Disease of the Nail

 

Nail Fungus (Onychomycosis)

Onychomycosis is the name for fungal infection of the fingernails or toenails.  Toenail or fingernail fungus can appear as thickening of the nail, yellowing of the nail, accumulation of white debris under the nail, and separation of the nail from the nail bed.

Proper diagnosis for Nail Fungus is important

There are several nail diseases, including psoriasis and lichen planus, that can look like toenail or fingernail fungus.  In addition, trauma to the nail matrix (the area where the nail grows from) can cause thickening of the nails that can look like fungus.

Testing for Nail Fungus

Your provider may take a clipping or scraping of your toenail or fingernail and send it to a lab for an onychomycosis analysis, to check for fungal growth. The fungal culture of your nail can take 4-6 weeks to show a positive or negative result.

Nail Fungus treatment

Treatment of nail fungus (onychomycosis) with oral anti-fungal medications is not a guarantee for cure.  Approximately 2/3rds of the people treated with these medications will have resolution of their nail fungus.  Additionally, after the fungus has been killed, it takes about 6 months for a normal fingernail to grow out, and it takes about 1 year for a normal toenail to grow out.  So, even if the treatment works for you, it will be 6 months to a year before your nail looks better.  It is important to complete the entire 6 or 12-week course of your medication to prevent the fungus from becoming resistant to the medication.

Nail Fungus treatment cautions

It is important to determine whether the fungus is the cause of the changes in your nails prior to treating them.  This is because the treatment of nail fungus requires the use of oral medications for 6-12 weeks.  These medications can cause inflammation of the liver that can be quite serious, so it is important to be certain that you actually have fungal infection before using these medications.

Before you start the oral medication for your nail fungus, your doctor may do a blood test to evaluate the health of your liver.  It is important to tell your doctor if you have a history of liver disease or hepatitis.  Many physicians will test your liver enzymes again at the midway point of the treatment to be sure the medication is not causing problems for your liver or red and white blood cells.

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