Onychomycosis: Current Trends in Toenail Fungus Diagnosis and Treatment

Toenail fungus, also known as onychomycosis, is a pesky condition that affects millions of people in the United States annually. It is unsightly and often causes discoloration in the toenail. However, do not dismiss it as a purely cosmetic issue. If left untreated, toenail fungus can cause pain, nail damage, and secondary conditions, especially among people with diabetes or a compromised immune system.

Fortunately, medical advancements have ensured toenail fungus is easier than ever to diagnose and treat. There are new ways to identify and manage this condition to ensure it does not affect your quality of life. If you suffer from persistent toenail fungus and want to explore different diagnostic and treatment options, these trends can help you make the best decision about your care.

Types of onychomycosis

Toenail fungus is not a one-size-fits-all condition. There are different types, each with its own characteristics. The first step to proper diagnosis and treatment is understanding the different types of toenail fungus. The four main types are:

New trends in diagnosing onychomycosis

Early detection of toenail fungus is crucial for effective treatment. However, in the past, the easiest way to tell that you have toenail fungus is through visual observation. Unfortunately, toenail fungus is not the only disease that causes toenail discoloration and brittle nails. Relying on visual examination alone can lead to misdiagnosis, ineffective treatments, worsening symptoms, and wasted time. Fortunately, several modern diagnostic tools are changing this.

1.    PCR (Polymerase Chain Reaction) testing

This is one of the easiest ways to get a fast and accurate toenail fungus diagnosis. If you suspect you have toenail fungus but are unsure, a PCR test will detect the fungal DNA in a nail sample. Furthermore, this test identifies the specific type of toenail fungus causing the infection, ensuring you get the correct treatment.

Unlike traditional cultures, which take weeks, a PCR test delivers results in a few hours. This speed allows doctors to confirm toenail fungus and give targeted treatments sooner.

2.    Dermoscopy

A PCR test requires a nail sample, which some people may find invasive. If you want a visual diagnosis without invasive sampling, dermoscopy is your best bet. This diagnostic technique uses a magnified light source to reveal the telltale signs of toenail fungus, including:

• Irregular streaking
• Discoloration
• Nail plate crumbling

When diagnosing toenail fungus, you can’t always trust your eyes. Dermoscopy means that you can spot fungal patterns immediately. It is non-invasive, meaning you don’t have to deal with unnecessary scraping or lab tests.

3.    Optimal Coherence Tomography (OCT)

Toenail fungus diagnosis can be challenging in the early stages before any of the usual symptoms are visible. However, this is also the best time to treat toenail fungus before it takes root in your nails. OTC is a cutting-edge imaging method that produces a cross-sectional image of your toenail. This detailed image can identify a fungal infection beneath the nail plate before it is visible on the surface. It is suitable for early-stage infections and complex toenail fungus cases.

OCT is non-invasive and reduces the risk of a false diagnosis in the early stages. Early detection ensures patients get the correct treatment from the start.

4.    Fluorescence staining

Another modern diagnostic technique is fluorescence staining, which involves applying a special dye on the toenail. This die glows under fluorescent light and reveals fungal infections that may not be visible with traditional diagnostic methods.

Fluorescence staining is suitable for patients with recurring or severe infections where visible symptoms are not obvious.

5.    MALDI-TOF mass spectrometry

If your toenail fungus is not responding to medication, you may have to know the exact strain to get more targeted treatment. MALDI-TOF mass spectrometry analyzes the specific protein pattern in your nail samples to identify the fungal species. This helps your doctor prescribe the most effective treatment, especially if your toenail fungus is stubborn or recurring.

Emerging trends in onychomycosis treatment

Toenail fungus is notoriously difficult to treat, and you may have to use the medication or treatment solutions for 6 months to a year to notice any results. However, modern treatment strategies are improving success rates. These new approaches have better delivery methods, improved formulas, and innovative therapies.

1.    Enhanced topical solutions

Topical solutions are often the first line of defense when treating toenail fungus. However, toenails have a thick keratin structure and traditional treatments can struggle to penetrate the nail and reach the fungal infection. Fortunately, new formulations have improved absorption, allowing the ingredients to effectively reach the infected nail bed.

New topical treatments:

• Are easy to apply
• Require less frequent application
• Have few side effects

This advancement is significant because people with moderate to severe toenail fungus have had to resort to oral medications to treat the toenail fungus more effectively. However, oral medications often have more side effects. These topical solutions with improved penetration are a safer and more effective alternative.

Our toenail fungus uses undecylenic acid, a powerful antifungal compound that inhibits fungal growth. It also penetrates the nail easily to help manage mild and moderate toenail fungus infections.

2.    Antifungal nail lacquers

Antifungal nail lacquers are applied on top of the infected nail to form a barrier while continuously delivering antifungal agents. Unlike other topical solutions that require application daily or even twice a day, antifungal nail lacquers offer ongoing protection. They are a simple and low-maintenance treatment for busy individuals. They are an effective solution for toenail fungus, especially when combined with other treatments.

3.    Laser therapy

Laser therapy has become a very popular solution for anyone seeking non-invasive treatment alternatives to antifungal medication. This method uses concentrated light energy to heat and destroy the fungal cells beneath the nail.

Laser therapy sessions usually last between 30 and 45 minutes. Depending on the severity of the infection, you will need multiple treatments for optimal results. This procedure is painless and has no side effects or downtime. It is an effective and ideal solution for anyone concerned about the potential side effects of using oral antifungal medications.

4.    Combination therapies

For a long time, patients with toenail fungus would start with topical solutions and then take oral medications if the fungus does not go away. However, doctors are now recommending combining toenail fungus treatment methods to increase success rates. This can include combining topical and oral antifungals to attack the fungus internally and externally. Other doctors recommend combining laser therapy with topical toenail fungus treatments to improve nail penetration and target stubborn fungal cells. Combination therapies are particularly effective in patients with recurring infections or multiple infected nails.

5.    Photodynamic therapy (PDT)

PDT involves using a special photosensitizing solution on the nail and exposing it to a specific light wavelength. The light activates the solution, which then targets and destroys fungal cells. PDT is a promising alternative for patients who are not responding well to other traditional therapies.

Lifestyle and prevention strategies

While advanced diagnostic techniques and treatments are more effective than ever, toenail fungus prevention remains better than cure. If you have recurring toenail fungus, these lifestyle strategies can reduce your risk and support healthy nails during treatment:

1.    Maintain proper foot hygiene

Wash and dry your feet, especially between your toes. Trim your nails straight across to prevent buildup under the nail. Finally, avoid walking barefoot in damp public spaces like pool decks and locker rooms.

2.    Choose breathable footwear

Only wear shoes made from materials that reduce moisture buildup and allow airflow. Rotate your shoes regularly to let them dry fully. If you have recently had toenail fungus, clean and disinfect your socks and shoes to prevent recurrence.

3.    Use antifungal powders or sprays

Use antifungal sprays or powders in your socks and shoes if you have recurring toenail fungus infections. These products keep your socks and shoes dry, reducing fungal growth.

4.    Disinfect nail tools regularly

Always clean your nail files, clippers, and other tools after each use to prevent reinfection. Avoid sharing these tools with others to prevent spreading toenail fungus infections.

5.    Support nail health with proper nutrition

Certain nutrients can help support the treatment and recovery of toenail fungus. Eat a diet rich in vitamins and minerals like zinc, biotin, and iron to strengthen your nails and improve recovery.

Conclusion

Onychomycosis can be hard to detect and challenging to treat. Fortunately, modern diagnostic tools and treatment options are making it easy to detect toenail fungus early and treat it effectively. If you have toenail fungus, consider these new treatments for better results. Do not let toenail fungus prevent you from feeling confident in your skin. Embrace the latest trends in diagnosis and toenail fungus treatment, and you will be on your way to clear and healthy nails.