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Coping with Illness

Toenail Fungus

It’s ugly and persistent! Here’s how to cope

Embarrassed to wear sandalsbecause of toenail fungus? You’ve got plenty of company—35 million Americans have the condition, and the older you get the more susceptible you are.

“Toenail fungus is not attractive,” says podiatrist Scott Lipkin of Lehigh Valley Hospital and Health Network. “The nail thickens, turns yellowish or brownish, and may get crumbly, warped or even detached.”

Fungus thrives in the dark, humid environment inside shoes, Lipkin says. Once it sets up housekeeping, it tends to colonize neighboring toenails. The condition isn’t serious for healthy people, but if you have a compromised immune system or poor circulation from diabetes, see your physician.

The best treatment is always prevention:
  • If your feet perspire, change socks often and use an anti-fungal powder daily.
  • Treat an outbreak of athlete’s foot aggressively with anti-fungal cream—athlete’s foot is often the precursor to infected toenails.
  • Avoid walking barefoot at public pools and showers.
  • Avoid trauma to the nailbed by keeping your toenails short and wearing shoes that give your toes wiggle room.
  • Avoid toenail polish and artificial nails, which can trap moisture.
If you do get an infected nail, treat it quicklyfor the best results, says Lipkin’s colleague, registered pharmacist Jay Needle. “People try all sorts of over-the-counter treatments including anti-fungal creams, tea tree oil, even Vicks Vapo-Rub. Topical creams rarely succeed because the infection is below the surface. Whatever remedy you choose, persist with it a couple of times a day for about nine months.”

The most aggressive way to fight toenail fungus is with an oral prescription drug such as terbinafine or itraconazole. “A course of treatment can cost up to $900,” Needle says, “and health insurance may or may not cover it.” If you go this route, you’ll need periodic blood tests to monitor for possible side effects including liver damage.

"Instead of prescribing daily pills for three months," Needle says, "some doctors now recommend a potentially less toxic, intermittent approach. You take the pills one week a month over a longer period of time."

Want to Know More about caring for your nails and preventing toenail fungus? For guidelines from Lehigh Valley Hospital’s Youthful You Institute, click here.


This page last updated 2/12/08 04:08 PM
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Lehigh Valley Hospital has campuses in Allentown and Bethlehem, Pa. and serves the Pennsylvania communities of Easton, Doylestown, Quakertown, Hazelton, Lehighton, Perkasie, Pottstown, Pottsville, Reading, Scranton, Wilkes Barre, Stroudsburg, and the Poconos and also Phillipsburg and Flemington, N.J., and western New Jersey. You don't have to travel to Philadelphia or New York for quality health care.

 
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