Consult Doctors. FREE.
Real Doctors, Expert Answers
Connect with Facebook Connect with Google For Doctors
By creating an account, you are indicating that you have read and accepted the DoctorxDentist Terms of Use.
Consult Doctors. FREE.
Real Doctors, Expert Answers
By creating an account, you are indicating that you have read and accepted the DoctorxDentist Terms of Use.
Registration Progress
Step 1: Indicate Topics of Interests
Step 2: Follow Relevant Doctors
Complete!
What are your interests?
Please select at least 3 interests.
NEXT
NEXT
Registration Progress
Step 1: Indicate Topics of doctors
Step 2: Follow Relevant Doctors
Complete!
Follow your favourite doctors
We found some doctors you may like. Click continue to follow them.
CONTINUE
CONTINUE
Consult Doctors. FREE.
Real Doctors, Expert Answers
Continue with Facebook Continue with Google

or

OOPS!

SOMETHING WENT WRONG.

PLEASE TRY AGAIN.

OOPS! SOMETHING

WENT WRONG.

PLEASE TRY AGAIN.

Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

Continue with Facebook Continue with Google

Disclaimer: Any answers provided are for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

YOUR QUESTION HAS BEEN

SUCCESSFULLY SUBMITTED.

YOUR QUESTION

HAS BEEN

SUCCESSFULLY

SUBMITTED.

YOUR ANSWER HAS BEEN

SUCCESSFULLY SUBMITTED.

YOUR ANSWER

HAS BEEN

SUCCESSFULLY

SUBMITTED.

YOUR QUOTE REQUEST HAS BEEN

SUCCESSFULLY SUBMITTED.

OUR DOCTORS WILL GET BACK TO YOU SHORTLY!

YOUR QUOTE REQUEST

HAS BEEN

SUCCESSFULLY

SUBMITTED.

OUR DOCTORS WILL GET

BACK TO YOU SHORTLY!

YOUR THREAD HAS BEEN

SUCCESSFULLY CREATED.

HEAD OVER TO FORUM PAGE NOW

TO JOIN THE DISCUSSION

YOUR THREAD

HAS BEEN

SUCCESSFULLY

CREATED.

HEAD OVER TO THE FORUM PAGE NOW

TO JOIN THE DISCUSSION!

YOUR REVIEW HAS BEEN

SUCCESSFULLY SUBMITTED.

THANK YOU.

YOUR REVIEW

HAS BEEN

SUCCESSFULLY

SUBMITTED.

THANK YOU.

OOPS!

THERE IS SOMETHING

WRONG WITH YOUR EMAIL.

PLEASE TRY AGAIN.

OOPS! THERE IS

SOMETHING WRONG

WITH YOUR EMAIL.

PLEASE TRY AGAIN.

YOUR EMAIL HAS BEEN

SUCCESSFULLY SUBSCRIBED.

THANK YOU.

YOUR EMAIL

HAS BEEN

SUCCESSFULLY

SUBSCRIBED.

THANK YOU.

YOUR CONSULTATION HAS BEEN

SUCCESSFULLY SUBMITTED.

OUR DOCTORS WILL

GET BACK TO YOU SHORTLY.

YOUR CONSULTATION

HAS BEEN

SUCCESSFULLY

SUBMITTED.

OUR DOCTORS

WILL GET

TO YOU

SHORTLY.

MESSAGES TO

Treating Fungal Nail Infections: Tips From A Singapore Dermatologist

Treating Fungal Nail Infections: Tips From A Singapore Dermatologist  undefined

Infections used to be a greater threat to human life than they now are, with advanced healthcare and public hygiene improvements in Singapore. However, one infection lies literally under our feet and is often underestimated: fungal nail infections.

Fungal nail infections include:

  • distal subungual onychomycosis (caused by Trichophyton rubrum, leading to thickened, yellowing, or crumbling nails)
  • white superficial onychomycosis (caused by fungi in the nail plate layers, including Trichophyton mentagrophytes)
  • candida onychomycosis (caused by candida fungi species infections, often in people whose nails are often exposed to water or previously affected by infections or injury)
  • and proximal subungual onychomycosis (usually caused by T. rubrum, often seen in patients affected with HIV with weakened immune systems).


While such infections may not be as life-threatening as some other types of infections, they can be indicators of the overall picture of your health, and affect appearance and confidence. [1]

Dermatologist Dr Liew Hui Min responded to a reader question on treatment methods typically used for fungal nail infections. Here is her detailed response about how to identify and ultimately manage the issue.

What are the common causes of nail infection in Singapore?

 

nail polish on fingernails


Fungal nail infection is the most common nail infection in Singapore. So be careful where you walk barefoot. Walking on dirty surfaces is one cause of fungal nail infections. A visit to the nail salon may also cause an infection if the manicurist does not practice good hygiene.

Trauma to the nails (possibly caused by activities or ill-fitting shoes) and athlete's foot, which may cause infection, are all possibilities. [2]

Nail deformities may not actually be infections

 

deformed toenail


While fungal nail infections can come in various forms, they may also just be nail deformities that somewhat resemble infectious conditions. These are a little trickier to identify, which is why nail clippings are typically sent for a fungal culture to determine if there is a type of fungus or mould present.

Conditions that can be mistaken as fungal nail infections include psoriasis, contact dermatitis, trauma, and yellow nail syndrome. [3]

Results can take up to two months to finalise

 

nail medication being applied

Once a sample has been sent to the clinic, it could take up to two months for the culture results to be confirmed. In the meantime, you could try applying topical treatments (like clotrimazole lotion +/- amorolfine lacquer). [4]

Oral antifungals could be solutions to your problem

antifungal medication

Once a fungal nail infection has, in fact, been confirmed by your dermatologist, he or she may then discuss the option of using oral antifungals as possible solutions for you.

Oral antifungals are effective but could take at least 3 months or more, which also means costs are considerably high. [5]

There's a possibility that oral antifungals could affect your liver

illustration of a liver


In addition, oral antifungals could have certain side effects (particularly liver toxicity). This is uncommon, but the possibility is still there, so doctors will need to monitor your liver through blood tests (especially if prolonged treatment is required). [6]

Topical treatments can help, depending on the severity

 

a woman applying hand cream


Due to the factors involved with oral treatment (like price, prolonged application and possible side effects), some people instead only opt for topical treatments when dealing with fungal nail infections.

Their effectiveness, however, depends on the severity of the infection (so you might want to consult your doctor first). [7]

Infections may be followed by pain

doctor checking a patient's toenail


If a fungal nail infection leads to pain, get the nail closely examined to make sure other underlying causes are ruled out. [8]

Consider nail plate removal

an infected fingernail


Once a fungal nail infection has been identified and confirmed through thorough assessments, there is an alternative option that could be effective - nail plate removal under local anaesthesia. Once the nail bed starts to heal, topical antifungal medicine can be applied.


If you suspect an infection, it's important that you seek treatment and consultation from a dermatologist before things get worse. There's a possibility that infections could actually be something else entirely so a proper inspection is required.

 

Would you like to ask any related health questions? 

You can Ask A Doctor right away, or view the complete list of DoctorxDentist Sessions.

 

References:

1. Phillip Rodgers and Mary Bassle. Treating Onychomycosis. American Family Physician. Feb 15, 2001. Accessed March 2019.

2. Diseases Of The Nail. National Skin Centre. National Skin Centre. 28 Oct 2013. Accessed April 2019.

3. Ann Pietrangelo and Alana Biggers. Nail Abnormalities. Healthline. 30 March 2018. Accessed April 2019.

4. Mayo Clinic Staff. Nail fungus. Mayo Clinic. 3 Jan 2019. Accessed April 2019.

5. Stephanie S. Gardner. How are oral antifungal agents used to treat skin conditions? WebMD. 20 Apr 2017. Accessed April 2019.

6. Frank C.Odds, Alistair J.P.Brown, Neil A.R.Gow. Antifungal agents: mechanisms of action Trends in Microbiology Volume 11, Issue 6, June 2003, Pages 272-279. Accessed April 2019.

7. Catherine Moyer. Topical Treatments for Toenail Fungus. VeryWellHealth. 18 Dec 2018. Accessed April 2019.

8. Sabrina Felson. Paronychia Treatment. WebMD. 22 Oct 2017. Accessed April 2019.

9. Neh Onumah. Nail Surgery Treatment & Management. MedScape. 15 Feb 2019. Accessed April 2019.

 

208 views 2 Apr 2019 Medically reviewed by Dr Liew Hui Min, last update on 17 Apr 2019
Not the answer you're looking for? Browse other answers tagged Skin, Hair & Nails or ask your own question now FOR FREE.