Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Onychomycosis is a fungal infection of the toenails or fingernails. Onychomycosis causes fingernails or toenails to thicken, discolor, disfigure, and split. At first, onychomycosis appears to be only a cosmetic concern. Without treatment, however, the toenails can become so thick that they press against the inside of the shoes, causing pressure, irritation, and pain. Fingernail infection may cause psychological, social, or employment-related problems.
Half of all nail disorders are caused by onychomycosis, and it is the most common nail disease in adults. Toenails are much more likely to be infected than fingernails. The incidence of onychomycosis has been increasing and is related to diabetes, a suppressed immune system, and increasing age. Adults are 30 times more likely to have onychomycosis than children. In fact, only 2.6% of children younger than 18 years are reported to have onychomycosis, but as many as 90% of elderly people have onychomycosis.
Onychomycosis is divided into subtypes. The main subtypes of onychomycosis are distal lateral subungual (the area under the nail) onychomycosis (DLSO or DSO), white superficial onychomycosis (WSO), proximal subungual onychomycosis (PSO), endonyx onychomycosis (EO), and candidal onychomycosis. People with onychomycosis may have a combination of these subtypes. Total dystrophic onychomycosis is the term used to refer to the most advanced form of any subtype.
Whether to treat a fungal nail infection is up to you. If it is not treated, it won't go away, and it might get worse. But fungal infections can be hard to treat. If you do treat it, you could spend a lot of money, and the treatment might not work.
If you decide to treat a fungal nail infection, you can try an antifungal cream, lotion, or nail polish. You can buy some types without a prescription, or your doctor can prescribe a stronger one. You may need to use this medicine for a few weeks or for as long as a year. Even so, it may not get rid of the infection.
Antifungal pills give the best chance of curing a severe fungal nail infection, but they may cost a lot and have serious side effects. You will need to see your doctor for regular testing if you take these pills. You should not take them if you have liver or heart problems.