Nail Disorders: Treatment Options for Onychomycosis and Abnormal Growth

Treatment of nail fungus and abnormal fingernails?

Hello, Doctor.
I would like to ask about my father, who is 71 years old.
Recently, I noticed that his toenails appear to have what is commonly known as onychomycosis (fungal nail infection).
They are very hard and look like armored scales.
However, he mentioned that they have looked this way since he was in his 30s, and he hasn't paid much attention to them.
Is it still possible to treat this condition after all these years? What might happen if we leave it untreated? Additionally, in the past few months, my father's fingernails have been behaving strangely; when new nails grow in, they push the old nails out, resulting in what looks like two or three layers of nails.
The old nails seem to be breaking apart, appearing as if they are shedding.
What could this symptom indicate? Due to the pandemic, we are hesitant to take him to a doctor right now, but we are very concerned.
I appreciate any insights and advice you can provide.
Thank you very much.

Acan, 20~29 year old female. Ask Date: 2021/05/26

Dr. Wu Yuxin reply Dermatology

It has been ongoing for 30-40 years, so there is no need to rush, but it is still advisable to first consult a dermatologist to confirm whether it is onychomycosis (fungal nail infection).

Reply Date: 2021/05/26

More Info

Nail disorders, particularly onychomycosis (fungal nail infection), can be a significant concern, especially in older adults. Your father's situation, where he has had hard, thickened toenails resembling "armor scales" for decades, suggests a chronic condition that may be fungal in nature. Onychomycosis is characterized by the thickening, discoloration, and often the crumbling of the nail, which can lead to discomfort and secondary infections if left untreated.

Given that your father has experienced this condition for many years, it is essential to understand that while treatment is still possible, the effectiveness may vary depending on the extent of the infection and the overall health of the nails. Treatments for onychomycosis typically include topical antifungal medications, which are applied directly to the nail, and oral antifungal medications, which can be more effective for severe cases. However, oral medications may have side effects and require monitoring of liver function, especially in older adults.

In terms of the abnormal growth of his fingernails, where new nails appear to be pushing out the old ones, this could indicate a condition known as onycholysis, where the nail separates from the nail bed. This can occur due to various reasons, including trauma, fungal infections, or underlying health issues. The appearance of multiple layers of nails could also suggest a condition called "nail dystrophy," which can be caused by fungal infections, psoriasis, or other dermatological conditions.

If left untreated, onychomycosis can lead to complications such as pain, difficulty walking, and secondary bacterial infections. Additionally, the abnormal growth of fingernails may lead to further discomfort and potential nail loss. Therefore, it is advisable to seek medical attention, even if it is challenging due to the current pandemic situation. Many healthcare providers offer telemedicine consultations, which could be a safer alternative for initial assessments.

In summary, while your father's nail conditions can still be treated, the approach may differ based on the severity and duration of the issues. It is crucial to consult a healthcare professional for a proper diagnosis and treatment plan. They may recommend antifungal treatments for the toenails and investigate the cause of the abnormal fingernail growth to provide appropriate care. Early intervention can help prevent further complications and improve nail health.

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