Can an individual with onychomycosis (fungal nail infection) work in sterile processing?

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Last updated: May 23, 2025View editorial policy

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From the Guidelines

Working in sterile processing with a fungal nail infection is not recommended without proper treatment and containment measures, as it poses a risk of contaminating sterile environments and potentially causing infections in patients. According to the British Association of Dermatologists' guidelines for the management of onychomycosis 2014 1, fungal nail infections are highly contagious and persistent, with high recurrence rates. To minimize the risk of contamination, it is essential to consult with your occupational health department and supervisor before continuing work in sterile processing.

Treatment typically involves oral antifungal medications like terbinafine (250mg daily for 6-12 weeks) or itraconazole (200mg twice daily for 1 week per month, for 2-3 months), along with topical treatments such as ciclopirox nail lacquer applied daily 1. While undergoing treatment, you must strictly adhere to infection control protocols, including:

  • Wearing intact gloves at all times
  • Practicing meticulous hand hygiene
  • Possibly covering affected nails with waterproof bandages

The guidelines for infection control in dental health-care settings--2003 1 emphasize the importance of ensuring the effectiveness of the sterilization process, monitoring each load with mechanical and chemical indicators, and placing a chemical indicator on the inside of each package. However, these guidelines do not specifically address the issue of working with a fungal nail infection in sterile processing.

In the context of real-life clinical medicine, it is crucial to prioritize caution and take measures to prevent contamination, as the risk of infection transmission is a significant concern. Therefore, it is recommended to prioritize treatment and containment measures before continuing work in sterile processing.

From the Research

Sterile Processing and Fungal Nail Infection

  • Fungal nail infection, also known as onychomycosis, is a common problem that can cause damage to the nail's structure and physical appearance 2.
  • There is no direct evidence in the provided studies that addresses whether someone with a fungal nail infection can work in sterile processing.
  • However, it is essential to consider the potential risks of transmission and contamination in a sterile processing environment.
  • Onychomycosis can be treated with various methods, including oral and topical antifungals, but the effectiveness of these treatments can vary 3, 4, 5.
  • It is crucial to follow proper infection control protocols and guidelines to prevent the spread of fungal infections in healthcare settings 6.
  • Individuals with fungal nail infections should take precautions to prevent transmission, such as wearing gloves and keeping their nails clean and dry.
  • Ultimately, the decision to allow someone with a fungal nail infection to work in sterile processing should be made on a case-by-case basis, considering the individual's condition, treatment, and ability to follow proper infection control protocols.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Fungal nail infections: diagnosis and management.

Prescrire international, 2009

Research

Antifungal Drugs for Onychomycosis: Efficacy, Safety, and Mechanisms of Action.

Seminars in cutaneous medicine and surgery, 2016

Research

Oral antifungal medication for toenail onychomycosis.

The Cochrane database of systematic reviews, 2017

Research

Onychomycosis: Diagnosis, Treatment, and Prevention.

Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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