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Athlete's Foot (Tinea Pedis)
Athlete's foot, also known as tinea
pedis, is a common foot infection caused by fungi called dermatophytes.
Found in many different places indoors and outdoors, dermatophytes
are especially common in the warm, moist environments of pools,
showers, locker rooms and other sports facilities, where people
walk with bare feet. Once dermatophytes contaminate the skin of
someone's foot, the warm, moist environment of sweaty socks and
shoes encourage them to grow.
Symptoms
Symptoms of athlete's foot include:
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Intense
itching of the feet |
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Cracked,
blistered or peeling areas of skin, especially between
the toes |
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Redness
and scaling on the soles |
In
most people, signs of infection are seen on the webbed skin
between the toes. In some people, the infection spreads to one
or more toenails, causing the nail to appear unusually thick
and cloudy yellow.
Diagnosis
Your
health-care provider will ask you about your symptoms and about
factors that make you more likely to develop athlete's foot,
such as your use of public sports facilities, clubs or showers.
He or she also will ask about your foot-care habits, including
the type of shoes and socks you wear, what kind of work you
do and what you wear on your feet to work.
Your health-care provider usually can diagnose athlete's foot
simply by looking at your feet. He or she can confirm the diagnosis
by gently scraping some flakes of skin from a scaly portion
of your foot onto a slide. The dermatophytes that cause the
infection often show up under a microscope.
Expected Duration
Response
to treatment usually takes several weeks to months. Even after
proper medical treatment, the infection can recur easily if
your feet are exposed again to fungi and sweaty, warm conditions.
For this reason, many people have persisting and recurring athlete's
foot infection for many years. Successfully curing the infection
often requires changes in how you care for your feet and what
you wear on your feet.
Prevention
Prevention
is as important as medications in treating athlete's foot because
of frequent recurrences. In general, you can help to prevent
athlete's foot by keeping your feet clean and dry. More specifically,
you can try the following:
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Wash
your feet thoroughly every day and wear a clean pair of
socks after your bath or shower.
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Take
time to dry your feet, including each toe, thoroughly (especially
the webbed area between the toes) after you bathe, shower
or swim.
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If
you use public pools or showers, wear thongs or sandals
to prevent your feet from being exposed to floors contaminated
with fungi.
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Choose
leather shoes rather than vinyl, since leather lets feet
"breathe" so they are more likely to stay dry.
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Wear
cotton socks to absorb sweat.
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If
possible, don't wear the same pair of shoes for two days
in a row. Give shoes a 24-hour break between wearing to
air out and dry out.
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Don't
share shoes. |
Treatment
Doctors
usually begin treating athlete's foot with an antifungal medication
applied to the feet. Theses medications include ciclopirox (Loprox),
clotrimazole (Lotrimin, Mycelex), econazole (Spectazole), ketoconazole
(Nizoral), miconazole (Micatin), naftifine (Naftin), oxiconazole
(Oxistat), sulconazole (Exelderm), terbinafine (Lamisil), terconazole
(Terazol), and tolnaftate (Desenex, Tinactin and others). Some
are available without a prescription. Many weeks of treatment
may be necessary. For people with long-standing or recurring
athlete's foot infections, topical antifungal drugs may relieve
symptoms without actually curing the infection.
Medications by mouth can be more successful at curing an infection.
However, you still can be susceptible to recurrences, and oral
medications may be more likely to cause side effects. These
require a prescription and include griseofulvin (Fulvicin, Grifulvin,
Grisactin), itraconazole (Sporanox) and terbinafine (Lamisil).
When To Call A Professional
If
you think you have athlete's foot, try a nonprescription antifungal
ointment, cream or powder. Keep your feet as dry and clean as
possible. If these measures do not help, make an appointment
to see your doctor. Call your doctor for a more urgent evaluation
and treatment if you see spreading redness or have fevers.
If you have diabetes and any foot problems, see your doctor
promptly. People with diabetes easily get skin infections, so
they should see a doctor as soon as an abnormality appears.
Prognosis
People
with new or short-term symptoms of athlete's foot usually can
be cured after several weeks of treatment with a medication
applied to the feet. Chronic or recurring athlete's foot infections
also can be cured, but may require significant changes in foot
care as well as several weeks of treatment. In more severe cases,
an oral medication may be used. Even after successful treatment,
you remain at risk of re-infection if you do not follow prevention
guidelines. Relapses are common.
Additional Information
American Podiatric Medical Association (APMA)
9312 Old Georgetown Rd.
Bethesda, MD 20814-1698
Phone: (301) 571-9200
Toll-Free: (800) 275-2762
Fax: (301) 530-2752
E-Mail: askapma@apma.org
http://www.apma.org/
Last updated October 02, 2003
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Jock Itch (Tinea Cruris)
The term "jock itch" is
used to describe an itchy rash in the groin of a man. Although
there are other causes of jock itch, this term has become synonymous
with the medical diagnosis of tinea cruris in both men
and women. Tinea cruris is a common fungal infection
that affects the groin and inner thighs and often is experienced
by athletes. Tinea is the name of the fungus; cruris comes from
the Latin word for leg.
Jock itch
can develop when tight garments trap moisture and heat, which
creates an environment in which fungi multiply and flourish.
It occurs more commonly in men, but can affect women as well.
The jock-itch fungus also may cause a rash on the upper and
inner thighs, the armpits, the area just underneath the breasts,
and the feet (athlete's foot). Many people with tinea cruris
also have athlete's foot. Athlete's foot is called tinea pedis.
Symptoms
Symptoms of athlete's foot include:
A
flat, red, itchy rash first appears high on the inner side
of one or both thighs. It spreads outward in a ringlike circular
pattern while the center partially clears. The border is sharply
demarcated, slightly raised and often beefy red in color.
Jock itch can spread to the pubic and genital regions and
sometimes to the buttocks.
Diagnosis
Your
doctor often can make the diagnosis just by looking at the
rash. He or she confirms the diagnosis by scraping a small
amount of irritated skin onto a slide. Usually, fungi can
be seen under a microscope. Occasionally, your doctor may
send the sample to a laboratory to pinpoint the trouble-causing
fungus. Other causes of a rash in the groin include yeast
infection of the skin, seborrheic dermatitis and psoriasis.
Expected Duration
Jock
itch can be treated in a matter of weeks, although it commonly
recurs. Treatment for chronic infections may last one or two
months.
Prevention
Your
general state of health helps determine your susceptibility
to fungal infections. Remaining healthy through diet, rest
and exercise is the first step in avoiding fungal infection.
Here are other steps you can take to remain fungus free:
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Keep
your body clean. |
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Dry
yourself well after showers and baths. |
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Shower
immediately after athletic activities. |
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Wear
loose clothing whenever possible. |
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Do
not share clothing or towels with others, and wash towels
frequently. |
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Clean
exercise equipment before use. |
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Wear
sandals in the shower area at the gym and swimming pool. |
Treatment
Most
likely, your doctor will prescribe a topical antifungal treatment
for you to apply once or twice a day for at least two weeks.
If you have athlete's foot, your doctor should address that
as well. Untreated athlete's foot may cause jock itch to recur.
Because
jock itch commonly recurs, you need to be extra cautious.
Daily application of a powder such as talc helps keep the
area dry. The itching can be alleviated with an over-the-counter
treatment such as Sarna lotion. You also should avoid hot
baths and tight-fitting clothing. Men should wear boxer
shorts rather than briefs.
When
To Call A Professional
Call
your doctor whenever you develop a skin rash.
Prognosis
Treatment
for jock itch is quick and usually effective, but the condition
often recurs. The following people should be especially vigilant
to prevent recurrence:
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Athletes |
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People
with fungal infections that affect other parts of the
body (such as athlete's foot) |
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People
who wear tight clothing |
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People
with damaged or altered immune systems |
Additional Information
Last updated January 17, 2003
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Ringworm
(Tinea)
Ringworm, also called tinea, is a
skin infection caused by fungi, microscopic organisms that are
similar to yeast and molds. It does not have any relation to
worms, but is called "ringworm" because the infection
can produce ring-shaped patches on the skin that have red, wavy,
wormlike borders.
Although
ringworm can affect almost any portion of the body from head
to toe, it favors places that are dark and moist, such as
skin in the groin area, the spaces between the toes and the
deep skin folds of obese people. People can catch ringworm
in several different ways, including:
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Direct
skin-to-skin contact with an infected person
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Playing
with, or caring for, an infected pet or farm animal
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Using
an infected person's clothing, shoes or personal grooming
items such as combs, brushes or towels
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Sharing
an infected child's toys, especially stuffed toys
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Touching
a contaminated surface — Some common high-risk
surfaces include floors in bathrooms, showers and locker
rooms; shower stalls; gym mats; and pool decks, especially
at school or community pools. In general, any surface
that is used by many different people can carry ringworm,
especially if the surface is also wet or damp. Even contaminated
carpets and couches can spread the infection. |
Depending
on its specific location, tinea may be known by a more common
name, such as athlete's foot or jock itch. The various types
of ringworm include:
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Ringworm
of the scalp — This infection, also known as
tinea capitis, causes patches of hair loss on the scalp.
It is especially common among children aged 3 to 9, particularly
children who live in crowded conditions in urban areas.
Scalp ringworm spreads on contaminated combs, brushes,
hats and pillows, and it may occur in epidemics in schools
and day-care centers.
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Barber's
itch (ringworm of the beard) — This fungal infection
affects bearded areas of the face and neck in adult men.
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Ringworm
of the body — Ringworm of the body, also known
as tinea corporis, involves the non-hairy skin of the
face, trunk, arms or legs. Of all types of ringworm, tinea
corporis is the one that most often produces the classic,
ring-shaped patches with wormlike borders. Ringworm of
the body occurs in people of all ages and races, with
women affected as often as men.
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Jock
itch (ringworm of the groin) — This infection,
also known as tinea cruris, typically causes itchy, scaly,
red patches of skin on the groin area. It most often affects
teen-age and adult men, especially those who are obese,
or who wear tight-fitting underwear. It is the most common
type of tinea.
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Athlete's
foot (ringworm of the foot) — Athlete's foot,
also known as tinea pedis, is the second most common form
of tinea. In some individuals, the fungus attacks not
only the skin of the foot but also the toenails. Athlete's
foot is often acquired by walking barefoot on contaminated
floors, especially in gyms and locker rooms. |
Doctors
estimate that at least 20 percent of all people will develop
tinea at some time during life. People with a higher-than-average
risk of fungal skin infection include people who live in hot,
humid climates; athletes, especially swimmers; children in
day care; people who work with animals; obese people with
deep, moist skin folds; and anyone whose immune defenses are
weakened by illness (HIV, organ transplant, some cancers)
or by medications.
Symptoms
Symptoms of ringworm vary, depending on the site of the infection:
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Ringworm
of the scalp — Symptoms can include a diffuse,
itchy, scaling of the scalp that resembles dandruff;
itchy, scaly, round patches of hair loss on the scalp;
black-dot ringworm in which stubs of broken hairs form
a dotted pattern on the scalp; or kerion, a thick, nodular,
patch of inflamed skin that may ooze pus
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Barber's
itch — Symptoms often include kerion and crusted
skin. Bearded areas of the face and neck are affected.
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Ringworm
of the body — This infection produces itchy,
red, scaly, round patches with a raised border. Individual
patches are usually less than 5 centimeters (2 inches)
in diameter, and may occur singly or in groups of three
to four
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Jock
itch — Jock itch causes red, scaly patches
that may itch or burn. These patches usually occur on
the groin area and upper thigh, but not on the penis
or scrotum.
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Athlete's
foot — Athlete's foot produces areas of redness,
scaling or cracked skin on the feet, especially between
the toes. The affected skin may itch or burn, and the
feet may have a strong odor. |
Diagnosis
If
you have symptoms of athlete's foot, ringworm of the body
or jock itch, you often can make the diagnosis yourself. Begin
by asking yourself whether you are at risk of these infections.
For example, do you have an athletic lifestyle that routinely
exposes you to pools, gyms, locker rooms and other places
where fungi thrive? Do you live or work in crowded conditions?
Have you shared clothing, shoes, towels or personal-grooming
items with other people? Have you recently been exposed to
a person or animal that has patchy hair loss or areas of scaly,
red skin? If you answered yes to any of these questions, then
you probably have tinea.
On the
other hand, if your symptoms involve the scalp or beard,
you should not attempt to diagnose and treat the problem
yourself. You should be checked by a health-care professional.
Your doctor will review your symptoms and risk factors,
and then examine your skin. In many cases, the ringworm
can be diagnosed based on your history, symptoms and skin
findings. Sometimes, however, your doctor may need to scrape
gently an area of skin to check for ringworm fungi under
the microscope. A few affected hairs may be examined as
well. If necessary, a tiny sample of skin or hair may be
sent for laboratory culture to isolate and identify the
particular type of fungus causing the infection.
Expected
Duration
With
proper treatment, both jock itch and ringworm of the body
usually improve within one to two weeks. Ringworm of the scalp
or beard may take a few weeks longer. However, athlete's foot
can be a chronic problem that comes and goes over many years.
This can be caused in part by an active lifestyle that keeps
the feet moist and sweaty.
Prevention
To
help prevent tinea, try the following suggestions:
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Avoid
sharing anyone else's clothing, shoes, towels or personal-grooming
items (hairbrushes, combs, makeup brushes).
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If
your child goes to sleepover parties, provide a sleeping
bag, pillow and blanket from home.
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Bathe
regularly and dry your skin thoroughly afterwards. Be
especially careful to dry the area between your toes and
under your breasts.
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Wear
clean socks and underwear every day. When possible, choose
absorbent cotton socks and underwear rather than synthetic
fabrics. At the gym, keep an extra pair of socks in your
locker to replace sweaty socks after a workout.
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Wear
sandals, flip-flops, shower shoes or other protective
footwear when you walk through locker rooms or shower
rooms or near pools.
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If
you care for a pet or farm animal that develops areas
of hair loss or scaly patches, take the animal to a veterinarian
for a checkup. |
Treatment
If
you have jock itch, athlete's foot or ringworm of the body,
you usually can begin treatment yourself with a nonprescription
antifungal cream, lotion or powder. Check the medication's
label for the type of skin symptom it treats, the list of
active ingredients and the way it should be applied. Some
of the nonprescription medications available include terbinafine
(Lamisil), tolnaftate (Tinactin), miconazole (Micatin and
other brand names), clotrimazole (Lotrimin, Mycelex) and undecylenic
acid (Desenex and other brand names). Be sure to follow the
directions carefully when you apply the medication. If your
symptoms do not improve significantly after you have used
a nonprescription medicine for approximately two weeks, call
your doctor. Your doctor may suggest a prescription antifungal
medication that will cure the problem. For extremely stubborn
infections, the antifungal medication may be taken by mouth
rather than being applied to the skin.
If you
have ringworm of the scalp or beard your doctor may treat
you with an oral antifungal medication, such as itraconazole
(Sporanox) or griseofulvin (Grisactin and other brand names).
In addition, you will have to apply antifungal creams to
your hair and scalp. Complete treatment can take up to two
months.
When
To Call A Professional
Make
an appointment to see your doctor if you have symptoms of
ringworm that involve the scalp or beard. For other forms
of ringworm, call your doctor if nonprescription medicine
does not improve your skin problem after two weeks of treatment.
If your
immune system is weakened by illness or medication, contact
your doctor promptly whenever you develop any unusual skin
symptoms. In particular, people with diabetes should have
skin symptoms, especially on the feet, checked as soon as
possible.
Prognosis
Although
treatment may take several weeks, antifungal medication almost
always cures ringworm infections. Hair eventually regrows,
and scarring is rare.
However,
people do not develop immunity to tinea. Because it is possible
to catch the fungus again, follow the suggestions outlined
in the Prevention section above to avoid recurrence.
Additional Information
Centers for Disease Control and Prevention (CDC)
1600 Clifton Rd., NE
Atlanta, GA 30333
Phone: (404) 639-3534
Toll-Free: (800) 311-3435
http://www.cdc.gov/
National
Institute for Allergy and Infectious Diseases (NIAID)
Building 31, Room 7A-50
31 Center Dr. MSC 2520
Bethesda, MD 20892-2520
Phone: (301) 496-5717
http://www.niaid.nih.gov/
National
Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
Phone: (301) 495-4484
Toll-Free: (877) 226-4267
Fax: (301) 718-6366
TTY: (301) 565-2966
http://www.nih.gov/niams
American
Academy of Dermatology
930 North Meacham Rd.
Shaumburg, IL 60173
Phone: (847) 330-0230
Toll-Free: (888) 462-3376
http://www.aad.org/
American
Academy of Family Physicians (AAFP)
11400 Tomahawk Creek Parkway
Leawood, KS 66211-2672
Phone: (913) 906-6000
Toll-Free: (800) 274-2237
E-Mail: email@familydoctor.org
http://www.familydoctor.org/
Last updated February 24, 2003
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Tinea
Versicolor
Many microorganisms are normally
live on our skin, including a yeast called Pityrosporum orbiculare.
The yeast lives in our pores. Under certain conditions, it can
grow out of control and produce a rash called tinea versicolor,
also called pityriasis versicolor.
Tinea
versicolor is common year-round in the tropics and subtropics,
and is seen in the summer months in more temperate climates,
because the yeast grows best in hot and humid conditions.
The rash occurs more often in teen-agers and young adults,
and appears on the back, neck, upper chest, shoulders, armpits
and upper arms. It is more likely to occur on oily skin.
It is
not clear why some people get tinea versicolor, while others
do not. The yeast grows slowly and normally is washed off
the skin during normal cleansing.
Symptoms
Your
doctor can shine an ultraviolet light on the rash. If your
skin is infected with P. orbiculare, the rash will
glow under the light. Your doctor also can take skin scrapings
from the lesions and examine them under the microscope to
see if the yeast is present.
Diagnosis
The
yeast responds well to treatment, but the changes in skin
color may remain for several months, especially if you have
spent time in the sun. Wearing a strong sunscreen and taking
other precautions against sun exposure can minimize the difference
in skin color between normal skin and skin affected by tinea
versicolor.
Expected
Duration
With
proper treatment, both jock itch and ringworm of the body
usually improve within one to two weeks. Ringworm of the
scalp or beard may take a few weeks longer. However, athlete's
foot can be a chronic problem that comes and goes over many
years. This can be caused in part by an active lifestyle
that keeps the feet moist and sweaty.
Prevention
Because
the yeast grows more readily in hot, humid conditions, keep
your skin as dry and cool as possible. Tinea versicolor
can be spread through skin-to-skin contact or by coming
in contact with contaminated articles such as unwashed towels
or bedding. Tinea versicolor is more common in people who
have a suppressed immune system (for instance, people who
are taking a corticosteroid medication such as prednisone
for another health problem). It is also more common in women
who are taking birth-control pills and pregnant women.
Treatment
Topical
treatments (shampoos, sprays) and oral medications are available
to treat tinea versicolor. Topical treatments usually are
used one or two times each day. Oral antifungal agents, such
as itraconazole (Sporanox), may be prescribed by your doctor
if you have a more severe case. For six months after your
original treatment, you may be advised to apply topical treatments
occasionally or take one or more doses per month of oral antifungal
medicine to help prevent a recurrence of the rash.
During
treatment, bed linens and pajamas should be washed daily
to avoid reinfection.
When
To Call A Professional
If
you have a skin rash that you think might be tinea versicolor,
you should make an appointment with your doctor to have the
rash evaluated.
Prognosis
There
are no serious complications from tinea versicolor. In most
people, the rash goes away with treatment. However, it takes
several months for the skin to return to its normal appearance.
The rash returns after treatment within six months in nearly
40 percent of people who are not using intermittent antifungal
treatments to suppress the rash.
Additional
Information
American Academy of Dermatology
930 E. Woodfield Rd.
Schaumburg, IL 60173-4927
Phone: (847) 330-0230
Toll-Free: (888) 462-3376
Fax: (847) 330-0050
http://www.aad.org/
Last
updated June 03, 2003
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Toenail
Fungus (Onychomycosis)
Toenail fungus, also called onychomycosis,
is a relatively common condition that disfigures and sometimes
destroys the nail. Onychomycosis can be caused by several different
types of fungi (microscopic organisms related to mold and mildew).
These fungi thrive in the dark, moist and stuffy environment inside
shoes. As they grow, they feed on keratin, the tough protein that
makes up the hard surface of the toenails. In most cases, the
fungus belongs to a group of fungi called dermatophytes, which
include Trichophyton rubrum and Trichophyton interdigitale.
Other, less common causes of onychomycosis include yeasts and
molds.
Toenail
fungus affects 2 percent to 18 percent of all people worldwide
and 3 percent to 5 percent of people in the United States. It
is relatively rare in children, affecting only about one out
of every 200 people younger than 18. However, the likelihood
of getting toenail fungus increases with age, so that up to
48 percent of people have at least one affected toe by the time
they reach age 70. Although 2.5 million Americans see a podiatrist
annually for treatment of toenail fungus, many more are infected
but never seek help. Some people consider toenail fungus just
a cosmetic problem, and don't bother seeking treatment.
Almost anyone
who wears tight-fitting shoes or tight hosiery has an increased
risk of developing toenail fungus, especially if they also practice
poor foot hygiene. Wearing layers of toenail polish, which doesn't
allow the nail to breathe, is another risk factor. Also, because
toenail fungi may spread from foot to foot on the floors of
showers and locker rooms, fungal infections of the toenails
are especially common among military personnel, athletes and
miners. The condition also tends to affect people with chronic
illnesses, such as diabetes or HIV, as well as people with circulatory
problems that decrease blood flow to the toes. However, many
people have no clear risk factors.
Of all the
toenails, those on the big toe and little toe are the most likely
to develop a toenail fungus. This may be partly because the
big toe and little toe are constantly exposed to the mild trauma
of friction from the sides of shoes.
Symptoms
When
a toenail develops a fungal infection, it typically turns yellow
or brown and becomes thick and overgrown. Foul-smelling debris
also may accumulate under the nail, especially at the sides
and tip. As the infection continues, the nail either may crumble
gradually and fall off or become so thick that the affected
toe feels uncomfortable or painful inside shoes.
In a less
common variety of toenail fungus, called white superficial
onychomycosis, the nail turns white rather than yellow or
brown, and the surface becomes soft, dry and powdery.
Diagnosis
After
you describe your foot symptoms, your doctor will ask you about
any factors that might increase your risk of toenail fungus.
These include a high-risk occupation, sports participation,
tight-fitting shoes or hosiery, poor foot hygiene or use of
heavy toenail polish. Your doctor will also ask whether you
have a history of poor circulation, diabetes, HIV or any other
illness that might decrease your resistance to infection or
interfere with blood flow to your toes.
Because
psoriasis sometimes can cause nail problems that look similar
to a fungal infection, your doctor may ask whether you or
anyone in your family has psoriasis. In some people with psoriasis,
the nails are the only part of the body affected; the skin
is largely spared. Also, it is possible for psoriasis and
a fungal infection to affect the same toenail.
If you
and your doctor decide that this nail problem is important,
he or she will examine your affected toenail or toenails.
To confirm that you have a fungal infection, your doctor will
take small samples of the affected nails and send them to
a laboratory. The nail samples will be examined under a microscope
and will be checked for fungi and other microorganisms.
Expected
Duration
Toenail fungus rarely heals on its own. It is usually
a chronic condition that gradually progresses to involve more
and more of the nail. Even if the affected nail falls off
or is knocked off, the new nail that grows usually is infected
with fungus.
Prevention
You can help to prevent toenail fungus by:
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Wearing
comfortable shoes and hosiery that allow your feet some
"breathing space" |
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Wearing
shoes, sandals or flip-flops in community showers or locker
rooms |
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Washing
your feet every day, drying them thoroughly and using
a good-quality foot powder |
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Wearing
clean socks or stocKings, Queens, Richmond every day |
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Keeping
toenails trimmed |
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Disinfecting
pedicure tools before you use them |
Treatment
There
are several approaches to therapy. Treatment may begin with
your doctor removing as much of the infected nail as possible.
This can be done by trimming the nail with clippers, filing
it down or dissolving it away with a paste that contains urea
and bifonazole.
Next,
if the infection is mild and very localized, your doctor may
prescribe a medicated nail polish containing either amorolfine
(Loceryl) or ciclopirox (Loprox). You should apply the nail
polish twice a week until your nail is cured.
If the
infection involves a wider area of your nail, or several nails,
your doctor will prescribe an oral antifungal medication,
such as itraconazole (Sporanox) or terbinafine (Lamisil).
Either itraconazole or terbinafine can be taken daily for
12 weeks, or a higher dose of itraconazole can be taken for
one week per month for three months. Both itraconazole and
terbinafine occasionally cause troublesome side effects, and
itraconazole has the potential to produce serious drug interactions
in people taking terfenadine (Seldane), astemizole (Hismanal),
cisapride (Propulsid), midazolam (Versed), triazolam (Halcion)
or lovastatin (Mevacor).
In very
severe cases of toenail fungus resistant to therapy, it may
be necessary to remove the nail surgically.
When
To Call A Professional
You
may wish to make an appointment to see your family doctor or
podiatrist if you notice that a portion of your toenail has
become abnormally thick or discolored. Call your doctor promptly
if any problem involving your feet or toes makes walking painful
or difficult.
Prognosis
According
to one study involving 195 patients with toenail fungus, 81
percent of those treated with terbinafine and 63 percent of
those treated with itraconazole were cured fungus after 12 weeks
of therapy. However, even after the fungus was dead in these
patients, only 36 percent to 50 percent had completely clear,
normal-looking nails.
After
treatment with itraconazole, the fungus returns after nine
to 12 months in 9 percent to 11 percent of patients. After
treatment with terbinafine, the fungus returns within 12 months
in about 12 percent of patients.
Additional
Information
National Institute of Arthritis and Musculoskeletal and Skin
Diseases
Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
Phone: (301) 495-4484
Toll-Free: (877) 226-4267
Fax: (301) 718-6366
TTY: (301) 565-2966
E-Mail: niamsinfo@mail.nih.gov
http://www.niams.nih.gov/
American
Podiatric Medical Association (APMA)
9312 Old Georgetown Rd.
Bethesda, MD 20814-1698
Phone: (301) 571-9200
Toll-Free: (800) 275-2762
Fax: (301) 530-2752
E-Mail: askapma@apma.org
http://www.apma.org/
American
Academy of Podiatric Sports Medicine
4414 Ives St.
Rockville, MD 20853
Toll-Free (800) 438-3355
E-Mail: info@aapsm.org
http://www.aapsm.org/
American
College of Foot and Ankle Orthopedics and Medicine
3525 Ellicott Mills Drive
Suite N
Ellicott City, MD 21043
Toll-Free (800) 265-8263
Fax: (888) 336-6832
E-Mail: info@acfaom.org
http://www.acfaom.org/
American
College of Foot and Ankle Surgeons
515 Busse Highway
Park Ridge, IL 60068
Phone: (847) 292-2237
Toll-Free: (800) 421-2237
E-Mail: mail@acfas.org
http://www.acfas.org/
Last
updated October 06, 2003
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This
health article is made available by
Dr. Eliot Y Ghatan MD a Dermatologist. AESTHETIC SURGERY &
DERMATOLOGY office at 1226 Ocean Parkway, Brooklyn, NY 11230.
Dr. Ghatan is easy reachable from Breezy Point, Bronx, Brooklyn,
Connecticut, Far Rockaway, Howard Beach, Long Island, Manhattan,
New Jersey, Queens, Ridgewood, Rockaway Park, and Staten Island.
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