My nail changed color, and now?

After this Post I have received several requests from my readers to write about nail infections. After discussing about the subject, I share with you the text by João:

To be a health professional implies many times telling people what they do not want to hear. This can range from the simple “you have to exercise more, eat better and have a more varied diet” that we are already used to hearing and ignoring, to the more conflicting examples that imply explaining that we do not have a solution for everything.

A rather good example of this paradigm are the onychomycosis – the nail infections by fungi. Frequently, someone will come to the pharmacy with one hope: that there is a simple, fast and efficient treatment for that nail (usually a toenail) that insists in changing color, deforming and becoming brittle and, in one word, ugly. This occurs mainly in summer, when we take the sandals from the closet and the socks off, and we notice that our feet have been “cooking” during winter.

“What do I do to this, then?” There are several treatments at your disposal. Some more effective than others, depending on the infecting fungus, type of infection (top of nail, under nail, close to the root, edge), progression of infection (if it’s already very advanced or not), and also the specific person. But the true determinant of success is not the product, it’s the way the treatment is carried out.

The problem with onychomycosis is that the fungus gets inside the nail – and the nail (especially, the toenail) is a terrible collaborator with treatments: on one hand, it doesn’t grow fast enough to expel the fungus, on the other hand, doesn’t allow for medicine to penetrate quickly enough to kill it. The solution? To be patient.

So, here is what people don’t want to hear: nail infections are the most tedious things to treat. It takes a year of treatment that, except for rare cases, has to be done every day (or week, depending on the product). And even so, there is no guaranty of total success.

I would like to end this post in a beautiful, quick and efficient informative transmission, but it seems that the Rolling Stones lyrics are valid also for me, “you can’t always get what you want”…

For those who come here looking for advice, here are some ideas worth considering:
  • Starting the treatment as soon as possible is always a good idea.
  •  If the infection is under the nail, close to the root, it is almost certain that you will need oral medicine (pills, capsules, etc.) – this implies going to the doctor.
  • Some hygiene care is often the best way to avoid that the treatment fails. To clean and disinfect nail files and nail cutters (with alcohol or bleach) is a good way to avoid the reappearance of infections.
  • The ugly nail might not be caused by a fungus. One of the most common causes is, for instance, age. The only way of knowing is going for a test. – This implies going to the doctor.

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