Nail Fungus: What Is the Most Effective Treatment?

Provider: Lee Mi-seok Theme Dermatology Clinic

What is nail fungus (onychomycosis)?

Nail fungus (onychomycosis) is commonly called nail fungus and refers to a skin disease in which a fungus, such as dermatophytes, invades and infects the stratum corneum, hair, fingernails, and toenails, causing a fungal infection.

Fungi use the keratin in our bodies as nourishment. They can cause infections in various areas, including the skin, hair, and beard, but nail infections account for about 46% of all cases, making them particularly common.

Types of nail fungus

Nail fungus is classified into various forms depending on the pattern and location of fungal invasion.

1. Distal lateral subungual onychomycosis

This type of fungus infection starts at the outer and lateral edges of the nail and causes infection beneath the nail. The epidermis at the base of the nail often appears yellow or yellow-brown, which is a result of inflammation and fungal growth. Over time, the nail and keratin thicken, become cloudy in color, and lose their shine, and nail separation occurs.

2. White superficial onychomycosis

If opaque white spots appear on the surface of the nail, white superficial onychomycosis may be suspected. The infected area becomes noticeable as a spot. This type can occur in both healthy individuals and people with HIV infection.

3. Proximal subungual onychomycosis

If the distal part is unaffected but the proximal part of the nail gradually becomes whitish, it may be proximal subungual onychomycosis. This is a form in which the fungus infects from the proximal nail fold and invades under the nail. It usually occurs in people with weakened immune function, such as those with HIV infection.

4. Total dystrophic onychomycosis

This is the most severe form of nail fungus among all types and appears when the infection has progressed over a long period. In this type, the nail plate often crumbles or is destroyed. It mainly occurs in patients with chronic mucocutaneous candidiasis or HIV infection, both of which severely weaken the immune system.

Why nail fungus must be treated

The reasons nail fungus treatment is necessary are as follows.

1. High contagion

Toenail fungus treatment and fingernail fungus treatment must not be delayed or done improperly because it is highly contagious. Not only is there a risk of infection spreading to other parts of the patient’s own body, but it can also easily spread to people around them, such as family and friends. Older adults with low immunity are especially vulnerable to infection, so contact should be minimized as much as possible and a hospital visit is needed as soon as possible.

2. Increased risk of complications

For patients with severe illness or chronic conditions, it is even more important to treat nail fungus properly. This is because patients with diabetes, peripheral vascular disease, or immunodeficiency have a high risk of recurrence. In addition, the likelihood of complications such as osteomyelitis and necrosis is higher, so prompt hospital visit is necessary.

3. Difficulty of complete cure

The later treatment begins after fungus symptoms appear, the harder it is to achieve a complete cure. Even if a cure is possible, it takes a long time. That is why early detection and a quick visit to a toenail and fingernail fungus treatment clinic are important.

4. High chance of recurrence

Even if it appears to be completely cured on the surface, fungus tends to recur easily. Visiting a dermatology clinic for fungus treatment as quickly as possible, receiving proper treatment, and managing the condition through consistent follow-up after treatment can reduce the chance of recurrence.

Treatment methods (oral medication, topical medication, the drawbacks of nail removal, and the advantages of Hiller laser)

After being diagnosed with nail fungus, how can it be treated?

When you visit a hospital, the specific treatment method is determined according to the type and severity of the fungus, as well as the patient’s characteristics.

1. Oral medication (oral antifungals)

Treatment with oral medication reaches the affected area through peripheral circulation, so the treatment period is relatively short and the cure rate is high. However, caution is needed because adverse effects may occur when taken together with other medications such as drugs for hyperlipidemia. In addition, side effects such as liver dysfunction, skin rash, and gastrointestinal adverse effects may occur rarely, so it is very important to take the correct amount properly under the diagnosis of a dermatologist.

2. Topical medication (topical antifungals)

Topical medication is divided into over-the-counter products that can be purchased at a pharmacy and prescription medications that require a dermatologist’s prescription. This method applies the medicine directly to the infected area so that it can penetrate the nail plate and reach the infected site. Because it acts only on the local area, it has fewer metabolic effects and drug interactions than oral medication.

3. Nail removal

Nail removal can be divided into surgical nail removal, which removes the damaged nail, and chemical nail removal using ointment. Because this method damages the nail bed during treatment, it can affect the shape of the new nail as it grows, and the procedure can be painful. In addition, recurrence is common after removal surgery, so sufficient consultation with a doctor is necessary.

4. Laser treatment

Toenail fungus laser treatment is a method of sterilizing the surface of the nail by applying laser energy. With a built-in real-time temperature sensor, side effects that may occur during the procedure can be minimized, allowing safe treatment. It also has the advantage that pregnant women, nursing mothers, and patients who cannot take medication due to liver or stomach conditions can undergo the procedure easily. Lee Mi-seok Theme Dermatology recommends using the Hiller 1064 laser for laser treatment because it causes less pain, is simple, and can deliver consistent effects even to deeper areas.

Prevention guidelines for nail fungus

1. Keep your hands and feet dry and always clean.

2. Wear well-ventilated shoes or change shoes frequently so your feet do not stay damp inside them.

3. Do not share nail care tools such as nail clippers with other people.

4. Be careful not to injure yourself when trimming your nails.

5. In shared spaces, wear your own shoes and socks whenever possible.

6. If you have nail fungus, do not share towels, slippers, or bathroom mats with family members.

7. If nail fungus symptoms are suspected, visit a hospital and receive treatment as quickly as possible.

Nail fungus (onychomycosis) often starts in the toenails and then spreads to the fingernails. If left untreated for a long period, it can spread and infect other parts of the body such as the scalp and face, as well as family members, so early treatment is important.

At Lee Mi-seok Dermatology Clinic, located in Sinsa-dong, Gangnam-gu, treatment is carried out through one-on-one personalized consultations and care programs suited to the patient’s skin condition. Rather than simply relieving symptoms, the clinic considers the underlying skin problem and provides customized combination treatment based on a dermatologist’s diagnosis. For effective treatment, the clinic continuously adds and replaces premium laser equipment in an effort to provide even better treatment results.