Table of Contents
- Introduction to fungal nails (onychomycosis, tinea unguium)
- What other conditions can be mistaken for fungal nails?
- What causes fungal nails, and what are some of the risk factors?
- Are fungal nails contagious?
- What are fungal nail symptoms and signs?
- What tests do health-care professionals use to diagnose fungal nails?
- Who should be treated for fungal nails?
- What specialists treat nail fungus?
- What is the treatment for fungal nails?
- What is the treatment for fungal nails? (Continued)
- Are there home remedies for toenail fungus?
- Are there over-the-counter treatments for toenail fungus?
- Are oral medications for nail fungus toxic?
- What about the cost of oral medications for fungal nails?
- Is it possible to prevent fungal nails?
- What is the prognosis of fungal nails?
- Is it possible to prevent the recurrence of nail fungus?
- Tips for prevention of fungal nails
What tests do health-care professionals use to diagnose fungal nails?
Physical exam alone has been shown to be an unreliable method of diagnosing fungal nails. There are many conditions that can make nails look damaged, so even doctors have a difficult time. In fact, studies have found that only about 50%-60% of cases of abnormal nail appearance were caused by fungus. Therefore, laboratory testing is almost always indicated. Some insurance companies may even ask for a laboratory test confirmation of the diagnosis in order for antifungal medicine to be covered. A nail sample is obtained either by clipping the toenail or by drilling a hole in the nail. That piece of nail is sent to a lab where it can by stained, cultured, or tested by PCR (to identify the genetic material of the organisms) to identify the presence of fungus. Staining and culturing can take up to six weeks to get a result, but PCR to identify the fungal genetic material, if available, can be done in about one day. However, this test is not widely used due to its high cost. If a negative biopsy result is accompanied by high clinical suspicion, such as nails that are ragged, discolored, thickened, and crumbly, it warrants a repeat test due to the prevalence of false-negative results in these tests.
Most of the medications used to treat nail fungus have side effects, so you want to make sure of what you are treating.
Who should be treated for fungal nails?
Medical treatment of onychomycosis is suggested in patients who are experiencing pain and discomfort due to the nail changes. Patients with higher risk factors for infections such as diabetes and a previous history of cellulitis (infection of the soft tissue) near the affected nails may also benefit from treatment. Poor cosmetic appearance is another reason for medical treatment.
What specialists treat nail fungus?
There are several doctors who can provide nail fungus treatment. Your primary care provider, a dermatologist, or a podiatrist can treat nail fungus. Any one of these doctors can provide proper diagnosis and prescribe medications specific to fungal infection. A podiatrist or dermatologist may shave the top layer of the nail off or even remove part of the nail.