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Published May 03, 22
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It is also advisable to contact a podiatrist if a person notices any discoloration, thickening, or abnormality of the toenails. Furthermore, people at higher risk for complications should seek medical treatment for their toenail fungus and avoid home remedies altogether. This includes those with diabetes or with weakened immune systems.

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While some options may help temporarily suppress milder infections, they are unlikely to treat the infection. Instead, people should use prescription-strength oral and topical antifungal medications. It is also important for people to take care of their feet and maintain good foot hygiene. A person should contact a doctor if they have any doubts about treatments, their infection is not clearing, or they have underlying conditions, such as diabetes..

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Ciclopirox products are usually applied every other day in the first month, at least twice a week in the second month, and once a week starting from the third month. With both treatments, the old layer of polish has to be removed using an alcohol swab before applying the new layer.

Newer ciclopirox nail polishes are water-soluble. They are applied daily, and the remaining polish is removed using water before each new application. Sets with creams and a nail scraper, Treatment sets that contain two creams and a nail scraper (spatula) can also be used for the topical treatment of nail fungus:One cream has urea in it, which softens the nail so it can be removed.

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For this treatment, the affected toe or finger first has to be soaked in warm water for ten minutes and then dried. After that, the urea-based cream is applied to the nail, and the nail is covered with an adhesive bandage. After 24 hours, the bandage is removed and the toe or finger is held in warm water again.

This treatment is carried out over 14 days. Once the infected part of the nail has been scraped away completely, the skin beneath is treated for another four weeks with a bifonazole cream. How effective are topical treatments? So far, only a few studies have looked into topical nail fungus treatments with nail polishes or creams.

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Also, the fungal infection returned in many participants, so it’s likely that neither of the two treatments can increase the chances of getting rid of the fungus in the long term. People did not take part in the study if their fungal infection covered more than half of the affected nail area or if the infection started at the base of the nail.

They are all prescription-only. Terbinafine and itraconazole are typically used for this purpose. Terbinafine is preferred if the nail fungus is caused by a skin fungus (dermatophyte). This is usually the case. Itraconazole is generally used if the nail infection is caused by yeast or mold. Itraconazole and terbinafine tablets can both be taken either continuously or with breaks between treatments.

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In treatment with breaks, the medication can be taken as follows:500 mg terbinafine (2 tablets) daily for a week, then a three-week break, Or: 250 mg terbinafine (1 tablet) daily for four weeks, then a four-week break, Even in this approach, the treatment typically doesn't take any longer than three to four months.

The dose is then 200 mg per day (two 100 mg tablets). In treatment with pauses, 400 mg of itraconazole is taken daily for a week (two 100 mg tablets in the morning and two in the evening). That is followed by a three-week break in treatment. This treatment also lasts three months or less.

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It is taken once a week (dose: 150 mg). But fluconazole has to be taken for about 6 to 12 months to work properly. How effective are tablets in treating nail fungus? Tablets for the treatment of nail fungus have been tested in several studies. All participants had an infection on their toenails caused by a skin fungus.

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One year after a three-month treatment with terbinafine:About 17 out of 100 people who didn’t have this treatment no longer had a detectable fungal nail infection. About 76 out of 100 people who had this treatment no longer had a detectable fungal nail infection. In other words, the treatment with terbinafine got rid of the fungal infection in about 59 out of 100 people.

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After one year,7 out of 100 people who didn’t have this treatment no longer had a detectable fungal nail infection. About 43 out of 100 people who had this treatment no longer had a detectable fungal nail infection. In other words, the treatment with itraconazole got rid of the fungal infection in about 36 out of 100 people.

They confirm that terbinafine is somewhat more effective than itraconazole. Treatment with breaks is thought to be about as effective as continuous treatment. But that has only been looked into in a few studies. What side effects and drug-drug interactions do the tablets have? The possible side effects of itraconazole include headaches, dizziness, stomach and bowel problems, and rashes.

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Overall, terbinafine has far fewer drug-drug interactions than itraconazole. Nevertheless, it’s still important to tell your doctor if you are taking any other medication. As a precaution, this medication should not be taken during pregnancy or if you are breastfeeding. The studies only rarely reported on how often the different side effects occurred.

When are the different treatments considered? Most doctors recommend treating nail fungus with nail polish or cream ifnot much more than half of the nail is affected by the fungus,the base of the nail is not infected, andonly some nails are affected. Topical treatment is also usually recommended for children.

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Another reason is that children have thinner nails that grow more quickly, so it’s assumed that treatment with nail polish or creams is more likely to work in children than in adults. White superficial onychomycosis is also often treated with a nail polish or cream. If several nails are infected by the fungus, or if the infection has spread out more on the affected nails, it’s usually necessary to take oral medication.

Additional treatments, If the fungal nail infection is severe, tablets can be used in combination with nail polish or cream. For example, if the nail is very thick, urea cream can be used (in addition to taking tablets) to gradually remove or partially file off the affected nail. Combining these treatments may also be an option if there are large collections of fungi beneath the nail.

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If the nail is filed off, it’s important to ensure good hygiene and disinfect the area, because the removed nail tissue could contain infectious fungal spores. Sometimes people with a fungal nail infection are offered laser treatment. This involves shining infrared or ultraviolet (UV) light on the nail in order to kill the fungi.

Because statutory health insurers in Germany don’t cover the costs of this treatment, people have to pay for it themselves. Which treatment is right for me? Nail fungus is usually harmless. But many people find discolored or thickened nails unpleasant to look at and want to get rid of the fungus as soon as possible.