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Last Updated: Oct 28, 2021
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Fungal Nail Infection: Symptoms, Causes, Treatment, Medications and Home Remedies

About Causes Symptoms Treatment Eligibility Ineligibility Side Effects Post-treatment Guidelines Recovery Cost Results Alternatives

What is the treatment?

Any part of the body can be affected by fungal infection. Fungi are usually found in and also on the body alongside multiple bacteria. You get infection when the fungus begins to overgrow. Fungal infection that affects the toenails or fingernails is known as onychomycosis or tinea unguium. Nail infections usually develop over time so any immediate difference in your nails may feel fine to notice at first. The occurrence of nail infection is from the overgrowth of fungi either on the nail, in it or under it. People with diabetes, nail injury, skin injury, weak immune system, public pool swimmers, moist fingers or toes, and aged over 65 are more likely to develop nail infection.

The only way you can confirm a diagnosis is if you see a doctor. The diagnosis is done by taking a scrap of the nail and observing it under a microscope for indications of fungus. This sample may also have to be sent to a laboratory for identification and proper analysis. Over-the-counter medications do not tend to provide reliable results and hence are not recommended by doctors. What can be beneficial are oral antifungal medications such as fluconazole (Diflucan), terbinafine (Lamisil), itraconazole (Sporanox), and griseofulvin (Gris-Peg).

Does nail cause infection?

Acquiring infection in a person through an infected nail fungus in another person is unlikely to happen. However, infection starting from a single nail can spread to other nails in the same individual as seen in the case of an athlete's foot where a fungal infection in the toenail can be the starting point, spreading the infection to other nails.

What does a Nail Infection look like?

Nail Infection is a common type of fungal infection that starts appearing as a white or yellow-colored spot underneath the nails of fingers or toes. As the infection gets severe, it reaches the deeper area of the nail bed, resulting in a discoloration of the nail with a thickened and crumbled appearance at the edge of the nails.

How is the treatment done?

Early diagnosis along with rapid appropriate treatment is considered the cornerstone of successfully managing the reduction of mortality rate in association with nail infection. Prophylaxis treatment includes oral fluconazole as superior or effective as compared to topical therapy for nail infection. Oral therapy is considered more tolerable and convenient than topical therapy. In addition, oral therapy is more efficacious than topical regimens in treating severe fungal infection on the toenail. Oral fluconazole (100 to 450 mg/week) is considered the best drug to treat nail infection.

The usage of topical agents for the treatment of nail infection diminishes systematic drug exposure, lowers the risk of drug-drug amalgamation, reduces the likelihood that antifungal resistance may develop, and systemizes adverse events. Multiple daily dosing and unfavourable taste in case of nystatin and clotrimazole leads to reduced endurance of topical therapy. An alternative to fluconazole is miconazole in mucoadhesive buccal tablets (100 mg/week) or clotrimazole troches 5 times daily may be used for the treatment of nail infection. According to a multicenter, randomized study, these regimens were equivalent to fluconazole. Pastilles (4 times daily) or nystatin suspension remains till date as an additional alternative. An effective treatment for fungal nail infection is systematic antifungals. A 14-21 day course of either oral intraconazole or intravenous or oral fluconazole solution is considered highly effective.

Do you need antibiotics for Nail Infections?

Application of antibiotics is not always necessary in case of Nail Infections. The treatment approach is different in this case as this is a type of fungal infection. Antifungals including topical as well as oral, are recommended in such cases which are considered as a long-term treatment, unlike antibiotics. Antibiotics are given only when there develops a secondary bacterial infection.

Which antibiotic is best for Nail Infection?

Nail Infection may be due to bacterial infections, the condition referred to as Acute Bacterial Paronychia. Such cases are treated by application of antibiotics which usually have a course of seven days. The antibiotics which are considered to be best for such infections include penicillin as well its derivatives such as ampicillin. However, Clindamycin and Augmentin are also preferred when the infection-causing bacteria include staphylococcus or Bacteroides.

Can a Nail Infection go away on its own?

In cases of Nail Infection when the symptoms are mild, the condition may get healed spontaneously without any need for treatment. However, when the infection causes pain and thickening of nails at their edges, self-care techniques, as well as medications, are required. Furthermore, severe infections are followed by consultation with a doctor.

Who is eligible for the treatment? (When is the treatment done?)

The eligibility criteria depends on the CD4 count. If the CD4 count is 200 cells or lower, the person is eligible for the treatment. The treatment is started as soon as the patient starts showing signs related to the disease.

Who is not eligible for the treatment?

In case of co-existing conditions patients are excluded. Patients are excluded in case of chronic fungal infection. Severe or moderate liver disease is also a criteria of non-eligibility. History of intolerance or allergy to azoles or imidazoles excludes you from receiving the treatment.

Are there any side effects?

Side effects of the treatment include vomiting, nausea, abdominal pain, transaminase elevations, diarrhea, and hypertensive reactions like pruritus and rash.

What are the post-treatment guidelines?

Soak the fingernails and toenails in lukewarm water. For best results, mix the water tub with a few tablespoons of Epsom salt and submerge your feet in the bathtub for 10-15 minutes for good results. This method can be repeated several times throughout the day to stimulate the healing process after the treatment. The doctors strictly advise you not to dig under the nail, cut it or drain the infection as it can make your condition worse. Your nails need proper nourishment to remain healthy. This is the reason why applying an ointment will provide relief to the infected area and also prevent the infection from spreading any further.

How long does it take to recover?

It usually takes maximum 21 days to recover.

What is the price of the treatment in India?

The price of treatment ranges between Rs.100 to Rs. 1,000.

Are the results of the treatment permanent?

The results of the treatment is not permanent, hence fluconazole is used as a suppressive therapy in such cases. Relapse rate is quite high even though there has been growth of a new nail, hence proper hygiene needs to be maintained. Make sure to have a proper bath and keep your finger and toenails clean.

What are the alternatives to the treatment?

The alternative treatment methods for nail infection is the intake of garlic, food items made from coconut oil, food items made from oregano oil, yogurt, apple cider vinegar. These food items will prevent the recurrence of fungal infections.

Summary: Nail Infection is a common type of fungal infection that starts appearing as a white or yellow-colored spot underneath the nails of fingers or toes. It results in a discoloration of the nail with a thickened and crumbled appearance at its edges. The treatment can be done by the application of antifungal medicines including topical as well as oral and antibiotics as well. Self-care techniques and home remedies are preferred measures for prevention.
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