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| To treat or not to treat? |
Nail Fungus: To Treat or Not to Treat?
What are fungal infections of the nails?
Fungal infections of the nails are common. The fungus grows in the nail bed, where the nail meets the skin. The fungus grows slowly and does not spread to internal organs.
The main concern is the nail discoloration (usually yellow) and change in nail texture and growth. Nails can become crumbly, break easily, and grow irregularly. However, because other nail conditions sometimes mimic fungal infection, most doctors will confirm the diagnosis by sending a nail clipping for laboratory evaluation -- especially if treatment is being considered.
Fungal infections are not commonly contagious nor do they spread easily between people. Nail fungus grows more often in people with weaker immune systems, which rather than suppress it, allow the fungus to become established. There is currently no known way to boost your immune system to make fungal infections less likely.
Here are some ways that may help to prevent fungal infections:
- Keep your feet dry, avoid constant moisture
- Avoid nonporous, closed shoes made of synthetic materials
- Wear absorbent socks
- Wear water proof sandals when in public showers
What can be done about fungal nail infection?
Because the fungus grows slowly, it can be hard to eliminate. Anti-fungal medications are available to combat fungal infections; however, they are strong oral medications that must be taken consistently for months in order to be effective. The medications also have potential side effects to other body organs (especially the liver, skin and/or bone marrow).
To monitor side effects your physician must order periodic blood tests (usually monthly) during treatment. Any of the symptoms (listed below) suggesting organ damage should be reported immediately to your physician.
Unusual fatigue
- Severe loss of appetite
- Nausea
- Yellow eyes
- Dark urine
- Pale stool
- Skin rashes
- Bleeding
- Enlarged lymph glands
Unfortunately, anti-fungal creams applied to the nail do not penetrate the nail bed to kill the fungus at its source and are generally ineffective.
How effective are medications at curing the fungus?
The anti-fungal medications usually suppress the nail infection when taken as directed. Unfortunately, they cannot guarantee a permanent cure. At least 1 in 5 patients, or 20 percent, will have a recurrence of the original nail infection at some time, making re-treatment with medication necessary.
Should I take medication to treat my fungal nail infection?
Doctors usually recommend treating fungal nail infections only when such infections cause secondary problems including pain, recurring ingrown toenails, or secondary bacterial infections of the nails or skin.
If the nail infection does not cause any of these problems, then doctors often discourage treatment because of the potential side effects, the need to monitor the blood throughout therapy and the high recurrence rate. Patients with liver or heart disease generally should not take these medications.
Some insurance companies require documentation of secondary problems beyond the mere presence of the fungal infection before they will cover the costs of the anti-fungal medications. |
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