Fungal Toenail
Description:
A fungal toenail occurs when the nail is lifted from the underlying skin allowing the fungus to get under the nail and grow creating a white, yellow, green, or even brown coloring. A fungal nail infection can arise from cutting the edges improperly, tight fitting shoes, trauma, or ingrown toenails.
They are often associated with other foot conditions such as:
Pain ranges from dull to sharp, depending upon the level of irritation and compression of the nail.
Treatment: Conservative Care
| Shoes: | A larger, softer shoe can relieve the direct pressure or pressure from adjacent toes. Make sure that the shoe has enough room at the end about the width of your thumb and that the toe box (front of the shoe) is high enough to allow your toes to move freely. |
| Trimming: | Cutting the nail edges straight across without cutting the corners will prevent ingrown edges. If the nail is ingrown, over grown or thick, it can be reduced with a file at home or by a professional to temporarily relieve the pressure. |
| Padding: | There is an array of over the counter pads that can be placed between the toes or behind the painful nail to relieve pain associated with shoe pressure. |
| Medication: | Anti-fungal medication can be applied directly to the nail (topical creams, gels, solutions). Oral anti-fungal medication will kill the fungus at the nail root, but laboratory tests are needed to assess liver function. |
Surgical Options:
The nail can be removed to relieve the pressure and infected tissue. Topical medication is then applied until the nail completely returns. If the nail thickness and pain persists, a chemical can be applied to the nail root and prevent the nail from returning. The procedure is performed in the office with local anesthetic or occasionally at an out-patient facility under sedation (e.g. young children, anxiety, bone infection). Full weight bearing is allowed immediately without restrictions.
