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Fungal nail infections are fairly easy to get. If you have a fungal infection on your foot, it may gradually spread to one or more of your nails. This happens quite often in both children and adults. You can get a fungal nail infection in a warm, damp place, such as by the pool or in the gym locker room. If someone else in your community has a fungal infection and has walked barefoot on the floor, all you have to do to catch the infection is walk barefoot on the same area.
Keeping your nails wet for a long time can also lead to nail fungus. Some people get fungal infections because they wear the same pair of sweaty or wet boots every day. Nails that are damaged due to work or hobbies are also susceptible to fungus. What you see outwardly on infected nails depends on the type of fungal infection.
Treatment can prevent infection in the nails from developing. If you have diabetes or a weakened immune system, comprehensive treatment is especially important. After the development of a fungal infection of the nails in people with diabetes, the risk of developing trophic ulcers that do not heal increases. At the first sign of nail problems, it is important to see a dermatologist (or mycologist, a specialist in fungus). A dermatologist can tell you if you have a nail infection or something else.
When do you need pills to treat a fungus?
Early diagnosis and treatment is recommended for anyone with toenail fungus. The disease at an early stage allows you to use only local remedies (varnishes, creams, gels) and the fungus will probably go away, you will grow a healthy nail again. Treatment can also prevent the fungus from spreading to other parts of the body and avoid infecting other people. But with a long-term, neglected infection, when the legs and skin are affected, local preparations alone are indispensable, you will need pills for nail fungus for systemic therapy.
You will not be able to get rid of a nail infection by covering your nails with varnish (even medicinal ones) or artificial nails. A weak effect will also be from applying therapeutic solutions to the nails. It is important to remove the fungus from the inside by choosing the best nail fungus pills for this.
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Antifungal tablets contain active fungicidal components that inhibit the activity of the fungus in the tissues, acting from the inside and on the whole body. It is important that the tablets for nail fungus are selected only by a doctor, taking into account the indications, the type of infection and side effects, excluding all possible contraindications.
1. Terbinafine
The drug is available in the form of a cream for external use, it is available in pharmacies without a prescription. Tableted forms of the drug are dispensed by prescription. The main active ingredient is terbinafine hydrochloride. It belongs to the group of allylamines, which have a wide antifungal spectrum against pathogenic fungi that affect the skin, nails and internal organs. This is a synthetic compound that has a direct effect on the shell of mushrooms, destroying it. The main action is the suppression of the synthesis of ergosterol of the fungus, a substance similar to hormones and strengthening, sealing the cell wall of the fungus.
Used for:
- fungal infections of any etiology;
- complex therapy of ringworm;
- dermatophytosis;
- fungal infection on the feet with peeling and skin lesions;
- fungal infection of internal organs in conjunction with other drugs.
The drug has a number of side effects when taken, so treatment should be monitored by a doctor. It is important to regularly check the blood test – platelets and neutrophils may decrease. Possible skin allergies, dizziness, taste disturbances and problems with the liver, kidneys, exacerbation of arthritis activity. The higher the daily dose, the more likely side effects.
The drug is contraindicated in case of allergy to components, renal and hepatic insufficiency, during pregnancy and lactation, in children.
The dose is selected individually, as well as the course of treatment – with severe damage to the feet, it can reach 180 days. With nail fungus – until a healthy plate grows and negative tests for the fungus.
2. Fluconazole
The drug is available in the form of capsules and tablets, as well as local forms – sprays, gels, ointments, vaginal suppositories. Oral forms are dispensed by prescription. The active substance is fluconazole. It belongs to the group of antifungal drugs with a wide spectrum of activity.
Shown:
- with cryptococcosis of the nervous system, respiratory tract and skin;
- for the prevention of fungal infections in the presence of immunodeficiencies;
- as prevention of fungus during donation and immunosuppressive therapy;
- for the treatment of candidiasis of any localization;
- when the fungus affects the nails on the hands and feet, including with the involvement of the skin on the feet;
- in the treatment of rosacea.
The dosage is selected by the doctor, based on the type and severity of the lesion. When taken in high doses, side effects are possible – allergies, itching of the skin in the affected areas, abdominal pain, and blood disorders. During treatment, it is necessary to periodically monitor blood tests. The drug has a number of contraindications – intolerance to the components, liver damage and cirrhosis, viral hepatitis, kidney failure, psoriasis, pregnancy for oral administration (external forms are acceptable). In children, the dose is calculated on body weight, taken strictly according to indications.
For the treatment of nail fungus, tablets are combined with local forms of drugs. The course of treatment is 150 mg per day for a month, then 150 mg per week for another month.
3. Ketoconazole
The drug is available both in local forms – shampoo, suppositories, creams that can be bought without a prescription, and in the form of tablets that are dispensed by prescription. The active substance – ketoconazole, has a pronounced antifungal effect, is used to treat systemic fungal infections. Kills the fungus by affecting the proteins of the outer membranes of cells. The drug is taken with the ineffectiveness of local treatment or the resistance of the fungus to other agents. It suppresses the activity of opportunistic flora, which is important in the treatment of fungal infections.
Shown:
- with fungal infections of the skin on the hands and feet;
- with damage to the nail plates that have not been cured by local therapy;
- for the treatment of yeast infections of any localization;
- with thrush resistant to fluconazole.
When taken in high doses or a long course of treatment, side effects are possible – digestive disorders, hair loss, fever, decreased libido in men, sleep disturbances, irritability, conjunctivitis.
There are a number of contraindications for taking the drug – age up to 12 years, any serious problems with the kidneys and liver, allergy to the drug, pregnancy (only local forms can be used from the 2nd to 3rd trimester).
With nail fungus, the drug is taken for a long time, until healthy nails grow completely and symptoms disappear permanently (at least 4 weeks).
4. Itraconazole
The drug is available in capsules and solution, dispensed by prescription, the active substance is itraconazole. The drug has a broad spectrum antifungal activity, destroys the cell walls of fungi by blocking the synthesis of ergosterol. Practically does not form resistance from fungi, which allows it to be used in difficult cases.
It applies to:
- with fungal infections of the intimate area, resistant to other drugs;
- with fungal infections with immunodeficiencies;
- for the treatment of nail fungus of any localization;
- with lesions of internal organs caused by rare forms of the fungus (cryptococcus, paracoccidiosis, histoplasmosis).
The drug is not without side effects when taken, which the doctor should take into account when prescribing it. There may be a violation of the absorption of food in the intestines, pain in the abdomen, headaches and dizziness. With prolonged use, you need to monitor the condition of the liver.
Among the contraindications, it is important to note allergy to the components of the drug, severe violations of the hepatic function and kidneys, pregnancy, breastfeeding. With nail fungus, the course of treatment can last up to 90 days with possible repeated courses.
5. Orugnal
The drug is available in the form of capsules and solution for injection, dispensed by prescription. The active substance is itraconazole. It has an effect on many types of fungus, including those resistant to other types of drugs.
Used for:
- treatment of dermatomycosis;
- elimination of fungal nail infections;
- systemic fungal infections;
- candidiasis, especially recurrent;
- fungal infection of the skin and mucous membranes;
- pityriasis versicolor.
It is forbidden during pregnancy, with an allergy to the drug, against the background of severe damage to the liver and kidneys. Do not take with statins, ergotamine preparations.
How to choose pills for toenail fungus
The elimination of fungal infections of the nails is a complex procedure that includes topical drugs in mild cases, and usually a combination of topical and systemic drugs. Local remedies are varnishes, sprays, ointments or creams, nail solutions, files and plasters. All of them help to kill the fungus and remove the affected nails as soon as possible. Tablets from nail fungus supplement the action of local preparations, freeing skin tissues and subungual spaces from the fungus, where local agents do not penetrate. It is important to select drugs only with a doctor, individually, depending on the age and severity of the problems.
Treatment lasts up to 3 – 6 months, and often patients do not withstand such a course, quitting halfway, which is why relapses occur. To reduce the duration of therapy, new types of drugs are being developed, they can be used once a week.
Popular questions and answers
We asked questions regarding the choice of drugs against nail fungus and the treatment of onychomycosis pharmacist, teacher of pharmacology, editor-in-chief of MedCorr Olga Zorina.
Why can nail fungus occur?
Age. The risk of developing a fungal nail infection increases with age. It is most common in the elderly and least common in children. Before the age of 6, a fungal nail infection rarely develops.
Climate. Living in a hot and humid climate increases the risk of developing a fungal nail infection.
Health. You are at increased risk of developing a fungal nail infection if you have one or more of the following conditions:
• athlete’s foot (or other skin infection caused by a fungus);
• cancer and chemotherapy;
• diabetes;
• have had a nail infection before;
• damaged nail or recent nail surgery;
• people in your family often get sick with fungal pathologies;
• poor blood circulation in the extremities;
• psoriasis;
• weakened immune system.
Life style. Your risk of contracting a fungal nail infection is increased if you:
• wet your feet or hands often during the day;
• smoke;
• spend a lot of time in the water;
• walk barefoot in a hot, humid place, such as a pool, public shower, or locker room;
• wear tight, closed shoes, especially if you have sweaty feet.
What to do if you have nail fungus?
Having nail fungus is usually painless. At least in the beginning. However, if you delay treatment, the fungus can grow. As toenail fungus progresses, wearing shoes can become painful. If you see any changes in the nail, you should see a dermatologist. If detected early, nail fungus can only be eliminated with nail treatment. As the fungus grows, it becomes increasingly difficult to get rid of the infection.