Eastry Chiropody

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Fungal nail infection

Posted by Zsuzsanna Snarey on May 11, 2013 at 9:45 AM

Fungal nail infection (onychomycosis or tinea unguinum) is caused by an organism, a fungus called dermatophyte which is able to metabolise keratin, the constituent of skin and nails, and so to grow and multiply in the skin and nail. Once these fungi have established themselves it is very difficult to get rid of them.

The infected nail becomes thickened and often quite brittle, it takes on a brownish-yellow colour and eventually develops a 'worm eaten' porous appearance.

The causes are found in failing to maintain good foot hygiene, sweaty feet, walking barefoot in communal showers, not drying the feet properly and wearing trainers.

Treatment involves topical fungicides for mild cases, such as used for athletes foot, after the nail has been thinned or cut away by the chiropodist so that the medicament can be applied directly to the effected area. The treatment should be continued for up to three months after the infection is cleared in order to prevent reinfection.

Tablets for fungal nail infection in the past have been known to cause unpleasant side effects. However recent evidence shows that Terbinafine is effective with no reported side effects if taken for 6-8 months depending on the severity of the infection and is the treatment of choice for adults.  

Amorolfine, marketed as Loceryl is available as a varnish. Tioconazole is available as Trosyl to be applied to the nail plate. Unfortunately success rates for both these preparations have been disappointing.

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