Nail fungal infections can be painful and may cause permanent damage to your nails. Nail fungus can be difficult to treat, and repeated infections are common. Over-the-counter antifungal nail creams and ointments are available, but they aren't very effective. If you have athlete's foot as well as nail fungus, you should treat the athlete's foot with topical medication and keep your feet clean and dry.
To treat nail fungus, your doctor may prescribe an oral antifungal medication. Studies have shown the most effective treatments to be terbinafine (Lamisil) and itraconazole (Sporanox).
Your doctor is likely to recommend oral medication if you:
Have diabetes or other risk factors for cellulitis
Have a history of cellulitis
Are experiencing pain or discomfort from your nail infection
Want treatment because the infection is unsightly
These medications help a new nail grow free of infection, slowly replacing the infected portion of your nail. You typically take these medications for six to 12 weeks, but you won't see the end result of treatment until the nail grows back completely. It may take four months or longer to eliminate an infection. Recurrent infections are possible, especially if you continue to expose your nails to warm, moist conditions.
Antifungal drugs may cause side effects ranging from skin rashes to liver damage. Doctors may not recommend them for people with liver disease or congestive heart failure or for those taking certain medications.
Other treatment options
Your doctor may also suggest these nail fungus treatments:
Antifungal lacquer. If you have a mild to moderate infection of nail fungus, your doctor may prefer to prescribe an antifungal nail polish called ciclopirox (Penlac). You paint it onto your infected nails and surrounding skin once a day. After seven days, you wipe the piled-on layers clean with alcohol and begin fresh applications. Daily use of Penlac for about one year has been shown to help clear some nail fungal infections.
Topical medications. Your doctor may also opt for other topical antifungal medications. You may be advised to use these creams with an over-the-counter lotion containing urea to help speed up absorption. Topical medications usually don't provide a cure, but may be used in conjunction with oral medications. Your doctor may file the surface of your nail (debridement) to lessen the amount of infected nail to treat and possibly make the topical medication more effective.
Surgery. If your nail infection is severe or extremely painful, your doctor may suggest removing your nail. A new nail will usually grow in its place, though it will come in slowly and may take as long as a year to grow back completely. Sometimes surgery is used in combination with ciclopirox to treat the nail bed.
Treating nail fungus with a laser or photodynamic therapy, in which intense light is used, to irradiate the nail after it's been treated with an acid, may also be successful. However, this new treatment may not be available everywhere.
To help prevent nail fungus and reduce recurrent infections, practice good hand and foot hygiene by following these steps:
Keep your nails short, dry and clean. Trim nails straight across and file down thickened areas. Thoroughly dry your hands and feet, including between your toes, after bathing.
Wear appropriate socks. Synthetic socks that wick away moisture may keep your feet dryer than do cotton or wool socks (you can also wear synthetic socks underneath other socks). Change them often, especially if your feet sweat excessively. Take your shoes off occasionally during the day and after exercise. Alternate closed-toe shoes with open-toed shoes.
Use an antifungal spray or powder. Spray or sprinkle your feet and the insides of your shoes.
Wear rubber gloves. This protects your hands from overexposure to water. Between uses, turn the rubber gloves inside out to dry.
Don't trim or pick at the skin around your nails. This may give germs access to your skin and nails.
Don't go barefoot in public places. Wear shoes around public pools, showers and locker rooms.
Choose a reputable manicure and pedicure salon. Make sure the salon sterilizes its instruments. Better yet, bring your own.
Give up nail polish and artificial nails. Although it may be tempting to hide nail fungal infections under a coat of pretty pink polish, this can trap unwanted moisture and worsen the infection.
Wash your hands after touching an infected nail. Nail fungus can spread from nail to nail.
I know this may not restore your nail but it helps prevent the nail from further infections. If you have finished with treatment your nails may begin to physically look better with time, however, some of the damage may be permanent. The best thing you can do right now is to avoid the temptation to get acrylic nails as they are a definite possibility for re-infection, and keep your nails clean and short.
Wishing you the best,