DERMATOLOGY SOCIETY OF SOUTH AFRICA

For Patients

Nail Fungal Infection

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A common disease1 :
clear results in
nail fungal infections
 
 
Speak to your Doctor, Podiatrist or Pharmacist for more information on Topical Treatment for Nail Fungal Infections
 

Fungal infections are the most common infection of the nails, representing about 18-40% of all nail problems. It is more common as people get older and is found to be more common in men than in women.

Fungal infections of the nails (onychomycosis) occurs on average in up to 8% of the general population but can be much higher in diabetic patients and regular swimmers. As the rate of nail growth decreases by 0.5% per year, elderly patients are particularly vulnerable.
 
The following factors are known to increase the risk of
People acquiring nail fungal infections1: (in order of importance)
 
Trauma (injury)
Bone and joint disease
Sport
Diabetes
Obesity
Vascular disease (disease affecting
the blood vessels and circulation)
Onychomycosis most commonly affects the toenails
(7 to 10 times more frequently than the fingernails) and is often ignored. The nail of the big toe is particularly commonly affected up to 92% of the time.1
 
A true medical problem1
Fungal infections are responsible for symptoms such as pain and discomfort during walking in half of the patients affected, general discomfort and pain in another third and in 10% of cases, professional or other activities are restricted. Progressively it can affect your quality of life as the condition deteriorates. It is important to realise that the infection will get worse if it is left untreated. It is important to recognize the benefits of early diagnosis and effective treatment.
 
Types of fungal nail infections (onychomycosis)1:
  • All cases of onychomycosis are the result of a fungal infection caused by either dermatophytes (a special type of yeast), yeasts or moulds.

  • Fungal infections are generally separated between those without matrix
    involvement and those with matrix involvement. See diagram to the right.

  • Once the fungal infection has involved the nail matrix it becomes much
    more difficult to treat effectively. By treating the problem early, you improve the chances of success and reduce the cost.
Examples of Nail Fungal Infections
 
 
How to treat Nail Fungal Infections (Onychomycosis)
Ask your GP, dermatologist, podiatrist, or pharmacist for advice.

  • In cases that do not involve the nail matrix (nail bed), or where less than 80% of the surface area of the nail is affected, direct treatment on the nail (topical) is usually indicated.4

  • The advantages of topical treatment are rapid absorption through the nail plate to the nail bed, (NB: Your nail does not have to be removed), low risk of side effects compared with oral medications, high cure rate and the reduced cost

  • If the infection has progressed further to involve the nail matrix, or if there are more than 3 nails affected, your doctor may prescribe oral medication in combination with a topical treatment which are usually prescribed.

  • The chances of cure are significantly improved when oral medications are used in combination with a topical treatment.2,3

  • It is important when treating fungal infections to always complete the course of treatment, even when you may feel the infection has been cured.

  • Fungal infections of any type have a nasty habit of reappearing. It is important to continue with your treatment as prescribed.

  • As the infected nail needs to be replaced by new healthy nail growth and a nail grows at a slow rate, this can take up to 6 months for fingernails, and 9 - 12 months in toenails.