Fungal nails, onychomycosis is very challenging to treat and can take years to improve. Here are some of the reasons why your nails are not clear with treatment.
1. You don't have fungus.
About 40-50% of yellow thick nails are not actually fungal nails. Thick discolored nails can be from trauma, psoriasis, or lichen planus. We recommend nail samples be obtained for anyone that is considering treating the nails. There are treatment options if you do not have fungus.
2. You have a yeast infection and not a fungal infection in your nails.
Medications like Lamisil are not effective against yeast in the nails. This is why nail samples are important to properly diagnose what is causing the infection.
3. You are not using the right medication for the condition.
The yellow or white circle or streak is a fungal abscess or collection of fungus debris in the nail plate. Unfortunately, oral medications do not work for this type of infection. Topical medications like efinaconazole are more effective.
4. You are not being consistent with treatment.
New habits can be hard. Remembering to apply a topical medication to your toenails or taking a new pill can be challenging. Consistency is the key to treating the infection.
5. You have a family history of fungal nails.
Fungal nails can be very difficult to treat because your body does not see the fungus as a threat. Some folks have very little immune response to the fungus. Often this is due to a faulty gene that one of your parents or grandparents had. Chances are your mother or father have fungal nails too.
6. You waited too long before seeking treatment
It is much easier to treat one toe with some discoloration at the end of the nail rather than all 10 toes with 100% nail involvement.
7. The fungus is resistant to the medication
We are now seeing Lamisil resistance like drug resistance with bacteria and antibiotics. If you have been treated with Lamisil/terbinafine in the past we can take a nail sample to check for drug resistance.
If you or someone you know has fungal nails, Dr. Michele Kurlanski is here to help. We can evaluate your feet and make recommendations on proper treatment. Call us today at (207) 774-0028 to schedule your next appointment at our location in Scarborough, Maine!