase Chain Reaction in the Diagnosis of Onychomycosis: A Large, Single-Institute Study." Br J Dermatol. 163.3 Sept. 2010: 511-514.

Nair, A.B., S.R. Vaka, S.M. Sammeta, H.D. Kim, P.M. Friden, B. Chakraborty, and S.N. Murthy. "Trans-ungual Iontophoretic Delivery of Terbinafine." J Pharm Sci. 98.5 May 2009: 1788-1796.

Shemer, A., B. Davidovici, M.H. Grunwald, H. Trau, and B. Amichai. "Comparative Study of Nail Sampling Techniques in Onychomycosis." J Dermatol. 36.7 Jul7 2009: 410-414.

Shemer, A., H. Trau, B. Davidovici, M.H. Grunwald, and B. Amichai. "Onychomycosis in Psoriatic Patients - Rationalization of Systemic Treatment." Mycoses. 53.4 July 2010: 340-343.

Sigurgeirsson, B., J.H. Olafsson, J.T. Steinsson, N. Kerrouche, and F. Sidou. "Efficacy of Amorolfine Nail Lacquer for the Prophylaxis of Onychomycosis Over 3 Years." J Eur Acad Dermatol Venereol. 24.8 Aug. 2010: 910-915.

Smijs, T.G., and S. Pavel. "The Susceptibility of Dermatophytes to Photodynamic Treatment With Special Focus on Trichophyton rubrum." Photochem Photobiol. 87.1 Jan.-Feb. 2011: 2-13.

Sotiriou, E., T. Koussidou-Eremonti, G. Chaidemenos, Z. Apalla, and D. Ioannides. "Photodynamic Therapy for Distal and Lateral Subungual Toenail Onychomycosis Caused by Trichophyton rubrum: Preliminary Results of a Single-Centre Open Trial." Acta Derm Venereol. 90.2 Mar. 2010: 216-217.

Takahata, Y., M. Hiruma, Y. Shiraki, Y. Tokuhisa, T. Sugita, and M. Muto. "Treatment of Dermatophyte Onychomycosis With Three Pulses of Terbinafine (500 mg Day for a Week)." Mycoses. 52.1 Jan. 2009: 72-76.

Thomas, J., et al. "Toenail Onychomycosis: An Important Global Disease Burden." J Clin Pharm Ther. 35.5 Oct. 2010: 497-519.

Walling, H.W. "Subclinical Onychomycosis Is Associated With Tinea Pedis." Br J Dermatol. 161.4 Oct. 2009: 746-749.

IMAGES:

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2.Medscape/iStock/Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology Klaus Wolff, Richard Allen Johnson, Dick Suurmond Copyright 2009, 2005, 2001, 1997, 1993 by The McGraw-Hill Companies. All Rights reserved./"Infectionofcutical" by James Heilman, MD

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