Medical solutions for toenail fungus are not one-size-fits-all. Some patients go from treatment to treatment with no success. Usually these are the people who resort to fungal nail laser treatment to ultimately cure their condition. There are special considerations for treating fungal infections in the elderly.
Diagnosing Toenail Fungus In The Elderly
Nail changes are common in the elderly, reports the journal Canadian Family Physician. Age-related changes may include nails that are thicker at the base and more brittle at the tips, ridged, yellowed, or dull. Since thickened, yellowed, crumbling nails are the primary sign of severe toenail fungus, it’s important that the doctor or podiatrist take a culture sample to be certain it is, in fact, a fungal infection and not simply the normal signs of aging. Researchers aren’t exactly sure why these changes occur, but it could be due to impaired circulation, faulty biomechanics, infections or concurrent diseases that affect the nails.
Antifungal Drug Interactions
One of the challenges in treating the elderly is the fact that they are often on multiple other medications, which may interact with the standard oral treatments like terbinafine (Lamisil) or itraconazole (Onmel, Sporanox). For instance, terbinafine pills interact with 286 other drugs — including 7 serious interactions, according to Drugs.com. Terbinafine especially interacts with drugs like tamoxifen for breast cancer treatment and anti-psychotic drug pimozide, for instance. Itraconazole interacts with 469 different drugs, including 112 serious reactions. Popular drugs like Advair, Flomax, Lipitor and Levitra can all be compromised with itraconazole. People who have liver disease, neutropenia, renal dysfunction and immunosuppression should not try to eliminate toenail fungus with oral medication.
Toenail Fungus Treatment In The Elderly
Other options to eliminate signs of toenail fungus include:
– Fungal nail laser treatment: Laser treatment is generally considered effective, especially in people with hard-to-treat cases of nail fungus. The downside is that it can be expensive ($500 – $1,000) and insurance does not cover this “cosmetic procedure.” You will also still have to wait until the nail grows out to see real improvement.
– Topical foot cream or nail lacquer for toenail fungus: Topical solutions cannot usually penetrate to the root cause of the fungus, which is why the success rates are only eight to 12%. Many of these products contain antifungal ingredients, but have not been clinically tested. Newer lacquers like Penlac are currently being tested as a complementary therapy to help quicken recovery and prevent the return of nail fungus.
– Home remedies for toenail fungus, such as 100% tea tree oil: A few promising studies point to the antifungal powers of 100% tea tree oil from Australia. More research is needed to make this link clearer, but some people swear that it has worked for them.
– SteriShoe UV shoe sanitizer: Of course, part of a successful nail fungus solution involves preventing re-infection. Since fungus reproduces by tiny spores, you can imagine how easy it is for these spores to fall through sock fibers and into the shoes, where it collects and remains active for quite some time. The only true way to beat toenail fungus is to sanitize the shoes. One 45-minute treatment with our UVC light device can kill up to 99.9% of the bacteria and fungus living in your footwear.