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Terbinafine Tablets from £20
Advice for Nail Infection
Nail fungus is a common infection of the nail and is commonly known as onychomycosis. Many people experience fungal nail infections in the fingers or toes. It is not usually serious but can be unsightly and unpleasant. Fungal infections are caused by the overgrowth of fungi which can be unpleasant and often difficult to treat. Fungi thrive in warm and moist environments so they are able to overpopulate.
It begins as a white or yellow-brown spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, the nail may discolor, thicken and crumble at the edge. Nail fungus can affect several nails. It is very common for people to have a fungal infection on the skin surrounding the affected nails.
There are several different factors that can increase your chances of developing a fungal nail infection including living in a humid environment and smoking. Some people who have certain medical conditions such as diabetes, peripheral arterial disease or psoriasis are more prone to getting fungal nail infections.
If your condition is mild and not bothering you, you may not need treatment. If your nail fungus is painful and has caused thickened nails, self-care steps and medications may help. Fungal nail can be effectively treated by antifungal medication which usually is the best option when nail lacquers and other OTC treatment has failed.
You can help prevent getting fungal nail infections by keeping your feet clean and dry, wearing shoes and socks that are not too tight and not allowing your feet to get sweaty or too hot. Fungal infections can be contagious so don’t share towels or socks with other people and wear flip flops when in gyms or communal showers.
Take special care to monitor the skin and if signs of fungal infection develops on the skin such as itchiness, peeling of skin, or burning develop, you will need to apply a topical antifungal cream.
Symptoms of nail infection usually develop over several hours or days. Sometimes they take longer to develop. Symptoms of nail fungus (both toenails and fingernails) include:
- Pain, swelling and tenderness around the nail.
- Skin that is red and warm to the touch.
- Pus that builds up under the skin. A white to yellow, pus-filled abscess may form.
- Thickening and distortion of the nail – it may change its shape or texture and become difficult to cut.
- Brittle nails – the nail pieces may break off and come away completely.
- Discolouration of part or all of the nail which can be green, yellow or white
- Separated from the nail bed
- Smelly
- Ridges on the nail
- Discomfort around the area (pain is very unusual)
Sometimes the skin nearby may also become:
- infected
- itchy
- cracked
- red
- swollen
Untreated, the nail can start to grow abnormally and may have ridges or waves. It may look yellow or green, and it can be dry and brittle. The nail can detach from the nail bed and fall off.
Most fungal nail infections occur as a result of the fungi that cause athlete's foot infecting the nails. These fungi often live harmlessly on your skin, but they can sometimes multiply and lead to infections. The fungi prefer warm, dark and moist places like the feet.
The fungi that cause the infection thrive in the warm and moist environment. Warm, moist environments incubate the fungi and encourage them to grow, hence why fungal infections usually appear in the genitals, mouth, inner thighs and feet that have been wearing wet socks or shoes.
You're more likely to get a fungal nail infection if you:
- Don't keep your feet clean and dry
- Wear shoes that cause your feet to get hot and sweaty
- Walk around barefoot in places where fungal infections can spread easily, like communal showers, locker rooms and gyms
- Have damaged your nails
- Have a weakened immune system
- Have certain other health conditions, like diabetes, psoriasis or peripheral arterial disease
Fungal nail infections can be spread to other people, so you should take steps to avoid this if you have an infection.
The majority of people who suffer from fungal nail infections are often men with older adult men at the highest risk due to their poorer circulations and as you age your nails grow more slowly and thicken.
Fungal infections of the nail do not clear up by themselves, but not all of them need treatment. Some people with infected toenails are not bothered by them at all. In that case, they can sometimes be left alone (although the patient should remain cautious and try not to spread the infection to other parts of the body and nails or other people).
On the other hand, if infected nails are embarrassing or uncomfortable then they are usually treated. It is important to treat people whose infections may cause significant health problems such as those with diabetes or immune suppression, in order to prevent potentially serious health problems.
The aim of the treatment is to get rid of the fungus: the nail will then usually return to normal. However, if the nail was abnormal before it was infected, it will be harder to clear and may just go back to its former state. Nail infections caused by moulds and yeasts can be very resistant to treatment.
Oral antifungal medications are often the first choice when OTC medication has not worked. You typically take this type of drug daily for 6 to 12 weeks. But you won't see the end result of treatment until the nail grows back completely. It may take four months or longer to eliminate an infection.
Terbinafine is the first line treatment and works better and much more quickly, although only about 50% of nail infections are cured. It is considered as first line treatment for dermatophyte fungi (the ones that cause athlete’s foot). It is taken daily for 6 weeks for fingernail infections and for 12-16 weeks for toenail infections.
It is worth noting oral antifungal drugs may cause side effects such as rash and liver damage. Or they may interfere with other prescription drugs. You may need occasional blood tests to check on how you're doing with these types of drugs. It may not be suitable for people with liver disease or congestive heart failure or those taking certain medications.
Nail Lacquer
Nail lacquer bought OTC is used to treat fungal nail infections on your finger and toe nails. It contains the active ingredient amorolfine hydrochloride which combats a large variety of fungi that can cause an infection by disrupting its growth. It is important to use it until the infection has cleared completely and healthy nails have grown back. This usually takes 6 months for finger nails and between 9 and 12 months for toe nails.
Treatments applied to the nail work less well than those taken by mouth. They are most effective if the infection is treated at an early stage. The treatments used most often are amorolfine nail lacquer, ciclopirox and tioconazole nail solution. Alone, they may not be able to clear the deeper parts of an infected nail, though regular removal of abnormal nail material with clippers or filing can help with this.
Softening and scraping away the nail
As it can take a long time for antifungal medication to work, some people may prefer to use a treatment that involves softening and removing infected parts of nail over a few weeks. Treatment kits are available from pharmacies that contain a 40% urea paste, plasters and a scraping device. The paste softens the infected parts of the nail, allowing them to be scraped away so they can be gradually replaced with healthy nail.
Removing the Nail
A procedure to remove affected nails completely isn't usually necessary, but may be recommended if the infection is severe or painful and other treatments haven't helped. If your nail is surgically removed, a new nail should eventually grow back in its place. However, it could take a year or more for the nail to grow back completely.
Laser Treatment
Laser treatment is a possible option if you have a fungal nail infection that's particularly stubborn. The laser emits high doses of light energy, which are used to destroy the fungus. Early research suggests the treatment may be helpful in treating fungal nail infections, but there's currently not enough evidence to recommend it as a routine treatment. Be aware that the treatment may need to be repeated several times for up to a year, so it could get very expensive.
Frequently Asked Questions
Fungal infections of the nails are also known as dermatophytic onychomycosis, or tinea unguium. The responsible fungus is usually the same as that that causes athlete’s foot – a common infection of the skin of the feet, especially between the toes. In athlete’s foot the responsible fungus lives in the keratin that makes up the outer layer of the skin. When the fungus spreads to the keratin of the nails, the result is a fungal nail infection.
Generally speaking, no. However, in some extremely rare cases there is a genetic risk factor and other family members can also be affected.
When fungi infect a nail, they usually start at its free edge, and then spread down the side of the nail towards the base of the cuticle. Eventually the whole nail may be involved. The infected areas turn white or yellowish, and become thickened and crumbly. Less commonly there may be white areas on the nail surface. The nails most commonly affected by fungal infections are those on the big and little toes.
Fungal nail infections are usually diagnosed clinically. Your doctor may take a piece from the abnormal nail and send it to the laboratory to check if fungus can be seen under the microscope or grown in culture (this takes several weeks). The right treatment may depend on knowing which fungus is causing the trouble; it can take several weeks to get culture results.
Yes. However, to successfully cure fungal toenail infection requires long treatment and may take up to a year. Fingernails are easier to treat. Fungal nail infections commonly recur, especially on the toes.
The new nail will grow slowly outwards from its base, and it may be 6 months to a year after the treatment has finished before the nails look normal again. Fingernail infections clear up more quickly and completely than toenail ones; it can take 18 months for a toenail infection to grow out completely.
Sometimes very thick nails that are not likely to respond to tablets alone may have to be removed by surgeons under a local anaesthetic, however this is rarely performed since cure rates are not high enough to justify the discomfort of the surgery.
1. Keep your nails short, dry, and clean. Stick to one nail clipper for the infected nails and another for the normal ones. 2. Don’t just treat your nails; use an antifungal cream to treat the skin that has athlete’s foot as well. 3. Avoid cutting the cuticle, either yourself or by a manicurist, since this increases the risk of nail damage and infection 4. Wear well-fitting shoes, without high heels or narrow toes. 5. Keep your feet dry, wear cotton socks, changed daily, and use ‘breathable’ shoes. 6. Maintain good foot hygiene, including treating any athlete’s foot 7. Wear clean shower shoes when using a communal shower.
Terbinafine is used to treat fungal nail infections and can be used for both fingernail and toenail infections. When taken orally as tablets, Terbinafine can be very effective at treating fungal nail infections. It is typically much faster at treating fungal nail than topical solutions and creams that may be available over the counter.
Terbinafine fungal nail tablets are a prescription only medication which means that they have to be prescribed by a doctor.
Terbinafine tablets can affect the way your skin reacts to sunlight and can make you burn much more easily. It is therefore advised to avoid sun exposure (especially tanning beds) whilst taking Terbinafine. It is also advised to limit alcohol and caffeine intake whilst taking Terbinafine tablets. Always read the patient information leaflet for a full list of precautions and side effects before taking your medicine.
