Fungal toenails are often characterized by discolored, thickened, or deformed nail plates due to fungus infections. Although, many similar looking nails are due to trauma, congenital (birth) changes and other conditions such as drug use, high fever ailments and circulatory problems. The vast majority of fungus nails are asymptomatic or painless and for many, are more of a cosmetic problem than anything else.
Fungal nails are diagnosed through clinical cultures and identification of an involved organism. In most cases, the infection starts at the end of the toenail and progressively involves the remainder of the plate.
The treatment methods available for fungus nails are about as numerous as are the varieties of nails themselves. Oral medications are available but their use is expensive, long term and not without potential hazardous changes to the blood. Before starting oral medications for fungused nails one should have a nail culture to make sure it is fungus we are trying to treat. Laboratory tests to determine liver profiles should be taken prior to starting the medication and again at 6 weeks. Localized reduction and periodic care of the nails are purely temporary and resemble the use of Kleenex in treating the common cold. Although beneficial on a limited scale, this form of treatment is geared toward preventing the condition from worsening. Various types of topical medications are available both over the counter and by prescription, which can be effective. Many patients prefer the use of a topical medication over an oral or systemic drug.
An additional method of treatment that is frequently used is to surgically remove the involved nail plate and treat the underlying fungus infection on the nail bed area. Once the hardened plate is removed, the open exposure allows more effective penetration by topical products and medications. Other methods of treatment, less frequently used, are also available. In short, numerous treatment methods are available for the approach to fungus nails. A primary evaluation and decision must be made as to how serious the problem is to the patient. Whether to treat aggressively or periodically observe the condition are viable considerations for the patient. Fungus nails are frequently perplexing and persistent conditions both from a diagnostic and then a therapeutic standpoint. Perhaps, in the near future, more effective medication will become available which will facilitate the management of this problem.