Onychomycosis Health Article

Alternative treatment

For controlling onychomycosis, as opposed to curing it, some experts advocate using Lotrimin cream, available over the counter. The cream should be thoroughly rubbed into the nail daily in order to control the infection.

In general, nutrition may also play a role in promoting good nail health and thus preventing nail disease. Adequate protein and minerals, in the form of nuts, seeds, whole grains, legumes, fresh vegetables, and fish, should be consumed. Sugars, alcohol, and caffeine should be avoided. Certain supplements may also be beneficial, including vitamin A (10,000 IU per day), zinc (15–30 mg per day), iron (ferrous glycinate 100 mg per day, vitamin B₁₂ (1,000 mcg per day), and essential fatty acids in the form of flax, borage, or evening primrose oil (1,000–1,5000 mg twice daily).

Herbal remedies may also relieve some of the symptoms of onychomycosis. A combination of coneflower, oregano, spilanthes, usnea, Oregon grape root, and myrrh can be used as a tincture (20 drops four times daily).

Undiluted grapefruit seed extract and tea tree oil are also said to be beneficial when applied topically to the infected nails.

Prognosis

Onychomycosis is typically quite difficult to cure completely. Even if a clinical cure is achieved after long therapy with either topical or oral drugs, normal regrowth takes four to six months in the fingernails, and eight to 12 months in the toenails, which grow more slowly. Relapse is common, and often, the nail or nail bed is permanently damaged. For toenails infected with onychomycosis, terbinafine seems to offer the highest cure rate (35–50%). Itraconazole cure rates typically range from 25–40%, and those with fluconazole, which was recently approved in the United States, have not been documented by long-term trials

Prevention

Keeping the feet clean and dry, and washing with soap and water and drying thoroughly are important preventive steps to take to prevent onychomycosis. Other preventive measures include keeping the nails cut short and wearing shower shoes whenever walking or showering in public places. Daily changes of shoes, socks, or hosiery are also helpful. Excessively tight hose or shoes promote moisture, which in turn, provides a wonderful environment for onychomycotic infections. To prevent this, individuals should wear only socks made of synthetic fibers, which can absorb moisture more quickly than those made of cotton or wools. Manicure and pedicure tools should be disinfected after each use. Finally, nail polish should not be applied to nails that are infected, as this causes the water or moisture that collects under the surface of the nail to not evaporate and be trapped.

PERIODICALS

Harrell T. K., et al. "Onychomycosis: Improved Cure Rates with Itraconazole and Terbinafine." Journal of the American Board of Family Practitioners (July-August 2001):268-73.

Scher Robert K. "Novel Treatment Strategies for Superficial Mycoses." Journal of the American Academy of Dermatology (1999).

ORGANIZATIONS

American Academy of Dermatology. 930 N. Meacham Road, PO Box 4014, Schaumburg, IL 60168-4014. (847) 330-0230. Fax:(847) 330-0050. <http://www.aad.org>.

OTHER

<http://www.nailfungus.org/about.html>.

<http://www.emedicine.com/derm/topic200.htm>.

Liz Meszaros

KEY TERMS

Curette—Spoon-shaped instrument for removing debris, growths, or infected nail matter.

Dermatophytes, yeasts, and nondermatophyte molds—Three types of fungi responsible for fungal infections of the nails.