$Unique_ID{BRK02033}
$Pretitle{}
$Title{Characteristics, Prevention, and Treatment of Fungus Nail}
$Subject{fungus nail nails onychomycosis debridement antifungal ketoconazole
griseofulvin toenail toenails fingernail fingernails}
$Volume{}
$Log{}

Copyright (c) 1993  Tribune Media Services, Inc.


Characteristics, Prevention, and Treatment of Fungus Nail


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QUESTION:  The past 9 months I have what is referred to as "fungus nail" on my
right big toe, and recently one of the middle toes looks discolored.  Never
had this before, am age 64.  What can be done for it?  So far it hasn't
bothered me except looking odd.  Thank you.

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ANSWER:  The condition you refer to as "fungus nail" is called "onychomycosis"
in medical terminology, and it can be a stubborn and difficult situation to
treat effectively.  The infection often results after repeated minimal trauma
to the nail, particularly from tight or poorly fitting shoes.  In patients
with onychomycosis, the toenail becomes opaque at first.  Then the nail
becomes thickened, deformed, discolored and distorted, eventually becoming
brittle and separating from the nail bed (onycholysis).  The nail becomes
granular, crumbly and dry, with a characteristic musty odor.
     Treatment of fungal infections in finger nails is somewhat more
successful than toenails, where the infection can resist even the most
persevering and persistent treatment.  Clinical management includes
debridement (removing affected tissue by mechanical, surgical and chemical
means) and topical antifungal agents for control.  Even removing the nail is
of little use as the infection returns with the new nail growth.
     There are oral medications which are used to treat serious fungal
infections, including ketoconazole and griseofulvin.  While they may be
successful in eradicating the infection, they also pose a risk of serious side
effects (including hepatitis and other liver disorders) which are more
frequent in older people.  In addition, older people have diminished
circulation to the feet, which reduces the amount of the antifungal medication
to the toes.  You can understand why they find little favor among physician
for treating fungal nail infections.
     You might consult with your physician for a prescription for one of the
many creams or liquids that exist for combatting this widespread condition.
They serve to help control the situation, but seldom cure them.  Since it
isn't bothering you much I wouldn't be surprised if his (or her) advice is to
just leave it be, and keep your feet as clean and dry as possible.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.