How do I Treat Toenail Fungus?
Toenail Fungus Part 2
The most important thing to recognize about treating nail fungus is whether you are treating the symptoms of the fungus or the actual fungal infection. This episode talks about treating the SYMPTOMS of the fungus. Symptoms of nail fungus include pain, nail deformity, or ingrown toenails causing cellulitis or skin infection. Each of these can be treated differently.
Treating Symptoms of PAIN and DEFORMITY:
A podiatrist can use nail nippers and/or a mechanical tool with a sanding bit on the end to remove superficial nail damage:
Sanding Bits:
On Topical Antifungal Medication:
I am not impressed with the data on topical antifungal treatments. The only FDA approved topical medication for years (Ciclopirox/Penlac) only has a 6-7% effective rate and needs to be applied daily for at least ten months and removed weekly. In my opinion, it builds up horribly on the nails and looks awful. Think of it this way—its failure rate is 93-94%. I do not currently recommend any topical medications to CURE fungus. Tea Tree oil and Vicks do not cure nail fungus. Vicks may soften the nail— like 40% urea I describe below, and can be used for symptom relief (not a cure). But it doesn’t have the data of Urea 40, which is used like this:
Using Topical Therapy to control pain:
There is a research-proven effective debridement technique you can do at home. The standard for home debridement is to use a 40% urea cream or ointment (such as Urea 40 on Walmartdotcom). The following home treatment should be done at bedtime nightly until you see results:
Apply regular petroleum jelly to the skin surrounding the nail as a buffer.
Apply the 40% urea cream or ointment to the nail itself.
Occlude the nail (this typically means covering the nail with a light layer of plastic wrap or an adhesive bandage like a Bandaid) and keep it in place overnight by wearing a sock or perhaps securing with medical grade tape. Please be careful not to strangle your toe and perform your own amputation. That kind of thing is best left to ranchers gelding sheep or cattle. So, nothing tight around the toes please.
Sleep with your dressing on and remove it in the morning. Wash the foot with soap and water and hopefully find the nail beginning to easily flake off in layers with your own home nail cutting equipment.
Do this nightly until you can debride your nails down to a manageable shape or height. If this doesn’t relieve your pain, or this process doesn’t appeal, or you have serious underlying health conditions such as diabetes or poor circulation, please see your podiatrist and avoid self-care.
What to do if you Nail Fungus causes CELLULITIS or Skin Infection:
Skin infection, or Cellulitis, needs to be diagnosed by an examination from your medical professional. If two or more of these signs are present, see your podiatrist or family doctor for care ASAP. If a skin infection pr cellulitis is present, it usually involves two or more of these symptoms:
Pain
Redness
Swelling
Odor
Drainage
Increased Warmth. In worse cases, you may get a fever, which is a very dangerous sign. When infection starts, the skin where the infection is will feel feverish to touch.
It only takes two of these symptoms to be present to suspect skin infection. If your doctor diagnoses you with a skin infection, you will likely be prescribed an oral antibiotic, or have the toenail or part of the toenail removed, or sometimes BOTH.
As always, I am reminding you that I am NOT your doctor. I am helping you understand your body so you know when you might NEED a doctor. Please see your local podiatrist if you have any questions and to seek medical treatment, if needed.