Fungal nail treatment options

Fungal nail – Treatment and options

Fungal nails also known as onychomycosis are very common affecting approximately 1 billion people globally and 1.6 million being Australian. The risk of having nail fungus increases as we age.

Fungal nail infections can be caused by many things such as yeasts, moulds or dermophytes which are a unique group of cells that grow fungi on nails and skin.

This is why fungal nail treatments generally need to be targeted to each individual and helps us understand what may or may not work.

Anecdotally, in the clinic currently we are seeing many patients with a diagnosis of a fungal affected nail. This may be due to the presence of working from home during covid-19. Onychomycosis may be noticed more now that products such as nail polish haven’t been used so often and toenails and skin are being noticed more by the patients.

It is important to eliminate other pathologies or conditions that may present similarly to a fungal nail and could be reason for antifungal treatment not to be effective. These causes could be psoriasis, eczema or psoriasis, lichen planus, bacterial infection or trauma.

The only way to definitely diagnose a fungal infection is to take a nail sample from the nail and any skin build up from the nail bed.

The symptoms of the fungal nail such as thickness, colouring and skin involvement are also helpful to diagnose. Sometimes, the thickness and changed shape of the nail can cause pain and increased pressure, please take note of your symptoms to help your health professional guide through treatment and care and how to prevent problems in future.

A positive result leads us to the gold standard treatment of an oral antifungal medication.

Terbinafine. Is the ‘Gold standard treatment’, if you are able to take this medication. It does have some side effects, and is not indicated if any form of liver disease or pathology or if on a multitude of medications. The nail must be tested by pathology for presence of fungus and to be prescribed this medication. A nail sample can be done here on site or sent to pathology by your GP.

There are many treatments available that we can offer at the clinic such as deep burring of the nail allowing topical treatments to work more effectively along with reducing the infected tissue and allowing healthy nail to grow through.

Photodynamic Treatment

PACT treatment works on bacteria, fungi and virus cells to destroy the cell wall. This is a painless procedure and uses light therapy as it’s mechanism.

The use of photosensitive agents kills the biofilm and promotes healthy cell regeneration and collagen growth. PACT is a great alternative to oral treatment as has up to 99.99% killing rate of binding cells.

Topical Treatment Options

A long process no matter what fungal nail treatment you use.  It is important you continue to treat the fungal nail until all the discoloration has grown out – this may take up to 12 months for a big toenail as toenails grow approx. 1mm per month.

Loceryl

  •  Apply  1-2 times per week to the nail plate
  • File down nail each time you apply solution
  • Approximate cost:  $80.00
  • Find out more –Loceryl

Rejuvenail

  • Apply  daily to fungal nail, 5mm surrounding skin and under the nail bed
  • Apply at night/leave on for at least 5hrs, wash off with water in the morning
  • Approximate cost:  $50
  • Find out more – Rejuvenail

Gordochom

  • Apply daily to affected nails
  • File down nails once per week with an emery board
  • Approximate cost:  $35.00
  • Find out more – Gordochom

Daktarin

  • Apply daily to affected nails
  • File down nails once per week with an emery board
  • This solution will form a black film over the nail, use nail polish remover between treatments
  • Approximate cost:  $20.00
  • Find out more – Daktarin 

Tea tree oil

  • (suggest Thursday Plantation brand) daily application on cotton wool to all nails. Will not necessarily eliminate fungal nail infection, but will help to prevent the infection spread from the nails to the skin.

Apple cider vinegar

  • Use a container your foot can fit into
  • Fill 50% water and 50% apple cider vinegar
  • Soak 7-10 minutes 2-3 times a week
  • The container can be reused until liquid becomes cloudy
  • You can build up the percentage of apple cider vinegar if your skin does not get any irritation
  • This is a natural treatment for fungal nail infections

Other

  • Can also use topical fungal creams/oils to treat fungal nail such as Lamisil or canesten to the affected nails and skin to treat infection depending on type of fungal infection and severity.
  • Ensure that the nail infection is not being delayed with treatment as the skin is involved such as the presence of Tinea pedis also known as Athlete’s foot. This can be treated with SolvEasy or Daktarin Tinea spray along with washing the shoes and socks regularly.

 

OTHER – LASER THERAPY

  • A newer form of fungal treatment. Reported to have approximately 70% success rate. Advantages: quick visit to laser clinic, approx. 15min duration, only mild discomfort reported. May continue to use nail polish in-between visits. Usually takes between 4-6 treatment sessions. Works best if the nail has been thinned out significantly by a podiatrist prior to treatment.
  • A clinical opinion should be advised before commencing laser to treat fungal nail

 

For any form of treatment a regular visit with a podiatrist for thorough filing of the nail will assist the speed at which the fungal infection clears

Home, shoe and self-care maintenance to assist in the treatment of fungal infections in the nails and skin –

This advice is important to follow for the best outcome when treating skin or nail fungal infections via topical, oral or laser treatment methods.

  • Wash your feet daily and dry them well all over, particularly between the toes
  • Change your socks during the day if you have overly sweaty feet
  • Try to keep your shoes clean and dry. Fungal spores can be found in shoes and can cause re-infections. Tea tree oil sprays can be purchased to treat shoes, also removing liners and placing shoes and liners in the hot sun for several hours can assist to kill fungal spores.
  • Add Canesten Hygiene Laundry Rinse, or similar, (available at the supermarket) to your washing machine to aid elimination of fungal spores in hosiery, linen and towels.
  • Clean your shower thoroughly, and either replace, or clean any nail trimming devices with a bleach cleaning product
  • Discard all nail polish that has been applied to fungal nails. Do not use nail polish whilst applying topical treatments to the nails
  • Wear footwear such as thongs when in communal or public areas, such as pools, hotels, spas
  • Treat your feet with a topical antifungal agent whilst undergoing fungal nail therapy. We recommend mixing a solution of approximately 10ml tea tree oil (Thursday plantation is a good brand) with 1 cup of white vinegar in a spray bottle and applying this to your feet after your shower. Alternatively Lamisil or similar antifungal treatments can be used daily to all surfaces of the feet including the toenails and between the toes.
  • Be aware that topical treatment requires diligent use for approximately 12 months for a successful outcome for a fungal big toenail.
  • Once you have finished treatment of onychomycosis check skin and nails regularly for any re-infection
  • For any form of treatment a regular visit with a podiatrist for thorough filing of the nail will assist the speed at which the fungal infection clears. Talk to your podiatrist if you notice any side effects such as irritation when applying products.
  • Advice: a fungal nail infection takes time, antifungal treatments work to treat the nail bed, nail surface and nail plate to resolve the infection and may be required to continue treatment up to one month post infection to prevent re infection. Treatment for fungal nail should be individualised.

At Foot Centre Group our podiatrists treatment fungal nails successfully. Call us on 9553 0044 or book online to see one of our podiatrists – We will provide you with a tailored treatment plan.

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