Fungal infections
Onychomycosis (onchyo = nail, mycosis = fungus) is an infection of the nail plate by one or more types of fungus. The same or similar organisms may also affect the skin of the foot causing a rash and itch. This is called tinea pedis or "athlete's foot". An affected nail will appear discoloured, either white, brownish or yellow, and may be thickened, flaky and chalk-like. The thickened nail may become painful due to pressure from shoes.
Persistent, long-term fungal infections may be treated by taking a 3 month course of oral medication which can only be prescribed by your doctor. These "Lamisil" tablets are effective in resolving toe nail infections compared to older oral treatments but have some side effects to consider (discuss with your doctor). Oral therapy is the only method by which a fungus which has affected the nail's matrix (the cells it grows from under the skin) can be cleared.
To get government subsidy for the oral therapy ($23.00 for the course) the fungus must be positively identified by a pathologist in a sample of your infected nail. Otherwise the cost of the course is $160.00. Fungal infections of the skin and lesser infections of the nails may be treated by applying a paint, powder or ointment which is available over the counter from the chemist.
In order for the treatment to be effective, topical medication should be applied to nails daily for six months, possibly longer. Skin infections are also treated daily and applications should continue a week or two after all affected areas appear clear. If you have difficulty reaching your feet to apply an antifungal directly, an antifungal spray may be applied twice daily. Loceryl is a antifungal agent in a "nail polish" like base and it is applied weekly. Unfortunately, Loceryl costs $120.00 for the treatment kit unless you are covered by the Department of Veteran's Affairs when a prescription from your doctor will reduce the cost.
Having nails debrided periodically by your podiatrist can reduce the nail thickness and remove infected nail pieces. This helps reduce the discomfort and risk of further spread associated with fungal nails. It also helps to remove residual antifungal paints and facilitate entry of the medicament into the nail plate.
Topical Treatments for nails include:
Tea Tree Oil (100% in spirit or pure)
Daktarin Paint
Gordochom
Canesten Paint
Whitfield's Ointment
Lamisil Gel
Loceryl
