ONYCHOMYCOSIS

Onychomycosis refers to fungal infection of the nails. Fungal infection of the nails caused by a subgroup of fungi called dermatophytes is known as Tinea unguium.

Nail infection commonly develops in individuals who have tinea pedis (athletes foot).

Spread occurs through contact with infected individuals, carpets or floors.

Fungal nail infection may look identical to psoriasis of the nails.

for this reason, a nail clipping for microscopy, culture and histology is sent off to the laboratory in order to confirm the diagnosis and choose the appropriate treatment.

Fungal infection of the nails is not just a cosmetic problem. The nails are important structures in providing counterbalance and fine movements of the hands and feet are dependent on normal nails.

New Treatment of Fungal Nail infection

The NdYAG laser (Nordlys NdYAG laser made in Denmark shown on left) is the newest method of treating fungal nail infection. A laser beam is passed a few times over the nails, effectively killing fungus present in the nail. To ensure that all fungus is killed, all 10 nails are treated in one treatment session.

Even though the fungus is killed immediately, it can take a few months for the diseased nail to grow out and the for the nail to become clear. The new nail that grows out grows without the fungus, thus producing the clear nail.

Watch this you tube video to see how laser works for nail fungus (except you don't have to go to San Francisco for treatment - we offer it right here at Westville Hospital)

Watch these you tube videos now

 

LASER TREATMENT FAQS

How does laser treatment work for fungal infection

The laser is applied over each nail (on one foot or both), to cover the entire surface of the nails. 

The fungus is heated by the laser and killed.

How long does each treatment take?

About 10 minutes for each foot.

How many treatments are required?

Usually 2 to 3 treatments are required for a satisfactory response. These are separated by intervals of 3 to 6 months.

Are the treatments painful?

Not usually. Often just a sensation of warmth during treatment.

Any special instructions after treatment?

Shoes can be disinfected with Formaldehyde, or by leaving them in the sun for a few hours. Report any recurrence immediately.

Other treatments for fungal nail infection:

Terbinafine (Lamisil)

Itraconazole (Sporanox)

Griseofulvin (Microcidal)

Amorolfine (topical application) (Loceryl)

The dose of the 4 oral medications is calculated according to whether the fingernails or the toe nails are involved and the age of the individual,

Onychomycosis 1759 2

Onychomycosis. A nail clipping revealed numerous fungal elements

Fungi 4085

Fungal elements on microscopy of the nail

Psoriasis nails 4997

Psoriasis nails. The patient had typical psoriasis affecting his skin.

Chronic paronychia 3563

Chronic paronychia. Swelling of nail fold with secondary nail changes

Psoriasis pitting 9584 2

Psoriasis. Pitting of the nails is a classical feature.

Psoriasis oil drop sign 9488

Psoriasis. Oil drop sign. Zone of redness before the lifted nails.

Pterygium

Pterygium. The nail fold becomes continuous with the nail bed. A classical feature of lichen planus

12 Tips for prevention of nail fungus

 

  • Wear open footwear (sandals) as much as possible 

  • Wear cotton socks - they absorb sweat better than polyester or nylon.

  • If you have athletes foot (scaling, redness. white discolouration between the digits,) see your dermatologist or GP for treatment.

  • Dry feet thoroughly after washing (warmth and moisture are the best friends of fungi)

  • If family members have athletes foot, refer them to a doctor to have it treated.

  • If you have athletes foot or nail fungus, wear slops in the shower. Fungal infection is contagious.

  • Sterilise nail clippers before clipping non-infected nails.

  • Do not share nail clippers

  • Do not share socks/ shoes/ sandals/ towels.

  • Keep slops on in gymnasia, swimming pools, public bathing facilities and places of worship if barefoot.

  • If toe nails are thick, use appropriate nail clippers like the type shown on the right.

  • Remember that hotel carpets and showers may harbour fungus. - Wear your slops!

© 2020 Dr N Raboobee

Appointments for physical and online consultations can be made with the secretary - Tel: 031 265 1505 or 079 562 3251. 

Please note that consultations and opinions are not offered by email unless an online consultation has been scheduled.

This practice is contracted out of medical aid.

031 265 1505 or

079 562 3251