Fungal infections may affect one or more toenails and fingernails. It can present in different patterns and may lead to complete destruction of the nail. Nail clippings are used to confirm the diagnosis. The choice of an oral anti-fungal treatment is based on the infective organism identified.
Onychomycosis must be distinguished from:
- Psoriasis, eczema and lichen planus
- Nail trauma
- Nail thickening in the elderly
Nail clippings before initiating treatment:
- Clippings at the end of the infected nail
- Scrape the discoloured surface of the nails
- Scoop debris out from under the nail
Treatment of onychomycosis
Fingernail infections are usually cured more quickly than toenail infections. Combined and prolonged topical and oral antifungal treatment is more effective. The choice of oral antifungal treatment is based on the identified organism. They may have side-effects and should be avoided in certain individuals at risk. Non-drug treatment includes softening with urea ointment.
