The most frequently diagnosed nail infections are caused by an organism called a fungus. These infections are called nail fungus, or onychomycosis; they are more common on the toenails than the fingernails. It occurs in approximately 25% of people age 40 or younger, and 40% of older people. Onychomycosis tends to run in families because of an inherited tendency, but not everyone is susceptible. It is rare in children unless one or both parents are infected.
A dermatologist may take samples from the nail in order to properly identify and treat the problem. Sometimes, the scrapings from under the nail can be used to culture the material to see what grows and identify it. A portion of the infected nail can be sent to a laboratory for a biopsy. A PAS test can help identify fungal strands. Nail psoriasis and other conditions such as or allergic reactions to hardeners, nail polish, or acrylic nails can resemble fungal infections, but they are not. These tests help make the proper diagnosis.
Fungal infection of the nails is also important in people who have suppressed immune systems or other diseases such as diabetes. Cancer patients, those who have AIDS, are HIV+, and particularly those taking anti-cancer medications, and transplant patients who are also taking drugs which suppress the immune system, should be treated to prevent future health problems.
Topical antifungal creams and lacquers may be used; although, it is difficult for them to penetrate the nail.
Oral medicines such as terbinafine (Lamisil) and itraconazole (Sporanox) are used to treat nail infections; these treatments can require blood tests to monitor the patient. These are typically not prescribed to patients who have a history of liver problems including hepatitis and are not given to pregnant or nursing women. These new internal treatments are very safe when monitored by the dermatologist. In general, toe and fingernail fungus typically are treated with pills with the exception of very mild cases.
RECURRENCE AND PREVENTION
- Cleanse all foot instruments with alcohol.
- Do not share clippers and files.
- Keep toenails cut short to minimize trauma or injury.
- Applying an antifungal cream to your feet can prevent fungal infections such as athlete's foot.
- Use an antifungal foot powder to help control the perspiration which can promote fungal infections of the feet.
- Treat nail fungus in order to avoid complications especially in patients with diabetics or are immunosuppressed.
- Wash and dry your feet properly.
- Wear "outside shoes" for outside work.
- Avoid wearing tennis shoes as regular shoes.
- Wear shoes that fit properly and avoid wearing the same pair of shoes two days in a row.
- Use antifungal sprays and powders in the shoes weekly.
- Never wear someone else's shoes.
- When you are in public facilities such as pools and locker rooms avoid being barefoot.
- Take the proper tests.
- Be certain of the correct diagnosis by seeing a dermatologist.
We put academic qualifications, many years of combined experience, and training in a variety of special interest areas to work for your healthy, radiant skin. Our providers – Drs. Schachter, Hanna, Curtis, Abdulla, Pollack, and Taradash – welcome new patients for treatment at the Dermatology on Bloor practice on Park Road in Toronto. Our team is here to serve your needs
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Dermatology on Bloor has been recognized by Consumer's Choice as a top cosmetic dermatology clinic in 2011, 2012, 2013 and 2014