Toenail fungal infection (onychomycosis)

Toenail fungal infections are very common. Known as onychomycosis, infected nails often appear discolored (yellow or brown), thick, brittle/crumbly, and frequently curve or separate from the nailbed.  The incidence seems to increase with age, and men are more affected than women.  These infections are seen more frequently in diabetics, and often start from exposure to a contaminated public shower floor, working in sweaty, damp shoes or workboots and/or sharing contaminated towels.  People with athlete’s foot are more likely to develop onychomycosis.

Treatment usually requires an oral antifungal medication such as Lamisil, usually taken daily for 6 months, and sometimes up to a year.  Antifungal creams alone do not work. Even with oral medication, the long term success rate for complete eradication is only around 60%.  Furthermore, there is a chance of liver irritation as well as potentially dangerous interactions with other medications.  The key is prevention.  Always wear sandals in a public shower, and never share towels.  If need be, keep your feet dry by using antifungal powder and try to wear cotton socks.  If your socks get wet, try to change them as soon as possible.  Finally, always treat any evidence of athlete’s foot immediately with an over-the-counter medication such as miconazole, Lamisil or Tinactin…..Richard R Samuel, MD     Family Practice and Urgent Care   Hayden, ID  USA

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