Q: I recently lost a toenail, probably the result of fungus. Would it help to apply Miranel or some other product on the nail bed to deter the reappearance of the fungus?
A: Yes, it certainly would. A nail fungus is technically known as onychomycosis, a condition that begins as a white or yellow spot under the tip of the nail. As the infection continues, the fungus may have caused your nail to discolor and thicken, become brittle and crumble, and turn dark because of the buildup of debris under the nail. Causes for a fungus to form may include yeasts and molds, both of which love environments such as the feet, simply because warm, dark, moist shoes provide a perfect setting for a fungus to form on toenails. And, the toes have less blood flow than do finger nails, making it more difficult to eradicate the infection. Factors that may increase a person’s risk for developing an infection include walking barefoot in public areas such as a fitness center or gym, near a swimming pool or locker room, wearing socks that hinder adequate ventilation, having diabetes or circulatory problems, being diagnosed with a skin condition, or athlete’s foot. You may also have a suppressed immune system or be older and have diminished circulation to your feet.
There are a number of over-the-counter medications such as the Miranel you mention which should help your new nail grow free of infection. An option is oral anti-fungal drugs that can also be prescribed by your physician. On the downside, oral medications may take up to 12 weeks to be effective and the end result will not be observed until your nail grows in completely which could take an extended period of time. You don’t indicate your age but the success rate with medication is markedly reduced in individuals over the age of 65 and success appears most apparent when a combination of oral medications and OTC Miranel or others are used simultaneously. Oral antifungals have the potential for liver damage so your physician may insist on periodic blood testing to be assured things are okay. Keep in mind that repeat infections are common, so don’t despair.
Antifungal medicated nail polish is now available that can be painted on infected nails. The polish is applied to the nail and surrounding skin once daily for a week. At the end of that time period, the layers are wiped off with alcohol and the process is repeated all over again – for up to a year!
On the home front and to prevent re-infection, keep your nail(s) trimmed. Wear socks that are a blend which will allow the wicking away of moisture and allow for better ventilation. If possible, rotate your shoes so the insides can dry completely between wearings. Treat your shoes with a disinfectant or anti-fungal powder between wearings. Refrain from going barefoot in public areas such as shower rooms and instead, keep a pair of flip flops available for such occasions. Be sure to wash your hands after working on or touching any infected nails.
