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Will toenail fungus go away without treatment?

Dr. Kline & Green Team
30 October 2019
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Will toenail fungus disappear on its own? The short answer, No.

Your immune system cannot defeat and eliminate a fungal infection such as onychomycosis without help. Left untreated, toenail fungus can infect the nail bed and enter the bloodstream with, in the most severe cases, life-threatening results. Untreated toenail fungus often results in cracks in nails and skin, which may invite cellulitis, a dangerous bacterial skin infection characterized by redness, swelling, and pain in the lower leg. Serious infections may even require surgical nail removal in order to treat the fungal infection. Fungal spores are stubborn and resourceful. They stay viable by eating keratin, the plentiful stuff of your skin, hair, and nails.

The American Podiatric Medical Association and The American Academy of Dermatology offer good practical advice about treating toenail fungus, including information about any side effects and risk factors that may arise from secondary skin infection or the presence of other medications and health issues.

How did I get a toenail fungus infection?

There are circumstances that may leave you particularly susceptible to a fungus infection. Age is certainly a factor, and older people with poor circulation to the feet or who have diabetes are at heightened risk. In general, everyone should be vigilant about foot protection in environments that nurture fungi, such as locker rooms, swimming pool areas, and public showers. Get in the habit of wearing shower shoes or flip-flops – and wash and disinfect them thoroughly when you get home. The absence of infection will be your proof that good foot hygiene habits work.

If you suspect you have a toenail fungus infection, your first course of action should be to see your doctor, who will diagnose the type and severity of the infection and the best course of treatment, up to and including blood tests. Your doctor may also refer you to a dermatologist or podiatrist. There are many oral and topical treatment options available and your health care professional will prescribe the most effective to address your fungal infection. One possibility of many is laser treatment, which has proven safe and effective against most cases of toenail fungus. Clear nail growth has been shown to emerge after the first laser treatment session.

Symptoms of fungal nail infection

Symptoms of fungal nail infection are hard to miss, but sometimes easy to ignore. Nail discoloration may be your first alert. Look also for white or brownish spots on the nail, brittle or crumbly nails, distorted shape, debris build-up under the nail; or a foul odor. If home remedies and self-care practices produce no improvement, see your doctor. If you have diabetes, see your doctor right away.

Frequently prescribed medications

Toenail fungus (onychomycosis)and athlete’s foot (tinea pedis) are sturdy and often persistent fungal infections. Both are treatable, but toenail fungus may require the most patience, because you’ll only be able to see good results emerge first at the base of the nail. Toenail growth is slow, and complete regrowth of a healthy new nail will take over a year.

There are good oral antifungal agents and topical medicines available by prescription to treat onychomycosis and dermatophyte infection. Lamisil (terbinafine), Diflucan (fluconazole) and Sporanox (itraconazole) enable new nail growth free of infection, slowly replacing the infected nail. Typically, you’ll take these medications for from six to 12 weeks, but won’t see the outcome of treatment until the new nail has completely replaced the infected nail. The US Food and Drug Administration (FDA) has approved the following medicines that you apply directly to the nail to treat nail fungus: Amorolfine, Ciclopirox, finaconazole, and Tavaborole.

Home remedies and good foot hygiene

Over-the-counter and home remedies can be effective against mild cases of athlete’s foot and toenail fungus. Like prescribed remedies, they require your dedication and patience. Some substances, such as tea tree oil and Vicks Vaporub, may be used as topical medications in the treatment of onychomycosis. Vinegar (acetic acid) also has antifungal properites and Lysol, used in your washing machine, kills athlete’s foot fungus. Baking soda (sodium bicarbonate) or a small amount of bleach in a foot soak act as antifungal agents; and hydrogen peroxide kills fungus and bacteria when it’s dabbed on the surface of the foot. Tea tree oil, mixed with a carrier oil, acts as a surprisingly good antifungal agent. You may use tea tree oil daily on toenail fungus and afterward to prevent reinfection. Whether or not you wear socks, use an antibacterial spray inside your shoes and wash all socks in hot water with bleach or Lysol to kill any fungi. And be sure to wash your feet every day and dry them thoroughly, especially between the toes where moisture often becomes trapped.

Many topical over-the-counter antifungal powders and antifungal creams, ointments, solutions, and lotions are readily available: butenafine hydrochloride, clotrimazole, miconazole nitrate, terbinafine hydrochloride, tolnaftate, and medicated bar soaps are generally safe to treat mild-to-moderate fungal skin infections and may help prevent their spread to toenails from the skin.

Is it safe to get a pedicure if I have onychomycosis?

A pedicure will cause no further harm if you already have a fungal nail infection. Some professional pampering may even make you feel more relaxed about yourself and your foot hygiene during the long process of eliminating a toenail fungus. It’s a good idea to tell the nail salon about your fungal infection before you arrive. That way, they’ll be prepared to carefully disinfect the tools used on your nails. Don’t be embarrassed. They see a lot of foot fungus. Some salons may request that clients bring their own nail care kit, including nail clippers, trimmers, files, and even a small towel. If you bring your own kit, be sure to clean, disinfect, and thoroughly dry everything when you get home.

Forego nail polish, lacquer, and gel or acrylic nail application while treating your fungal infection. Your nails need time to breathe! All these applied products act to trap fungus beneath the nail and make it worse. It’s also impossible for you to monitor the progress of your nail treatment and new growth.

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