Treatment of Fungal Nails

August 25, 2014 Posted by Dr.Chang

Toe nail fungus cures can include both oral and topical medication treatments. The gold standard for treating onychomycosis in an otherwise healthy individual is the oral therapy. The most widely prescribed medication today is Terbinafine ( Lamisil – Novartis). Newer oral medications are currently in development and clinical testing. Oral antifungals, like Terbinafine, are very safe medications if properly used. Terbinafine tablets has adverse response rate of less than 3 percent. Typically, the dosing for Terbinafine is one tablet per day for three months. Blue Ridge Foot and Ankle Clinic will take blood test to verify norFungus2mal liver function prior to starting this medication.

Dr. Murray and Dr Chang may also take a sampling of the nail and have it lab tested to confirm that it is true nail fungus. Visual inspection is adequate to make a diagnosis, but when uncertain or as required by insurance companies’ lab confirmation may be required. Sometimes a thickened nail is nothing more than hyper-keratinization of the underlying nailbed from repeated trauma. Nail thickening alone does not automatically make an Onychomycosis diagnosis. However, a thickening nail from thickened skin and repeated trauma makes is a good focal point for fungus to establish.

In addition to oral mediation, at the Blue Ridge Foot and Ankle Clinic we will also use topical antifungal medications to treat the infection from the outside. We also have very effective regimens of topical treatments which does help to reduce the fungal infection of the nails and help prevent this aggressive condition from getting worse. When attempting topical therapy, serial aggressive nail debridements by your podiatrist are recommended to enhance the outcome.

The best way to use topical medication is to see a foot specialist who will thin down and cut away as much of the diseased nail as possible (a painless procedure), so that the topical medication will penetrate to the live fungus more readily. The topical medications then are applied once to twice a day by the patient. The nail has to be maintained or kept thin on a regular basis. Depending on the degree of fungus this process can take upwards of a year for new healthier nail to grow out. We have seen some very gratifying results with the combination of oral and topical medication.

Laser treatment of toenail fungus is becoming more common. Laser treatment is indicated and recognized by FDA for temporary clearing of toenail fungus. It is not a covered by nearly all medical insurance companies and can be very expensive. The doctors at Blue Ridge Foot and Ankle Clinic do not advocate this form of treatment for toenail fungus.

As with any medial condition, there sometimes there can be unsuccessful results using either topical or oral medication but it is important to follow all of the directions for the best results possible. The outcome will often be dictated by the severity of the condition upon initiation of treatment. Returning toenails to a perfect pristine state is nearly impossible. Making toenails less ugly, less discolored, less thick and fungus free is an obtainable goal. 

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Blue Ridge Foot and Ankle Clinic
887 A Rio East Court Charlottesville, VA 22901
434-979-8116
 417 South Magnolia AveWaynesboro, VA 22980
540-949-5150
 

Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.

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