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Medical Author:

Allison Harvey, MD, FACEP

Medical Editor:

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.

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In this Article

• What other conditions can be mistaken for fungal nails?
• What causes fungal nails, and what are some of the risk factors?
• Is nail fungus contagious?
• What are the symptoms and signs of fungal nails?
• How are fungal nails diagnosed?
• How is nail fungus treated?
• Are oral medications for nail fungus toxic?
• What about the cost of oral medications?
• How do you prevent fungal nails?
• What is the prognosis of fungal nails?
• Conclusion
• Patient Comments: Fungal Nails - Treatments
• Find a local Dermatologist in your town
• Fungal Nails Index

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.

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.

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.