From the Guidelines
Proper toenail care involves regular trimming, keeping nails clean and dry, and wearing properly fitting shoes, as emphasized in the most recent guidelines 1. To achieve this, trim toenails straight across using clean nail clippers, then file the edges to prevent sharp corners that could become ingrown. Aim to cut nails no shorter than the edge of your toe. After bathing when nails are softer is the ideal time for trimming. Clean under nails gently with a soft brush, and thoroughly dry feet after washing to prevent fungal infections. For fungal infections, over-the-counter antifungal treatments like clotrimazole or terbinafine can be applied directly to affected nails twice daily for several weeks, as supported by studies 1. More severe infections may require prescription medications like oral terbinafine (250mg daily for 6-12 weeks), with terbinafine being the preferred treatment due to its higher efficacy and tolerability 1. Ingrown toenails can be prevented by proper trimming and avoiding tight shoes. If you have diabetes or circulation problems, regular professional foot care is recommended as minor injuries can lead to serious complications. Moisturize feet regularly but avoid applying lotion between toes where moisture can promote fungal growth. These practices help maintain healthy toenails by preventing common issues while supporting overall foot health, and are particularly important for individuals with certain health conditions or those taking anticancer agents that may increase the risk of nail-related complications 1.
Some key points to consider:
- Regular trimming and cleaning can help prevent fungal infections and ingrown toenails.
- Properly fitting shoes can reduce the risk of nail trauma and pressure.
- Topical antifungal treatments can be effective for mild to moderate fungal infections.
- Oral antifungal medications like terbinafine may be necessary for more severe infections.
- Regular foot care is crucial for individuals with diabetes or circulation problems to prevent serious complications.
- Moisturizing feet can help maintain healthy skin, but avoid applying lotion between toes to prevent fungal growth.
Overall, prioritizing toenail care and taking preventive measures can significantly reduce the risk of common nail-related issues and support overall foot health, as highlighted in the recent guidelines and studies 1.
From the Research
Toenail Care and Fungal Infections
Toenail care is crucial in preventing and managing fungal infections. Fungal infections of the toenail, also known as onychomycosis, can be caused by dermatophytes, which are a type of fungus 2.
Causes and Treatment of Fungal Infections
- Dermatophytosis is an infection of the hair, skin, or nails caused by a dermatophyte, which is most commonly of the Trichophyton genus and less commonly of the Microsporum or Epidermophyton genera 2.
- The treatment of fungal infections caused by a dermatophyte has been successful when treated with oral or topical antifungal agents 2.
- Terbinafine, itraconazole, and fluconazole are oral antimycotics that are effective in the treatment of superficial mycoses, although, depending on the severity of the infection, a topical antifungal may be sufficient 2.
Effectiveness of Oral Antifungal Agents
- Terbinafine and itraconazole are the two most frequently prescribed oral antifungal agents to treat onychomycosis, with terbinafine having a relatively low potential for drug-drug interactions 3.
- A study found that itraconazole was superior to fluconazole, griseofulvin, and terbinafine in treating chronic and chronic relapsing dermatophytosis in India 4.
- Another study found that terbinafine and azole-based medications were associated with higher clinical and mycological cure rates compared with placebo, with terbinafine having higher cure rates than azoles 5.
Oral Therapy for Superficial Fungal Infections
- Oral therapy with fluconazole, itraconazole, and terbinafine is effective in treating common superficial fungal infections of the skin, including tinea corporis, tinea cruris, and tinea pedis 6.
- The effectiveness of oral antifungal agents can vary depending on the specific infection and the severity of the disease 6.