Onychomycosis

Onychomycosis is infection of the nails with dermatophyte fungus. Most commonly it involves the toenails, although advanced infections may eventually involve the fingernails as well. The challenge of these infections is that commonly the fungus is able to get underneath the actual nail, where it lives in a highly protected environment, living by digesting the nail itself for nourishment. Because the fungus hides under the nails, it is extremely difficult to eradicate. Many topical treatments ranging from folk remedies like Vick’s VapoRub all the way to prescription medications are used, but the success rates are disappointingly low. Even with powerful oral antifungal medications, treatments take months, and still do not work in 100% of the cases. While typically more of a cosmetic nuisance, in some cases, like with diabetic patients, the nail infections can make it easier to get a deep infection of the foot. Thus in diabetics, treatment of nail fungus is considered medically necessary.