Why is toenail fungus so hard to treat

The latter is a very old drug and carries the risk of causing damage to the liver. Terbinafine is most effective and therefore is the preferred oral treatment. It can, however, cause gastrointestinal side effects and depression. Most nails with extensive fungal infection may still look disfigured even after 12 weeks of treatment, as the nail plate grows slowly and it takes about nine months to grow out fully.

Even once the fungus is successfully eradicated, there may be long-term effects on the appearance of the nail. When you go to your doctor, marking a line on the nail with a scalpel blade at the base of where the fungus starts is helpful for treatment follow-up.

The patient can follow the marking as the nail grows out. If the newly grown-out nail is growing out discoloured, further treatment is required. Onychomycosis patients may need to learn new, healthier habits to stop the fungus growing back.

These could include protecting toes from sources of infection, wearing correctly fitting footwear, laundering socks in hot water with disinfectant, wearing protective footwear at the pool and gym, keeping nails short, using open-toed footwear and wearing shoes made of breathable material. Even the chemicals in nail polish can discolor the nail.

You should see a podiatrist as soon as you notice your nail changing, he advises. Only a lab test on a scraping from your toenail can show for certain that fungus is responsible for your nail distortion.

Misdiagnosing toenail fungus can cost you time and money trying over-the-counter products that won't have an effect. Whether you're trying to clear up a fungal infection or hoping to avoid getting one, the following can help. There are a myriad of treatments for fungal infections , which vary widely in cost and effectiveness. To be fully effective, the antifungal drug has to penetrate the nail and often the nail bed as well.

Over-the-counter products. Antifungal preparations that are applied on and under the nail with the same type of brush used for polish are widely available. They don't promise a cure but instead suggest that they can improve the appearance of fungal nails. There is no evidence that any one is particularly effective.

Ioli says. Prescription topical treatments. Effective products include efinaconazole Jublia , tavaborole Kerydin and ciclopirox Penlac. All require daily applications, and it may take as long as a year to see noticeable improvement. These products may work for early, superficial fungal infections because they kill fungi on the surface of the nail.

Filing down the surface of the nail may enable them to penetrate more deeply into the nail or the nail bed. Oral medications. If it gets into the nail bed, the fungus eats and digests the keratin in the nail, and that causes discoloration and thickening of the nail. Sometimes the fungus gets into the nail bed after the nail was cracked or cut too short. The very place where people go to beautify their feet and toenails is often responsible for spreading disease, says Tennessee podiatrist Dr.

Robert Spalding. Nail fungus and other microorganisms are really tough to kill, and Spalding says the only sure-fire way to sterilize the instruments is to use something called an autoclave. The foot-soaking tubs are another cesspool of infection that Spalding says some salons are eliminating. Spalding estimates that 75 percent of salons do not disinfect their instruments and tubs properly and according to state regulations.

He has developed training seminars for nail-care techs, and he offers both an app and a website where consumers can check out if their salon is safe. That is the grossest thing! It started about 10 years ago when Liz cracked her big toe nail.

After that, the nail started to look funny and became discolored. Then it spread to three more toes on that foot. There is a topical called Penlac that seems to work sometimes for very mild cases. Laser treatments sometimes make the nails look a bit better — but have not been proven to kill the fungus.

Then there are pills that people have to take for several months. They tend to be quite expensive, and at this time most medical insurance does not cover that type of treatment. In some specific cases, I do suggest a more aggressive treatment plan for toenail fungus.

If left unchecked, the fungus may be able to spread to other parts of your body and make you quite ill. Treatment in these situations usually involves the topical medications mentioned earlier, as well as an oral antifungal drug, such as terbinafine or itraconazole.

These drugs help a new nail grow free of infection, slowly replacing the infected part. You typically take this type of drug for six to 12 weeks. With this treatment, it may take several months or more to completely eliminate the infected nail.