Onychomycosis, better known as nail fungus, is a common infection that can affect your fingernails and toenails. While both can be affected, toenail fungus is more common.
If you think you have a nail fungus infection, it’s important to see a specialist. Dermatologists are experts in conditions that affect the skin, hair, and nails. They are equipped to diagnose nail fungus accurately and recommend the best course of treatment.
This article will provide you with information about how a dermatologist diagnoses and treats nail fungus, so you can be prepared to discuss your options with a doctor for nails with fungus.
How is nail fungus diagnosed?
If you think you might have nail fungus, you’ll want to visit a dermatologist for an accurate diagnosis. Here’s what you can expect.
Visual Examination and Patient History
Often, the dermatologist will start by looking at your nail. They’ll check for the classic signs of nail fungus, like:
- Thickening
- Discoloration
- Brittleness
They’ll also ask you questions about your symptoms, medical history, and any treatments you’ve tried before.
Laboratory Testing
To really know for sure, lab tests are usually needed. The dermatologist will take a sample of nail debris, clippings, or skin scrapings from under your nail.
This sample goes to a lab for analysis. They might do a fungal culture or look at it under a microscope.
Ruling out Other Conditions
It’s also important to rule out other things that can look like nail fungus. Conditions like psoriasis or nail injuries can cause similar symptoms.
Getting the right diagnosis is key so you can get the right treatment.
Creams, gels, and lacquers for nail fungus
If you have a mild to moderate nail fungus infection, and it only affects a few nails, a doctor may recommend a topical treatment.
Types of topical antifungal medications
Common topical antifungals include amorolfine, ciclopirox, efinaconazole, and tavaborole. You apply these medications directly to the affected nail.
How to use topical treatments effectively
Before you apply the medication, trim the infected nail and remove any debris from underneath it. The medicine needs to be able to reach the nail bed to kill the fungus, so you don’t want anything blocking its path.
Topical treatments take a long time to work, so you have to be patient and persistent. You’ll need to apply the medication consistently for several months — about 4 to 6 months for fingernails and 12 to 18 months for toenails. It’s important to follow the doctor’s instructions and keep using the medication for as long as prescribed, even if your nail starts to look better.
Oral medications for nail fungus
If you have a bad case of nail fungus, your doctor may recommend oral medications. You may also need oral medicine if creams and lacquers haven’t helped.
When are oral medications necessary?
Oral antifungal medications are usually prescribed for more severe or widespread nail fungus infections.
Types of oral antifungal medications
Common oral antifungals include, and some like Ketoconazole, may have specific uses, side effects, and more.
- fluconazole
- griseofulvin
- itraconazole
- terbinafine
These medications work by killing the fungus from the inside out.
What are the side effects?
Oral antifungals can have side effects, such as liver damage or drug interactions. Your doctor will likely order blood tests to check on your liver function. Be sure to discuss the risks and benefits with your dermatologist.
Other Treatment Options and Emerging Therapies
If those first-line treatments aren’t cutting it, here are some other things your doctor might suggest:
- Combination Therapy: Sometimes, using both topical and oral medications together works better than using just one.
- Nail Removal: In really bad cases, your doctor might suggest removing the nail completely. This can be done surgically or with chemicals.
- Emerging Therapies: Scientists are always looking for new ways to fight fungus! Lasers and light treatments are some of the newer options being explored.
Frequently Asked Questions
Which doctor is best for nail fungus?
For nail fungus, you’ve got two main options: a dermatologist or a podiatrist. Both are qualified to diagnose and treat nail fungus, so the “best” really depends on your personal preference and insurance coverage. If you have other skin conditions, a dermatologist might be a good choice. For foot-specific issues, a podiatrist is often the way to go.
Does a dermatologist treat nail fungus?
Absolutely! Dermatologists are skin, hair, and nail specialists. They’re well-versed in diagnosing and treating various nail conditions, including fungal infections. They can prescribe topical or oral medications, or even recommend other treatment options.
Does insurance cover toenail fungus treatment?
Coverage varies widely depending on your insurance plan. Some plans cover oral medications and certain topical treatments, while others may have restrictions or require prior authorization. It’s always a good idea to check with your insurance provider to understand your specific benefits for toenail fungus treatment.
Does insurance cover podiatrists?
Again, it depends on your insurance! Most insurance plans do cover podiatrists, but some may require a referral from your primary care physician. Be sure to verify your coverage details with your insurance company before scheduling an appointment.
How do I get rid of nail fungus ASAP?
Unfortunately, there’s no magic bullet for getting rid of nail fungus overnight. Treatment usually takes time, often several months, as the new, healthy nail needs to grow out and replace the infected portion. Prescription oral medications tend to be the fastest (though come with potential side effects), but topical treatments can also be effective over a longer period. See a doctor for diagnosis and treatment recommendations!
In Summary
If you think you have a nail fungus, it’s important to see a dermatologist. They can make sure you get the right diagnosis and treatment.
Treating nail fungus can take a long time, so you have to be patient and follow your dermatologist’s instructions. Even after the fungus is gone, it can come back, so it’s important to take steps to prevent it.