Treatments for Nail Diseases

Your hands are among your most noticeable features. So unsightly nails can be distressing. Though dermatology is thought to focus solely on the skin, our Orlando dermatology practice also provides expert diagnosis and treatment of nail diseases and nail fungus.


An infection with nail fungus can affect one or more fingernails or toenails and may begin with a white or yellow spot. The cause often is a fungus called a dermatophyte, but could also be a yeast or mold. These organisms thrive in warm, moist places such as showers or swimming pools and invade the body through small cuts or separations in the nail bed.

Signs and Symptoms

The affected nail often becomes thickened, dull, brittle or crumbly with a discolored yellowish appearance. The primary nail diseases are: Onychomycosis (The nails become thickened and brittle. They can be colored yellow, green, black, or white.); Onycholysis (This occurs due to detachment of the nail plate from the nail bed. It starts at the tip or distal end of the nail and "lifts up" the nail plate); Median canaliform dystrophy (The nail assumes a characteristic "fur-tree" appearance due to longitudinal splitting of the middle nail. This deformity can be congenital or acquired via constant picking of the nail.); Onychocryptosis (Ingrown nails become inflamed and red. They can become infected and filled with pus. Sometimes removal of the embedded nail is the only effective treatment.); and Onychomalacia (The nails become deformed, crumbled and frail.). It is possible also to have a skin infection around the toes called Tinea Pedis (athletes foot), a contagious disease caused by a fungus that thrives on moist surfaces, which causes itching, peeling and sometimes burning skin between the toes. It can spread to other areas of the body.

Nail Disease Diagnosis and Treatment

The medication recommended depends on the type and severity of the nail infection. The docotor may send your nail clippings to an offsite laboratory for further diagnosis if there is any doubt about the diagnosis or if treatment has failed. Toenails often require oral medication for up to 12 weeks in patients who do not have liver disease (these medications are processed through the liver). Blood tests before and during treatment may be recommended to check the liver enzymes.

A topical gel may be used either instead of or along with oral treatment for best results. Your dermatologist also may prescribe a special nail lacquer and nail file. Tinea Pedis is best treated with antifungal cream or ointment, as over-the-counter medications rarely are often strong enough to be effective.

Follow up and Outcomes

Preventative actions include keeping nails short, wearing loose shoes, avoiding exposure of the feet or hands to damp environments, and avoiding going barefoot or wearing open sandals. Breathable fabric socks and shoes are highly recommended, as are regular visits to our practice where skincare specialists can screen for recurrence and remind you of preventative actions.

DISCLAIMER: The information provided by this site is intended solely for educational purposes. This information is not to be used for medical diagnostic purposes and is not intended to serve as a recommendation for treatment and/or management of any medical/surgical condition. Most of all, this information should not be used in place of a physician or other qualified health provider. If you believe you have a medical condition, please contact your physician immediately.

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