Nail Fungus

Deciding on which method you will want to treat nail fungus with can be confusing as a patient. ” Should I take the pill, I hear it is unsafe”. “Do the polishes and creams really work”. “what about those lasers?” Yes you are faces with decisions that require a lot of information. Also cost is very important for you. So What to do. First of all , treating nail fungus otherwise known as onychomycosis is not just a cosmetic thing. Many diabetics with fungal thickened nails are at higher risk for toe and foot infections which can lead to amputations. I have many patients that can not fit their feet into shoes because of the nails being so thick. That alone is an excellent reason to have it treated.

One thing i have found is it is very important to send the nail off for a culture to see if it really is fungus. There are many other nail conditions that can look like fungal nails but are something else. There are even instances of nail bed cancers (subungual melanoma) that have been confused with fungal nails. Once the nail culture is identified as positive for nail fungus then you can have it treated.

Treatments are tailored to the individual and their full medical profile . The terbinafine pill has been shown to have very good outcomes. In a study by Darkes terbinafine was shown to have a 81% cure rate by 16 weeks. Lasers have not shown such numbers in evidence based studies. There are no double blind studies showing cure rates and no studies showing recurrence rates with lasers.The terbinafine pill can have side effects. The biggest concern is about the liver. The simple answer is that in 15 years of writing for terbinafine I have had zero patients with elevated liver enzymes after taking terbinafine. A liver enzyme blood work exam is performed and if it is high then one can not take the medicine. I have had patient stop the terbinafine from upset stomach and loss of taste in their mouth but no liver issues.

If one can not take the pill there are some excellent medicines that are topical . The key is to recognize it can take six to nine months for a new nail to grow in. So you will not see results for a good couple of months.

Nail fungus is treatable , so don’t wait.