Treatment of nail fungus

Introduction

Nail fungus is a harmless but common disease in the population and is caused by pathogenic fungi called dermatophytes. In most cases, the treatment of nail fungus is unproblematic, but rarely an attack of deeper skin layers occurs. In principle, any person can be affected by nail fungus, but there are some risk factors that make its occurrence more likely. Most frequently the toes, especially the big toe, are affected, in about 25% of cases nail fungus develops on the fingernails. The treatment depends on the extent of the infestation and is usually successful, but requires a little patience.

The different treatment options

The nail fungus should be treated after the diagnosis. Most patients can be quickly rid of nail fungus and have no further consequences to fear. Although the treatment may take some time, therapy-resistant fungi are rare.

Methods: For the treatment of nail fungus there is now a wide range of methods that are more or less effective. The methods start with well-tried home remedies such as rubbing in vinegar, may consist of pharmacotherapy with antifungal agents or use a laser. Locally applied methods, which are often administered in the form of varnish or ointment, play a major role, as this treatment is sufficient in most cases.

In addition, general methods favour the course of the disease. For example, socks should be changed daily, breathable footwear should be worn and care should be taken to keep feet dry. Only in severe cases, simple methods are not sufficient and must be supplemented by orally taken medication.

Special patient groups such as women in pregnancy or breastfeeding benefit above all from non-drug methods, as these offer the greatest safety for the unborn child. The individual methods are described in more detail below. In the treatment of nail fungus, household remedies such as tea tree oil or the treatment with vinegar play a not unimportant role.

Especially in the case of mild symptoms, a treatment with household remedies can be useful to contain and fight the nail fungus. Whether a direct antimycotic, i.e. against the fungus directed, effect is present, could not be clarified so far however clearly. For the support with uncomplicated nail fungus household remedies are not unsuitable however.

A popular household remedy against nail fungus is baking powder, which is stirred with some water to a tough mass. This is then applied to the affected nail several times a day, the treatment lasts one to two weeks. Furthermore, some people swear by the treatment with own urine, which is also brushed on daily.

In fact, the urea contained in the urine is a frequently used agent in dermatology, but the effect of this treatment has not yet been clearly proven. In addition, there are household remedies such as salt water or alcohol. Frequent applications with these substances can, however, also irritate healthy skin.

The most frequently used household remedies, which also show the best evidence in their effect, are the treatment with vinegar and tea tree oil. In the case of nail fungus, many sufferers use a treatment with vinegar. Water is mixed with vinegar in a ratio of 1:1 and applied to the nail fungus several times a day.

The treatment with vinegar has the background to create an acidic environment on the nail in which fungi cannot survive. Mostly apple vinegar is recommended. Another method for nail fungus on the foot is to take a foot bath with vinegar and bathe the feet in it for about 15 minutes.

After the treatment with vinegar, some people recommend the use of vinegar essence, i.e. concentrated vinegar. However, caution is required here, as long-term treatment with vinegar can cause skin damage. Besides the treatment with vinegar, tea tree oil is another popular household remedy against nail fungus.

The advantage of tea tree oil is that there are no harmful effects such as irritation. However, the oil has proven antimicrobial effects. Again, many people report Tea Tree Oil as a very effective treatment.

The Tea Tree Oil is applied to the affected nail several times a day with a cotton swab, usually for 1-2 weeks. The concentration of tea tree oil should not exceed 5-10% when treating nail fungus.One of the newer methods in the treatment of nail mycosis is the use of laser light, which is mainly used in the USA and is not entirely free of criticism. A laser is mainly used when there are contraindications against other methods of treatment or when the nail fungus has proven to be resistant to other treatment attempts.

A neodymium-Yag laser is preferred. The laser works by developing heat on the nail and is thus able to kill the fungal threads. Healing effects through increased blood circulation are also discussed.

The duration of the treatment is weeks, although some sources describe a single session as sufficient. However, this statement should be considered carefully. Overall, the use of lasers proves to be a promising alternative, but currently there are not enough study results available.

A cure with laser alone is still considered unlikely and should be combined with other methods. In the treatment of nail fungus, very often a lacquer is applied to the nail, which contains antimycotic (against the fungus directed) active substances. These substances influence the metabolism and growth of the fungus and show good effects.

Active substances often used in the varnish are Amorolfin, Ciclopirox or Clotrimazol. In many cases, the varnish is available without prescription in pharmacies, otherwise you must consult your family doctor. As with other methods, patience is required to successfully fight the nail fungus.

Over a period of 2-3 months, the varnish is applied to the nail, first every 2 days, then twice a week. Other preparations are also used daily. The application is similar to that of a normal nail polish.

To improve the success of the treatment, as much affected material as possible should be removed before applying the polish again. Mostly the varnish is waterproof, which gives a good effect on the spot, but on the other hand, you have to remove the varnish with solvents or arrows. Therefore, when treating nail fungus, water-soluble lacquers are also offered, which are simply brushed on before going to bed.

Which varnish is the most useful, depends also on the pathogen. Not every varnish works equally well, so that one should change the varnish after an unsuccessful treatment or consult a doctor for a closer examination. As an alternative to the varnish, there are also ointments against nail fungus, the advantages of which come into play when a lot of skin around the nail is affected.

The treatment with a varnish is one of the most common methods. The antifungal anti-fungal agents can also be administered orally in the form of tablets. This becomes necessary when the nail fungus has penetrated into deeper layers and can no longer be reached from the outside.

This is rarely the case, but requires specific treatment. The treatment of nail mycosis in women during pregnancy or lactation differs in some points from other patient groups. Local treatment from the outside in the form of varnish, with vinegar, tea tree oil or other household remedies is not dangerous for the unborn child during pregnancy and lactation.

However, there is an increased tendency to nail fungus during pregnancy, so preventive methods play a greater role in treatment. It becomes problematic if the nail fungus cannot be treated sufficiently with local treatment, because many medicines, which are taken against nail fungus, are contraindicated during pregnancy and lactation. Above all the active substance class of the azoles like Fluconazol or Itraconazol can harm the unborn child and should be avoided.

Other methods to combat nail fungus are therefore used during pregnancy or while breastfeeding. One possibility is the mechanical removal of damaged nail substance, which also removes the pathogens. A trained podiatrist offers the possibility to grind or mill off the nails for this purpose. Afterwards an antimycotic varnish is applied to treat the nail which is still affected by nail fungus. Women who are pregnant or breastfeeding should better consult a doctor immediately in case of fungal nail fungus, who can advise on the different methods and dangers.