What is a Fungal Nail?
Discolored, thick, crumbly nails are typically caused by a fungus or yeast infection. These microorganisms get under the nails and change the consistency of the nail itself. Initially the nail can look water logged or discolored with white patches, this usually gets worse with time and the nails become deformed. If caught early a topical or oral antifungal may reverse the condition. Nevertheless, the tendency to develop these ugly nails runs in families, there is a strong genetic predisposition for this condition. Changes in circulation, which can happen with age, also is a factor in nail changes. Fungal nails called onychomycosis can occur at any age. Injury may cause changes in the nail which mimics a fungal nail, and psoriasis can create the exact same nail deformity but it is not susceptible to antifungal medications.
Today there are multiple treatments available to reduce and often eliminate the deformity. There are antidotal remedies all over the internet with some limited success such as Listerine and vinegar, I have seen patients that claim it worked to note that their nails were still very thick and fungal but with less discoloration. Topical medications work only when the nails are thinned, the antifungal has to penetrate into the nail bed so applying the medication over a thin nail works much better than applying it over a thickened nail. Naturally, all topical medications are not equal, the prescribed medications such as Formula 3 have a higher concentration of the stronger antifungal ingredients and show faster and better results than the over the counter remedies. The oral medications such as Lamisil and Spornox are excellent antifungals but require multiply blood tests, these medications can cause liver changes and therefore anyone taking the oral antifungals needs to be closely monitored. Laser therapy is showing promising results but is very costly and long term outcome has not been verified. Once a fungal infection is cured it still may return and require further treatment.
What to expect from your podiatrist?
When a patient presents with thick, crumbly, mycotic nails, as a podiatrist, I want to find the cause. Most practices including mine take a section of nail and send it for mycology testing to determine if the nail is mycotic or if the problem is due to other causes such as injury, circulation, or psoriasis. Then, depending on patient’s age, health and life style, a treatment plain is initiated. Usually, the nails are thinned and if medication is indicated either topical or oral antifungals are prescribed. The earlier the nails are treated the faster and easier the correction.