Table of Contents
- Introduction to fungal nails (onychomycosis, tinea unguium)
- What other conditions can be mistaken for fungal nails?
- What causes fungal nails, and what are some of the risk factors?
- Are fungal nails contagious?
- What are the symptoms and signs of fungal nails?
- What tests do health-care professionals use to diagnose fungal nails?
- Who should be treated for fungal nails?
- What is the treatment for fungal nails?
- What is the treatment for fungal nails? (Continued)
- Are there home remedies for toenail fungus?
- Are oral medications for nail fungus toxic?
- What about the cost of oral medications for fungal nails?
- Is it possible to prevent fungal nails?
- What is the prognosis of fungal nails?
- Is it possible to prevent the recurrence of nail fungus?
- Tips for prevention of fungal nails
Quick GuideNail Color and Texture: What Nails Say About Your Health
What causes fungal nails, and what are some of the risk factors?
In normal, healthy people, fungal infections of the nails are most commonly caused by fungus that is caught from moist, wet areas. Communal showers, such as those at a gym or swimming pools, are common sources. Going to nail salons that use inadequate sanitization of instruments (such as clippers, filers, and foot tubs) in addition to living with family members who have fungal nails are also risk factors. Athletes have been proven to be more susceptible to nail fungus. This is presumed to be due to the wearing of tight-fitting, sweaty shoes associated with repetitive trauma to the toenails. Having athlete's foot makes it more likely that the fungus will infect your toenails.
Elderly people and people with certain underlying disease states are also at higher risk. These include anything that impairs your immune system can make you prone to getting infected with the fungus. These include conditions such as AIDS, diabetes, cancer, psoriasis, or taking any immunosuppressive medications like steroids.
Are fungal nails contagious?
While the fungus must be obtained from someplace, it is not highly contagious. Nail fungus is so common that finding more than one person in a household who has it is hardly more than a coincidence. It can be transmitted from person to person but only with constant intimate contact. Continue Reading
Averill, R.W., and R.K. Scher. "Simplified Nail Taping With Urea Ointment for Nonsurgical Nail Avulsion." Cutis 38 (1986): 231.
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.
Elewski, B.E. "The Effect of Toenail Onychomycosis on Patient Quality of Life." Int J Dermatol 36 (1997): 7.
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.
Grover, C., S. Bansal, S. Nanda, et al. "Combination of Surgical Avulsion and Topical Therapy for Single Nail Onychomycosis: A Randomized Controlled Trial." Br J Dermatol 157 (2007): 364.
Gupta, A.K., H.C. Jain, C.W. Lynde, P. Macdonald, E.A. Cooper, and R.C. Summerbell. "Prevalence and Epidemiology of Onychomycosis in Patients Visiting Physician's Offices: A Multicenter Canadian Survey of 15,000 Patients." J Am Acad Dermatol 43 (2 Pt 1) (2000): 244.
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.
Montgomery, B.J. "Urea Plasters Alternative to Surgery for Nail Removal." JAMA 241 (1979): 1559, 1563.
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.
Roujeau, J.C., B. Sigurgeirsson, H.C. Korting, et al. "Chronic Dermatomycoses of the Foot as Risk Factors for Acute Bacterial Cellulitis of the Leg: A Case-Control Study." Dermatology 209 (2004): 301.
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.
Sigurgeirsson, B., and O. Steingrímsson. "Risk Factors Associated With Onychomycosis." J Eur Acad Dermatol Venereol 18 (2004): 48.
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.
Szepietowski, J.C., A. Reich, E. Garlowska, et al. "Factors Influencing Coexistence of Toenail Onychomycosis With Tinea Pedis and Other Dermatomycoses: A Survey of 2761 Patients." Arch Dermatol 142 (2006): 1279.
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.
Tosti, A., B.M. Piraccini, C. Stinchi, and M.D. Colombo. "Relapses of Onychomycosis After Successful Treatment With Systemic Antifungals: A Three-Year Follow-up." Dermatology 197 (1998): 162.
Walling, H.W. "Subclinical Onychomycosis Is Associated With Tinea Pedis." Br J Dermatol. 161.4 Oct. 2009: 746-749.
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