Just like our skin, our nails can be affected by fungal infections, leading to discoloured, thickened and flakey nails that can hurt and even affect walking. The infection is called onychomycosis and is more common in our toenails, in males and with age. Here’s a few images of what it can look like:
The infection may be in the nail or in the skin under the nail. Fungi can attack nails that are already damaged through small cuts around the area. The infection may be secondary to untreated athletes foot or introduced through sharing nail clippers, towels, showers or pools. To properly diagnose a fungal nail infection, your doctor may send a clipping of your nail to the laboratory.
Preventing fungal nail infections
- Keep hands and feet clean and dry
- Ensure your shoes fit well
- Wear socks and shoes made from breathable, natural materials
- Keep your nails short
- Don’t share nail clippers, scissors, towels or socks with others
- Wash towels and socks regularly in a hot wash (above 60oC)
- Wear jandals in public showers and pools
- Throw out or treat shoes that could be contaminated already
- Treat athlete’s foot if it appears
- Choose reputable salons for nail treatments
Mild infections affecting less than 50% of only one or two nails may respond to topical antifungal treatments but more serious infections usually require tablets, a combination of the two or other therapies. A number of new treatments have come onto the market recently. Today, we’ll take a look at the leading products containing Ciclopirox and Amorolfine.
Amorolfine (brand names Loceryl, Myconail) is an antifungal that is effective against a broad range of fungi. It is applied once or twice a week and the nail is filed to expose the infection each time. The paint is applied like a nail polish to the nail to stop the infection spreading into good, new nail. You continue treating until the infection can be cut from the nail so can take at least six to twelve months.
Ciclopirox (APO-Ciclopirox, Batrafen) is similar to Amorolfine in that it penetrates the nail bed and is effective against a broad range of fungi. In comparison studies, it is more effective than Amorolfine.
As a natural alternative, the brush pen Nailclin is now available in NZ. It contains white thyme oil, eucalyptus citriodora, ethanol and lactic acid which penetrate into the nail bed to change the environment of the nail to make it unsuitable for the fungi to grow there. It isn’t necessary to file the nail and results can be seen in 4 weeks. We’ve had some really good feedback on the product so it is an interesting alternative.
Ask your pharmacist which is the right product for you because not all products are suitable for all people. Unfortunately, even with treatment, the nail can look different after the infection and infections recur in 25% of cases. A more severe infection may need oral anti-fungal treatments to clear. Tablets are prescribed by your doctor and taken for up to three months. Your doctor and pharmacist will check that the medicine is safe with any other medicines you may be taking as they aren’t suitable for everyone. Recently, non-drug treatments have become available including laser treatment, photodynamic therapy, iontophoresis and ultrasound.