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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery

Written by Dr. Ringpfeil

Nail Fungus (Onychomycosis)

nail fungus

Onychomycosis is a fungal infection of the nail. Either fingernails or toenails can be affected but the condition is more commonly seen in the toenails. People become aware of the condition because of the altered appearance of the nail or multiple nails. The nail can become yellowed, crumbly, thickened, lifted up from the nail bed or debris can be seen beneath the nail.

DIAGNOSIS

A definitive diagnosis is made by clipping a portion of the affected nail and sending it to the lab for analysis. Other clues to the diagnosis include rash on the feet or between the toes consistent with athlete's foot (tinea pedis). Longstanding athlete's foot infection can put individuals at risk for toenail fungus. Fungal infection of the skin of the hands (tinea manuum) can also be associated with onychomycosis of the fingernails.

TREATMENT

One of the most efficacious treatment options is treatment with an oral antifungal medication such as Lamisil. Fungal infection of the toenails requires treatment for a period of three months; fungal infection of the fingernails requires treatment for six weeks. Since the oral antifungals are metabolized through the liver, blood test monitoring of liver function is recommended when treatment for more than six weeks is required.

Another promising treatment alternative with a high percentage of effectiveness is treatment with the PinPointe laser. This laser can be found at some podiatrists' offices.

Topical treatment with antifungal solutions and creams is also available but treatment success is low and daily treatment for many months is required.

All treatments are hampered by the high recurrence rate for fungal nail infection. Even if treatment protocols are strictly followed and nail fungus is eradicated, there is a good chance that the problem will recur.

COPING

The dystrophic appearance of toenails infected with fungus can be improved through the use of topical keratolytics such as urea and by having the thickened nails filed down professionally by a podiatrist.

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What WE DID WELL

(Answers:674)

Dr. Ringpfeil's professionalism as well as her wonderful bedside manner.

#12021-01-12

from the minute I walked the reception was wonderful and I saw my doctor very quickly... very little waiting.

#22021-10-06

the doctor was very clear about treatment options, answered all questions thoroughly and was easy to relate to...no doctor/patient distancing.

#32020-11-22

I thought everyone was very professional and nice.

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How kind and attentive both Linda and Jenny were. I did not feel rushed and I did not feel pushed into buying products, which were two reasons I left the last practice I was using.

#52011-04-14 11:05:49

the doctor was very clear about treatment options, answered all questions thoroughly and was easy to relate to...no doctor/patient distancing.

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The doctor was friendly and very thorogh -- I didn't feel rushed.

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What can we do better?

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Everthing was excellent

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Improve the movement of the mouse on its pad.

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Maybe some more magazines for the guys. I`ll bring a few in...

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This visit was great.

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more availability for appointments.

#102020-11-23
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