Fungal Nail Infections – Types and Treatments
There are two main causes of fungal nail infections: Candida albicans (the yeast that commonly causes oral and vaginal yeast infections) and the dermatophyte molds (they are a common label for three types of fungus, causing skin and nail infections such as ringworm and athlete’s foot.) Many people often use the terms fungus and yeast interchangeably. However, there is a big difference between yeast and dermatophyte nail infections.
Candida yeast can cause onychomycosis, a chronic, usually painless infection that results in thickening and discoloration of the nail. Nail infections caused by Candida yeast usually affect the fingers rather than the toes and occur most commonly in people who frequently immerse their hands in water. Yeasts also commonly cause paronychia which is a painful infection adjacent to the nail.
However, most nail infections are caused by dermatophyte molds. Although dermatophyte toenail infections happen to be very common, fingernail infections caused by this type of fungus occur quite often as well. The symptoms range from a slight superficial whitening of the tips of the nails to deep discoloration of the entire nail. In many cases there is another infection of the nearby skin, such as athlete’s foot, associated with this condition. Nail infections are typically painless, so the main complaint of patients with onychomycosis is simply cosmetic.
If you have Candida paronychia, i.e. a Candida yeast infection adjacent to the nail, then the treatment involves applying a topical cream and avoiding immersing your hands in water. If you have an infection of the nail itself due to Candida or a dermatophyte, oral therapy is the best choice. Occasionally, very superficial nail infections can be cured with a topical agent, but as a rule, topical therapy fails in such cases. There are two main choices for oral therapy: terbinafine (Lamisil) and itraconazole (Sporanox). Itraconazole can be used for both Candida and the dermatophytes while terbinafine is only suitable for treating the dermatophytes.
It is true that these drugs can sometimes have side effects but most people tolerate them well. The main concern for both of these drugs is liver toxicity though serious damage to the liver is actually quite rare. For fingernail infections, usually only six weeks of treatment is necessary, while 12 weeks or longer is recommended for toenail infections.
Other alternatives include topical application of boric acid which may treat some superficial yeast infections but results usually do not last for too long. When it comes to natural remedies for true fungal infections there hardly are any that can provide satisfactory long term results. Just because something is natural does not necessarily mean it is safer to use. Amphotericin B, for example, a natural substance made by certain bacteria, is the treatment of choice for most serious, invasive fungal infections. But it is quite toxic, known for its severe side effects as it is causing at least some degree of kidney damage in most patients. Laser toenail fungus removal is the latest technology for effective removal of stubborn nail fungus onychomycosis but it is yet too early to say how well it compares with oral therapy and whether it can cure the nail fungus once and for all.
Where to Find Related Information: DermNet NZ