Nail fungus treatment

Prescription nail fungus:

This is where the prescription drugs come in and this is also why you need to take these for a long time (basically as long as it takes a whole nail to grow out).

Before you see a doctor for your nail fungus problem you need to be aware of a few things to do and don't in the weeks leading up to the appointment - to get the diagnosis right.

It is important for the treatment to get the right diagnosis as there are other diseases similar to nail fungus. These can be just normal nail damages, wear and tear for some reason or in some cases psoriasis.

The idea behind the treatment (getting rid of tonail fungus) is that a new nail - unaffected by the fungus - will grow out and replace the old one. For this to happen, it is necessary that the new nail contains something to reject the nail fungus as the new nail is in contact for a long time with the old and infected part.

Nail fungus - seeing a doctor

A doctor or a specialist will be able to diagnose finger- or toe nail fungus from a sample taken from the nail. There are a few guidelines which no doubt your doctor will tell you about when you make the appointment - but we will list them here as well as general information on the nail fungus treatment and diagnosis.

It is important to avoid any self-treatment (creams etc) and not to use varnish the week before your doctors appointment as these things can affect the sample and create a risk of wrong diagnosis. It is also a good idea not to trim your nails the week before your appointment as your doctor will need enough material for the sample.

You should not use any anti-fungal cream for at least 4 weeks prior to your doctors appointment because residues of this could interfere with the sample he will take for further analysis.

Prescription drugs for fungal nail (toenail and fingernail) treatment

The most common active ingredient is terbinafine, used in Lamisil and other well known drugs for treatment and cure.

Other active ingredients are itraconazole and griseofulvin. There are studies pointing towards a better success rate with the terbinafine based drugs - although the success rate is not very impressive in any case.

Some of the available (presciption) drugs are (the active ingredient stated before the name):

• Terbinafine Lamisil
• Terbinafine Actavis
• Terbinafine Alpharma
• Terbinafine Copyfarm
• Terbinafine Galderma
• Terbinafine Hexal
• Terbinafine IVAX
• Terbinafine Merck NM
• Terbinafine Nordic Drugs
• Terbinafine Ratiopharm
• Terbinafine STADA
• Itraconazole Merck NM
• Itraconazole Sandoz
• Itrakonazole Actavis
• Itrakonazole STADA
  

Prescription tablets (like Lamisil) are used for 3 months and it has approximately 50% success rate. Unfortunately there is a very high risk (90%) that your toe nail fungus will come back after treatment.

Varnish, creams for fungal nails

Using the prescription varnish (Loceryl) has a better success rate and a lower risk of recurrance but the treatment is longer and not easy. Creams and tablets are often used together (Lamisil etc) and need to be used daily for 3-6 months or even longer. Skin only infections can be cured in a shorter time, typically 1-3 weeks. When the nails are infected as well, it will take longer.

Nail fungus: Prescription drugs

With a more severe fungus infection, it is necessary to treat it with presciption drugs. Unfortunately there are no effective over-the-counter drugs (athletes foot cream etc will not work here, you need more powerful stuff).

If you have a surface nail infection, covering less than half the size of the nail, there is a prescription nail varnish available containing amorolfin (Loceryl). It will only work if your nail has not started to get thicker. Treat the infected nail once per week for 6 months (finger nail fungus) or 12 months (toe nail fungus).

There are also several creams available for supporting treatment, the common denominator is that they contain imidazols. Trade names are Mycosporan, Canesten, Daktar, Pevaryl, Terbinafine (Lamisil) etc.

In the severe cases, the varnish will not be enough. This will leave only prescription tablets or capsules. The most common active ingredient (found in Lamisil etc) is terbinafine, which works by interfering with the protective membrane surrounding the fungal cell. After long enough exposure to the drug, the fungus cannot grow and the infection will die out. Lamisil is the best known of the prescription drugs against nail fungus.

Nail fungus treatment side effects

When using Lamisil and other prescription tablets against toenail (or finger nail) fungus, there are unfortunately side effects. One common problem is stomach pains. Skin damages can be quite severe, there is also a risk of liver damage. Although there are clinical studies of Lamisil tablets showing the side effects to be rare and typically rather mild - these effects can still be a problem. When using Lamisil tablets (or any of the other prescription tablets against nail fungus) it is important to watch out for the signs of liver problems - fatigue, vomiting, yellowing of skin and eyes, darkening urine or very light colored stool. With Lamisil (etc) cream, there is lower risk of side effects as it is only applied locally.

Before deciding to use prescription tablets against nail fungus, it is important to weigh the problem itself (tonail funghus) agains the possible side effects and in many cases it can be wise to just avoid treatment and focus on avoidance and stopping it from spreading, it is not a dangerous condition after all.