Can anything be done to cure or at least control nail and skin fungus on my feet? It looks ugly and is annoying.
Fungus infections of the feet, and other parts of the body such as the groin, ear canals, and any part of the skin surface are very common. They are usually easily treated with an anti-fungal cream such as terbinafine (Lamisil AT), miconazole (Lotrimin), or tolnaftate (Tinactin). All are available over the counter without a prescription, and are quite safe to use, although they may have to be used consistently for several weeks to really cure the infection.
Infection of the toenails or fingernails (onychomycosis) by a fungus is a different thing entirely. When the fungus gets into the nail, it can infect the nail bed where the nail is being formed, and creams, liquids, or powders can’t get in there to be effective. Only a medication delivered by the blood to the nail bed, which gets incorporated into the newly formed nail and kills the fungus permanently will eradicate this infection.
For mild cases where the fungus has not reached the nail bed, a liquid solution of ciclopirox (Penlac) is available. I have had no experience with its use, but the published reports on it don’t report cures in a large percentage of cases.
Until recently the only treatment that was effective for onychomycosis was griseofulvin (Fulvicin), and the treatment was very prolonged, up to a year for big toe toenails which grow slowly. The nail had to continue to be exposed to the drug until it had totally grown out without fungus, which in the case of the big toes could be up to one year. Not many people could put up with the medication for a year, and of course, like all medicines, it has side effects.
Recently it has been shown that some of the newer anti-fungal agents, like itraconazole (Sporonox), fluconazole (Diflucan), and terfinabine (Lamisil), can eradicate onychomycosis with shorter courses of treatment, since the drug is incorporated into the nail in a permanent fashion that has a persistent killing effect on the fungus. Treatment may last only 8-12 weeks, and pulsed treatment, where the drug is taken for one week out of three or four for several months have also been successful. All of these drugs have fewer side effects than griseofulvin, and have largely supplanted it in the treatment of onychomycosis.