Spring is right around the corner and that means getting your feet ready for sandals and flip flops. If you haven't looked at your toenails all winter it may be a good time to take a look and see if they are at all discolored. If they are this blog will give you a nice road map on our evaluation and treatment for fungal nail better known as "Onychomycosis."
The first step would be at home if you have nail polish take it off and see if you notice any differences between the toenails. Look for any yellow discoloration in the nails or increased thickness. If you do notice any pain or nail color changes it may be a fungal infection, bleeding under the nail plate, or ingrown toenail.
During your evaluation our Doctors will evaluate if you have a fungal infection is typically diagnosed clinically but a culture of the nails can be sent off for evaluation. Trimming and filing of the nails is a painless approach to clearing some of the fungus. If you have an ingrown toenails we have experienced foot specialists who first and foremost ease any anxiety that our patients have if they need a procedure. Once the toe is anesthetized we consider our nail procedure "virtually painless."
Oral medication such as Lamisil is a good option if the fungus is in the nail root and patients are not take any cholesterol medication or multiple medications. We screen our patients carefully for this medication and obtain a Liver function test before treatment and one month into the three month course of the medication. Typically results are seen within the first thee to four months on using oral Lamisil.
We have a FDA approved topical Medication in our offices called Clear nails which is applied topically once to twice a day to toenails in which Lamisil is contraindicated or our foot specialists believe that topical would be a better option for treatment. Prescription topical Penlac is another option for topical application. The newer topical Medication called Jublia (efinaconazole) is on the market but our foot specialists have limited experience with this medication being so new and are uncertain of the long term results vs topical Clear Nails and topical Penlac. We have written a few prescriptions for this medication but it has been averaging at this point $400 with private pay insurances we will look further into this with local pharmacies. Compounding pharmacies can also make topical antifungal medications as an option as well. We sometimes recommend oral biotin to increase strength of toenails and vicks vapor rub to help soften thick toenails that are difficult to trim.
For more information please refer to our website at carolinafootspecialists.net