* For advanced cases of nail fungus (indicated by thickening of the nail and separation of the nail from the underlying nail plate), prescription pills may be necessary. If you and your doctor are considering this option, though, it's important that you discuss your medical history thoroughly. These drugs can be harmful to the liver, so you'll likely need to undergo a series of tests to check your liver function. It's also important to avoid alcohol while undergoing treatment. Patients typically need to continue taking these pills for 6-9 months to fully treat fungus (and give the healthy nail time to grow out).
* When fungus is still on the surface of nails (indicated by white flaking on the uppermost layer of the nail), prescription antifungal creams may be a good first line of treatment. They are less effective than pills (creams don't penetrate the nail body), but can stop nail fungus when used early. You might also talk to your doctor about Penlac, a prescription clear nail lacquer that can be applied daily to treat mild to moderate nail fungus.
* You can also look for over-the-counter antifungal creams, like Lamisil, that used to be available by prescription only but are now available at most drugstores. (They are typically cheaper than prescription topical products, but keep in mind that your insurance plan may cover prescription options.) The labeling on these products may indicate that they are not for use on nails -- that's not because there are safety issues, but simply because their makers know that creams won't work on advanced cases of nail fungus. Still, they're worth a try at the first signs of nail fungus (while you're waiting to see your doctor, for example).
* For those of you who prefer natural products, Miranel Antifungal Treatment may be an appealing option: It combines soothing botanical ingredients like tea tree oil, eucalyptus, menthol, and camphor with 2% Miconazole Nitrate, an effective anti-fungal ingredient. Miranel is available without a prescription and can also be an effective preventive measure if you spend a lot of time in the warm, damp places where fungus tends to thrive, like locker rooms or swimming pools. Or apply it after a pedicure, for example, as some pedicure baths have been found to harbor fungus.
Remember, fungal infections can be stubborn and may take several months to clear up -- the key is to stick with whichever treatment you and your doctor choose.
Wishing you great skin!
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Dr. Baumann is author of the best-selling book, " The Skin Type Solution." To learn more about her revolutionary skin typing system, visit her Web site, SkinTypeSolutions.com.
All of Dr. Baumann's recommended skin care products are available online, and a portion of proceeds goes to The Dermatology Foundation.
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