Onychomycosis, one of the many Nail Fungus out there

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Onychomycosis, one of the many Nail Fungus out there

By: Joe Leoni

Many natural changes in fingers and toenails come with age. Fine ridges, for example, may start developing from the cuticle of the nail tip. This and other similar changes are common, but they are not signs of poor health.

However,there are some nail conditions to watch out for such as small separations of the nail from the nail bed, yellow/brown color, or hardening ,crumbling or thickenings of the nail at the top edge.All these conditions are symptoms of a common fungal infection called Onychomycosis,which infects the nail bed under the surface of the nail causing thickening,roughness,discoloration and splitting of the nail.

It can be caused by a somewhat large variety of fungi and it's typically painless for several years after initial infection. But,if left untreated, the condition will worsen and it'll be unbearable to even wear shoes or walk.

Because fungi thrive in darkness,moist areas such as the inside of your shoes, Onychomycosis appears on toenails more often that fingernails. Like mold or mildew, these parasitic organisms live on dead things, which in this case is the dead nail tissue. Once the fungus is established on dead tissue, it excretes toxins into adjacent living tissue causing its death. As this tissue dies, it provides new ground for the fungus to expand.

The risk of fungus infection of toenails is decreased using the same methods to decrease the risk of fungus infection of the skin on the feet. Here are some tips to maintain your feat dry and healthy:

  1. Indoors, avoid wearing shoes and consider wearing open footwear.

  2. Change shoes daily. Try alternating between at least 3 pairs of shoes allowing them time to dry out.

  3. Change socks whenever they become damp.

  4. Wear high top boots only when needed for work or other activities.

  5. Treat every foot fungus promptly. Some fungus require daily application of anti-fungal creams to keep them away.

If the fungus still appears go to your dermatologist to prescribe you both oral and topical treatments for Onychomycosis. Newer, safer and more effective medications are currently available due to nail fungus treatment advancing significantly over the past years. These medications are generally taken for three months. During that time, the medicine incorporates into the nail tissue preventing the fungus to expand. As the nail grows out normally, The diseased nail is displaced and removed.

About The Author

Article provided by www.nail-fungus.org, a resource dedicated to providing information on the symptoms, treatment options, and cause of nail fungus.



Marybeth E 03.05.2007. 20:54

Does Lamisil work well for onychomycosis? I have read some other answers regarding onychomycosis on your toenails but I have it on all 10 fingers. I am going to go to the doctor tomorrow but I was just wondering if anyone has experienced this before? I have researched different types of nail fungus and I recognized that it is onychomycosis. Any info would be helpful. Thanks.

Marybeth E

Admin 03.05.2007. 20:54

Lamisil is active against most strains of causing Onychomycosis of the toenail or fingernail: Trichophyton mentagrophytes, Trichophyton rubrum. It may be effective for infections of Microsporum gypseum and M. nanum, Trichophyton verrucosum, Epidermophyton floccosum, Candida albicans, and Scopulariopsis brevicaulis.

Dosing - Fingernail: 250 mg/day for up to 6 weeks; toenail: 250 mg/day for 12 weeks; doses may be given in two divided doses

Contraindications - Not recommended for use in patients with pre-existing liver or renal disease

Talk to your doctor or pharmacist for more information


kerri_bliss 06.06.2007. 02:57

How do you treat a fungal infection under your finger nail? I received a fungal dark blotch under my pinky nail after wearing press on tips and am not sure how to treat the infection since it appears to be under the cuticule.


Admin 06.06.2007. 02:57

Fungal nail infection
Fungal nail infection is an infection of the nails by a fungus.

Alternative Names
Nails - fungal infection; Onychomycosis; Infection - fungal - nails
The body normally hosts a variety of microorganisms, including bacteria and fungi. Some of these are useful to the body. Others may multiply rapidly and form infections. Fungi can live on the dead tissues of the hair, nails, and outer skin layers.

Fungal infections include mold-like fungi that cause:

Athlete's foot
Jock itch
Tinea capitis

Fungal infections also include yeast-like fungi such as candida. Candida yeast infections include:

Diaper rash
Oral thrush
Cutaneous candidiasis
Some cases of genital rashes
Fungal nail infections are most often seen in adults. They often follow fungal infection of the feet. Fungal nail infections may be difficult to treat and may recur often. Toenails are affected more often than fingernails.

People who frequent public swimming pools, gyms, or shower rooms -- and people who perspire a great deal -- commonly have mold-like infections, because the fungi that cause them thrive in warm, moist areas.

The risk of getting a fungal infection is increased by closed-in footwear, prolonged moist skin, and minor skin or nail injuries.

Nail changes on one or more nails (usually toenails):
Loss of luster and shine
Distortion of nail shape
Crumbling of the nail
Debris being trapped under the nail
Loosening (detaching) of the nail
Exams and Tests
Your doctor will suspect a fungal infection based on the appearance of the nails.

The diagnosis can be confirmed by scraping the nail for a culture, or a microscopic examination to identify the type of fungus.

Over-the-counter creams and ointments generally do not help treat this condition.

Prescription anti-fungal medicines taken by mouth may help clear the fungus in about 50% of patients. However, such medicines can cause side effects or may interfere with other health medicines the patient is taking.

In some cases, the nail may be removed by the doctor. Nails grow slowly, so even if treatment is successful, a new, clearer nail may take up to a year to grow in.

Outlook (Prognosis)
Fungal nail infections may be difficult to treat and may become a reservoir for fungal organisms, causing them to return in the skin or nails. The fungal nail infection is cured by the growth of new, non-infected nails. Even with successful treatment, a relapse is common.

Possible Complications
Permanent damage to the nails
Secondary skin infections, including paronychia
Recurrent fungal infections of the nails or other parts of the body
When to Contact a Medical Professional
Call your health care provider if you experience persistent fungal nail infections, or if the fingers become painful, red, or drain pus.

Good general health and hygiene help to prevent fungal infections. Keep the skin clean and dry. Take proper care of the nails (see treatment). Wash and dry the hands thoroughly after contact with any fungal infection.


Review Date: 10/26/2006
Reviewed By: Michael S. Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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@ 09.10.2007. 02:46

How do nails attach to the nail bed? So my toenail got bruised, drained fluid out, now like two-thirds of the upper right of nail isn't attach to nail bed (but left side is).

I read that the new nail growing will attach itself to the nail bed while the part unattached at the moment is useless.

So what makes the new nail growing attach itself to the nail bed? I'm worried it won't.


Admin 09.10.2007. 02:46

Anatomically fingernails and toenails, which are made of a tough protein called keratin and are produced from living skin cells in the fingers and toes, are made up of many different parts:

The free edge is the part of the nail that extends past the finger, beyond the nail plate. There are no nerve endings in the nail - this is the growing part of the nail still under the skin at the nail's proximal end.
eponychium or cuticle, is the fold of skin at the proximal end of the nail.
paronychium is the fold of skin on the sides of the nail.
hyponychium is the attachment between the skin of the finger or toe and the distal end of the nail.
nail plate is the hard and translucent portion, composed of keratin.
nail bed is the adherent connective tissue that underlies the nail.
lunula is the crescent shaped whitish area of the nail bed (when visible)
nail fold a fold of hard skin overlapping the base and sides of a fingernail or toenail.
In common usage the word nail usually refers to the nail plate only.

Nails grow at an average rate of 0.03 centimeters a day (3 cm every 100 days).[1] Fingernails require 3 to 6 months to regrow completely. Toenails require 12 to 18 months. Actual growth rate is dependent upon age, season, exercise level, and hereditary factors.
This growth record can show the history of recent health and physiological imbalances, and has been used as a diagnostic tool since ancient times.[2] Major illness will cause a deep groove to form across the nails. Miscoloration, thinning, thickening, brittleness, splitting, grooves, Mees' lines, small white spots, receded lunula, clubbing (convex), flatness, spooning (concave) can indicate illness in other areas of the body, nutrient deficiencies, drug reaction or poisoning, or merely local injury. Nails can also become thickened (onychogryphosis), loosened (onycholysis), infected with fungus (onychomycosis) or degenerative (onychodystrophy); for further information see nail diseases.

Fingernail INJURIES
The fingernail and the underlying nail bed are the most commonly injured part of the hand.

Nail that has torn or separated from nail bed
It can be very painful to tear or rip your nail. A nail may separate from the nail bed for many reasons, including injuries- which is your case:

Separation caused by injury is common in people who have long fingernails. The nail may pry away from the nail bed when it is accidentally hit or jammed.
Severe or repetitive toe stubbing may cause a toenail to separate from the nail bed. This is also common in athletes who wear shoes that are not roomy enough.
The usual treatment for a separated nail involves removing the nail, keeping the area dry to prevent infection, and waiting for a new nail to grow. The infection or skin condition that caused the separated nail will also need to be treated. Home treatment often helps relieve pain, promote healing, and prevent infection.

Once a nail separates from the nail bed for whatever reason, it will not reattach. A new nail will have to grow back in its place. Nails grow back slowly. It takes about 6 months for a fingernail and up to 18 months for a toenail to grow back.


vman 27.12.2007. 23:23

Does Daktacort cream work on fungal nail infection? I have been suffering with nail fungas infection since January and I have been to the doctors and he prescribed me some daktacort cream for my infection but does daktacort work on the fungal nail infections.
Im also in the second phase of the infection.


Admin 27.12.2007. 23:23

Not sure why your doctor prescribed Daktacort. The company that makes it, Janssen-Cilag, Ltd., says nothing about using it to treat onychomycosis. This fungal infection is treated with systemic (oral) antifungals and must be taken from 6-12 weeks and sometimes longer. Onychomycosis is stubborn and can be difficult to resolve. I think you need to speak to your doctor about changing you over to something that will work. There's no direct evidence that vinegar kills fungus but it can slow the growth of some bacteria.


rosarosa 07.08.2007. 08:29

Any way to get rid of an advanced toe nail fungus? every nail has it, some of them have curled into what I can only descibe as tubes. They are very difficult to clip, if anyone can give me advice on that it would be much appreciated. I take so many perscriptions already that I have had one doctor tell me she wouldn't perscibe my anything for it because of potential liver damage.


Admin 07.08.2007. 08:29

This is a difficult one. You have onychomycosis, and it is very difficult to treat.

Topical antifungals (creams, ointments, lotions) are not very effective at getting rid of the infection...

There ARE some medications that can be used to treat it, though - like terbinafine, itraconazole, fluconazole, and griseofulvin.

You have to take the medication for 3 months, it can be very expensive, if you are on other medications there can be a lot of interaction problems, and even if you aren't on any other medications these medications can cause liver problems.

HOWEVER, you can obtain blood labs before and during treatment to monitor your liver, and the medications could be stopped if there was any sign of liver problems.

But the last bit of bad news is this:
Even if you convince a physician to prescribe it and you monitor your liver with blood lab draws and you find a way to pay for it and you take it for 3 months:

There is still a fairly high failure rate and you might have to repeat the treatment with one of the other medications...

AND...even if you "cure" it...and get rid of the infection completely, you will have around a 20-50% chance of having a recurrence in the future...

I don't want to discourage you, but am only providing you with the facts.

And if you are really determined to get rid of it, then talk to your doctor again armed with this information. Ask to get the lab draws to monitor your you liver and tell your doctor you are willing to accept the possibility of failure and recurrence. At this point, your doctor should agree...

If not, see another doctor or ask your doctor for a referral to a dermatologist, who will certainly help you.


I hope this helped some!


nandm_kumar 05.04.2006. 07:21

What is the best medical treatment for nail root fungus ? I have been suffernig from nail-root fungal problem for the past 10 years with no permanent cure though treated with commonly available anti-fungal creams/lotions containing miconazole/fluocinolone etc. , available in the market


Admin 05.04.2006. 07:21


Lamisil (Terbinafine HCL), is manufactured by Novartis, has less drug interaction, and costs slightly less than Sporonox. The spectrum of activity of Lamisil, however, is also less than that of Sporonox. This means that Lamisil does not inhibit as many other pathogens as Sporonox, although the success rate of each drug is reported to be the same. Lab work and physician care costs are the same and both drugs are in the same price range, although Lamisil?s dosage is 250 mg once daily for 90 days
nail fungus is not destroyed by taking Sporonox or Lamisil, the pharmaceutical company that manufactured the drug will reimburse the patient for his financial investment for the drug. It is important to know that taking the medication might destroy the nail fungus yet still leave the nail discolored and disfigured. This would leave the patient with an unaccomplished goal. Despite the fact that the nail does not appear normal, the pharmaceutical company would not reimburse the patient for the cost of the drug, as the fungus would no longer be present. Fortunately, this happens in a relatively small percent of all cases, only 10 to 15%.

Another treatment option available to patients with fungal nails includes the use topical antifungal agents. Topical antifungal agents only work on the superficial spreading of onychomycosis. Characteristically, this variety of fungal nail disease has superficial pitting with whitening of the nail plate. In order to effectively treat this condition, one must also keep foot moisture at a minimum. Drying agents, powders, and the use and frequent changing of cotton socks often help to dry the foot. The majority of topical nail fungicides are over-the-counter. These are Fungi Nail, Mycocide, and Restore AF. These agents are not as successful in the treatment of nail fungus as the oral antifungal agents.

Surgical intervention has great merit when chronic ingrown nails, thickened (dystrophic) nails, and pain are associated. The goal of the surgery is to remove all or part of the nail matrix (root) so that the nail plate is permanently destroyed. This method offers a success rate of about 95 to 99%. There is minimum discomfort post-operatively, and it is easily performed in the Doctor?s office under a local anesthetic. Remember that if the nail plate is removed, the nail disease is also removed.

Onychomycosis (fungal nail) is not considered to be a strong contaminant. Rather, it is considered to be a condition that some individuals are more susceptible to than other individuals. Factors that permit this disease include the pH level of the skin, trauma to the nail, hygiene of the foot and susceptibility of the patient. The fungus is prevalent and opportunistic. The treatments available are dependent on cost, ease, lifestyle, and effectiveness of the eradication of this nail disease.

The condition of fungal nails can be treated successfully, but can reoccur later. Your choice of treatment should be decided by you and your Podiatrist so that compliance, expectations, and results of therapy are realistic. Should you suspect that you have this condition of your toenails, please consult a podiatric specialist and ask questions regarding all treatment options available. This will allow you, the consumer, to be informed of which treatment will be most suited for your needs.


LB 23.05.2010. 18:16

How do you get rid of whitish colored toenails? I use nail polish a lot (always have it on practically) and I don't like going without the polish now since it's almost summer and I don''t want people to see the white colored toenails... Help! I hate it, it's gross! By the way, I have already tried lemon! =/


Admin 23.05.2010. 18:16

It sounds like you have a fungus infection called white superficial onychomycosis. I would suggest seeing a doctor and getting your nails checked.


0 10.07.2010. 17:00

How can I get rid of toenail infections - alternative medicine? Had it for 3 years - I used an anti-fungal toenail lacquer for 9 months, but it's still there. I am pregnant and not meant to use lacquer any more so is there an alternative treatment. The whole nail is yellow and now peeling away.


Admin 10.07.2010. 17:00

You must not use any anti-fungal preparations while pregnant, so please don't do that. Best advice is to leave it for now, and then when you're done with your pregnancy, resume some other treatment. The problem with the nail lacquer is that it does not always work, and can take a long time to work. It also does not work that well if the actual infection is near the skin or the skin surrounding the nail.
There are conventional oral anti-fungal drugs which have an efficacy rate of about 60% in most cases but these commonly cause side effects and certainly cannot be used in pregnancy. Apart from tea tree oil which has shaky evidence at best to support it, there are no AltMed preparations that have been demonstrated to cure fungal toe nail infections.

Leave it for now if I were you, and see your GP when after your pregnancy.

@ Pharmacy student: Careful where you go with that. There is insufficient evidence to recommend Tea Tree oil for Onychomycosis. Evidence is at best shaky, it isn't proven effective.
@ The thin skinned pharmacy student who dosen't like being challenged by a Nurse: I'm not suggesting I am more qualified in pharmacology than you- I'm not. I'm simply pointing out that although there is some evidence, there is no strong evidence to make recommendations on. Thats all. Of course if I am wrong, you could prove me wrong by presenting evidence to support your claim.
@ Pharmacy student: Of the two papers you mentioned that showed effect one used a mix of butenafine and the other one had some other combination. Both studies are old ? 1994 and 1999 and most references are on antibacterial properties supported by many laboratory studies (probably due to the compound terpinen4), and other fungi. There are only a small number of high quailty trials that have been conducted looking at this. As I said, not enough evidence to recommend use in this instance. I'm not saying it does not work, probably wouldn't hurt to try (although it can cause skin irritation) but I'd be careful about making recommendations at this stage due to the lack of data,

Most valid medical sites support what I have said...that there isn't enough data.

EDIT3: My knowledge on pharmacology has nothing to do with the presentation of data! You can't provide robust evidence to support your claim.

"Ok, so how many articles would you like me to show you?"

Any that supports your claim would be a start. Tell you what, how about we have this conversation when you've learned how to interperet data and grown up.

"I do not have the time to write you a memo. By the way, as a nurse are you even legally allowed to make medical recommendations?"

Rather than embarrassing yourself in public, it would have been better if you'd admitted your error. I've done a pubmed and cochrane search as well as a few others. There is evidence but not strong evidence.

Some Nurse ARE legally allowed to make medical recommendations and any recommendations I make are well within my scope of qualifications and knowledge. However, what that has to do with this question is beyond me. You are a pharmacy STUDENT you aren't a Doctor, even when you qualify you shouldn't be actually making medical recommendations. Stick to drugs, learn how to interperet data and grow up.


dave 25 01.09.2007. 05:18

how can eliminated a nail fungus in my feet? i don't have money for the doctor, please something works?

dave 25

Admin 01.09.2007. 05:18

You could try Lamisil you can buy at the drug store but nail fungus is hard to get rid of without medication. even with medication it may not work.

known as Onychomycosis, fungal nail infections are caused by an organism that digests the keratin found in our fingernails and toenails. Our nails are naturally built to be strong barriers, and resistant to fungi and other infections. The strength of this barrier also makes nail fungus very difficult to eradicate once it is present.

There are two primary treatment methods used for nail fungus. Topical treatments (liquids, aerosol sprays, and creams) are commonly used for to treat less severe cases of nail fungus. These treatments are usually acid-based liquids or anti-fungal creams like Tinactin and Lamisil cream. Oral treatments are powerful anti-fungal medications, such as Lamisil or Sporanox. Prescription oral medications are usually used in more severe or difficult cases.


linzi taylorson 19.06.2011. 17:09

is ther any way to keep nail extentions looking nicer for longer? i always wear nail extentions which need infilling every 2 to 3 weeks . but the acrylic /gel starts coming up after about 1-1half weeks , has anyone got any tips on making them look just as nice till i get them infilled , maybe lotions or something ???

linzi taylorson

Admin 19.06.2011. 17:09

Hands and feet of women are showing femininity and nurturing. Feminine woman always be proud of palms with soft skin and manicured nails and perfect.

Base, manicured nails is pretty healthy and strong nails. How to keep nails healthy and strong?

For strong nails should keep intact the nail.
? Keep nails clean and dry.
Avoid nail biting.
? Apply moisturizer on your nails every day. The cream prevents the splitting of the nails (regular hand lotion will do the job).
? No clear depth below the nail, thorough cleaning and too deep can cause infections.
? if you make sure to go manicure manicurist cares disinfect the dishes taken from a client. Nail fungus is very infectious.
? If you have artificial nails, check to see if the skin around the nails color changes. Skin discoloration indicates inflammation.
Eat a balanced diet that contains the necessary vitamins and calcium and make sure to drink 15 glasses of water a day.

How to achieve perfect nails and shiny?

1. Please bring a professional Lmnicorstit weekly to receive treatment and beauty care cuticle. It is important to check in advance the institute and ensure a qualified and professional where the disinfection equipment in order to avoid clinging various diseases, especially onychomycosis.

2. Must not be biting her nails.

3. Apply hand cream twice a day quality.

4. Peeling nail polish - not in any way! This might remove the top layer of the nail surface.

5. Remove nail polish - nail polish remover will do all kinds or acetone.

6. The moment a fragment or with the nail has to go right out and treat nail manicurist.

7. If any of the artificial fingernail infection or stones should not tear or rip the building. If construction starts falling apart has come right manicurist.

Perfectly manicured nails require a lot of work! And it's not cheap at all. You can cultivate your own nails at home with polish nails, clear nail polish, set Franchet home and polish remover.


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