Fungal Nails (cont.)
Is nail fungus 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.
How is nail fungus treated?
Oral antifungal therapy works about 50%-75% of the time. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back about 20%-50% of the time.
Creams and other topical medications are usually not effective against nail fungus. This is because nails are too hard for external applications to penetrate. However, a new medicated nail lacquer ciclopirox (Penlac)
topical solution 8% has been approved to treat finger or toenail fungus that does not involve the white portion of the nail (lunula) in people with normal immune systems. It only works about 7% of the time.
Oral medications that are effective against nail fungus include:
- Griseofulvin (Fulvicin, Gifulvin, Gris-Peg): This drug has been the mainstay of oral antifungal therapy for many years. Although this drug is safe, it is not very effective against toenail fungus. Newer agents have largely supplanted it.
- Terbinafine (Lamisil): This drug is taken daily for six to eight weeks for fingernail fungus and for 12 weeks for toenail fungus. The drug is safe, effective, and produces few side effects. However, it must be used with caution in patients with liver disease.
- Itraconazole (Sporanox): This is often prescribed in "pulse doses"—one week per month for two or three months. It can interact with some commonly used drugs such as the antibiotic erythromycin or certain asthma medications.
- Fluconazole (Diflucan):
This drug may be given once a week for several months. The dosing of this drug may need to be modified if the patient has impaired kidney function or is taking it simultaneously with certain other medications. It is not as effective as Lamisil or Sporanox and should be used cautiously in patients with liver disease.
Vinegar is a commonly recommended home remedy. Its effectiveness has not been proven or disproven in a medical study. Some people apply various oils and other tonics to their nails as well.
Next: Are oral medications for nail fungus toxic? »
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