Ringworm: see how to get rid of fungus on your feet – 09/14/2023 – Balance

It looks like I have some fungus under my toenail, but how can I be sure? Does nail fungus go away on its own?

Yellow, brittle, unusual-looking nails may be a sign that a fungal nail infection, called onychomycosis, has taken root. Experts say these infections don’t go away on their own and, without treatment, they can easily spread between people.

“The fungus tends to be greedy,” says Boni Elewski, chair of the dermatology department at the University of Alabama at Birmingham. If you contract it from contact with someone who is infected or from walking barefoot in a locker room, for example, it can crawl under your nail and spread to the nail itself, she says. Wearing damp, sweaty shoes can encourage fungus growth.

Nail fungus affects around 1 in 10 people worldwide and becomes more common with age – affecting more than half of those aged 70 and over. People with diabetes or a weakened immune system are also susceptible, points out Shari Lipner, a dermatologist at Weill Cornell Medical Center in New York City.

Is it really a fungus?

Experts say the first step to getting your nails back to normal is confirming that you have fungus. Some telltale signs include thickened, discolored, cracked, deformed, and occasionally painful or smelly nails.

But the fungus is responsible for only half of abnormal-looking toenails, Elewski says. Trauma to the toenails, whether from single injuries or repetitive activities with shoes that are too tight, can also cause discolored or thick toenails. “The eyes are not enough to be sure that it is onychomycosis,” he says.

According to Lipner, doctors usually confirm nail fungus by examining a cut piece under a microscope.

They may also perform a PCR test or fungal culture to determine which species infected your nail. But these tests aren’t always necessary because most people have a type of fungus called Trichophyton rubrum, says Lipner.

If your treatment isn’t working, however, your dermatologist may want to know more about which organism is there.

Prescription antifungals usually do the trick, but it’s a bad idea to take them without first confirming that you have the fungus, suggests Elewski. Unnecessary use of antifungals can make these medications less effective over time, contributing to a growing problem called antifungal resistance.

Which antifungals work best?

Although some drugstores dedicate entire aisles to over-the-counter ringworm ointments, Elewski says the most an over-the-counter treatment or home remedy can do is improve the appearance of your nails.

If you really want to kill the fungus, “a prescription antifungal is the only option,” says Antonella Tosti, a dermatologist who treats nail diseases at the University of Miami Miller School of Medicine. There are topical prescriptions, including creams, ointments, or serum-like solutions; and oral antifungals, i.e. pills.

Topical antifungals can be useful for milder cases that only affect one or two toenails, says Lipner. But one disadvantage is that it may be necessary to apply the medicine for about a year before the fungus disappears completely.

If there is fungus under several nails or if they are very thick, Lipner says she usually opts for oral prescriptions. These pills, terbinafine or itraconazole, can kill microorganisms in about three months. Even after oral pills kill the fungus, Lipner says your nail may look strange for a year as the new, uninfected nail grows.

Meanwhile, some over-the-counter remedies can improve the appearance of your nails by calming the surrounding skin or making them thinner, Elewski points out. It’s also generally good to wear nail polish on the infected nail while taking oral antifungals, says Lipner. But don’t do this if you are using topical medications.

Whether you’re prescribed a topical or oral antifungal, Tosti says it’s important to stay on top of your treatment every day. “It’s not something you can cure in a few weeks,” she says. “Persistence is very important.”

How can I avoid repeat infections?

Successfully eliminating nail fungus doesn’t mean you can’t get it again, experts warn. In fact, it is estimated that 25% of people get repeat infections.

Lipner recommends thoroughly washing any socks or other clothing that came into contact with your first infection and using spray disinfectant on the shoes you wore frequently when you had toenail fungus. Another alternative is to discard them.

To avoid ringworm in general, keep your nails trimmed and avoid walking barefoot in gym locker rooms or around swimming pools, says Lipner. If you sweat frequently in closed shoes, wear moisture-wicking socks and wear dry shoes if you can.

If the skin on your foot becomes dry, itchy, scaly, or inflamed, you may have athlete’s foot, caused by the same fungus that can spread to the nail. Therefore, it is important to be treated immediately.

“But don’t treat yourself blindly,” says Lipner. “You should confirm with a dermatologist that you are treating the right thing.”

Translation Luiz Roberto M. Gonçalves