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February 10, 2012

Fungal Nails (cont.)

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Are oral medications for nail fungus toxic?

The newer drugs are unlikely to cause any liver problems in patients without known liver disease. Blood tests are not needed for once weekly treatment with fluconazole; however, people taking longer courses often have their liver function tested before starting the medicine and then retested during the course of treatment.

What about the cost of oral medications?

A further consideration is cost. Because newer oral antifungal agents are very expensive, some insurance companies balk at paying for what they consider a "cosmetic issue," unless nail fungus causes pain or other functional symptoms.

How do you prevent fungal nails?

No one knows where a specific person catches the fungus, as it is everywhere. However, since the fungus does thrive in warm moist areas (like sweaty feet), there are certain areas one should avoid or use with caution. Shower floors, locker rooms, and swimming pools are suspected of being sources of the fungus, although there are no studies proving this fact. Nail polish and acrylic nails also make the nail less "breathable" and make the nail more susceptible to fungal infection. Fungi are everywhere -- in the air, the dust, and the soil. Hygienic measures such as spraying socks and footgear sound sensible, and perhaps these measures can even help a little bit. However, avoiding tight, nonbreathing shoes or steering clear of athletic facility floors may very well be the best prevention available. Daily washing of the feet and drying between the toes can help to prevent nail fungus. The fungi carried on the coats of pets, like cats and dogs, don't often cause nail fungus. Wearing white socks does not help.

What is the prognosis of fungal nails?

Curing fungal nails can be difficult and treatment can take up to 18 months. Relapse and reinfection are common (40%-70% reinfection rate). Trying to remove or modify your risk factors, if possible, is essential to preventing reinfection. People who have medical illnesses that predispose them to fungal nails can have an even more difficult time eradicating the fungus.


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