Toenail Cracks: Causes and Concerns After Fungal Treatment

Q: Toenail Cracks: Causes and Concerns After Fungal Treatment

Hello, A-Guang： Based on your written description, it is currently difficult to ascertain your specific condition. <br>The most significant characteristic of skin diseases is that "seeing is believing and tactile examination is essential." It is indeed challenging to convey a com

There are straight cracks in the toenail?

Hello Dr.
Hong,
I have had severe onychomycosis in both feet for many years.
Last year, I took Lamisil for 12 weeks, and by early this year, my toenails have mostly recovered.
However, I still notice some peeling on the soles of my feet, which is not itchy.
I'm unsure if this is due to dryness or if athlete's foot has not fully resolved.

Another concern is that I recently discovered vertical cracks in the middle of the second toenail on both feet and the third toenail on my left foot.
These cracks are also painless and not itchy, but I am worried that this could indicate a recurrence of onychomycosis or that it was never fully cured.

Over the past year, I have made an effort to keep my feet dry and have minimized wearing sneakers.
I followed my doctor's instructions while taking the medication, hoping to prevent any future issues.
Now that I have noticed these problems, I am very concerned and would like to ask for your advice on what these issues might be.
Thank you, Doctor.
P.S.
Since I am currently abroad, it is not very convenient for me to see a doctor in person, so I wanted to consult with you online first.
Thank you.

Aguang, 30~39 year old female. Ask Date: 2006/05/24

Dr. Hong Zhengsheng reply Dermatology

Hello, A-Guang: Based on your written description, it is currently difficult to ascertain your specific condition.
The most significant characteristic of skin diseases is that "seeing is believing and tactile examination is essential." It is indeed challenging to convey a complete picture solely through text.
Therefore, I recommend that when you notice the symptoms described, you should promptly visit a hospital and consult with a dermatologist.
The physicians are always willing to assist you.
Thank you for using "Taiwan e-Hospital" to ask your questions.
"Taiwan e-Hospital" cares about your health.

Reply Date: 2006/05/24

More Info

Hello! Thank you for reaching out with your concerns regarding your toenail health after undergoing treatment for fungal infections. It’s understandable to feel anxious about any changes in your nails, especially after a prolonged treatment like Lamisil (terbinafine), which is commonly prescribed for onychomycosis (fungal nail infections).

Firstly, it’s important to recognize that toenail health can be influenced by various factors, including previous fungal infections, the condition of the surrounding skin, and overall foot hygiene. The peeling of the skin on your soles could be attributed to several reasons. It might be a result of dryness, especially if you live in a dry climate or if you frequently expose your feet to water without adequate moisturizing afterward. Alternatively, it could be a sign of a residual fungal infection, although you mentioned that it is not itchy, which is a good sign.
As for the cracks you’ve noticed in your toenails, these can occur for several reasons. Nail cracks can be a result of trauma, excessive dryness, or even fungal infections. Given your history of fungal infections, it’s reasonable to be concerned about the possibility of recurrence. However, if the cracks are not accompanied by pain, discoloration, or other signs of infection (such as swelling or pus), it may not necessarily indicate a fungal return.
Here are a few considerations and recommendations:
1. Moisturization: Ensure that you are moisturizing your feet regularly, especially after washing them. Use a good quality foot cream that can help maintain skin hydration and prevent dryness.

2. Nail Care: Keep your toenails trimmed and filed to prevent further trauma. Avoid tight-fitting shoes that can cause pressure on the nails, leading to cracks.

3. Foot Hygiene: Continue to maintain good foot hygiene. Wash your feet daily, dry them thoroughly (especially between the toes), and consider using antifungal powder if you are prone to fungal infections.

4. Observation: Monitor the cracks and any changes in your toenails. If they worsen or if you notice any new symptoms, it would be wise to consult a healthcare professional.

5. Follow-Up: Since you are currently abroad and finding it difficult to see a doctor, consider telemedicine options. Many healthcare providers offer virtual consultations, which can be a convenient way to get professional advice without needing to visit a clinic in person.

6. Preventive Measures: To prevent future fungal infections, consider wearing breathable footwear and avoiding walking barefoot in communal areas (like pools or gyms).
In conclusion, while the changes in your toenails and skin may be concerning, they do not necessarily indicate a recurrence of your previous fungal infection. However, maintaining proper foot care and monitoring your symptoms is crucial. If you have any further concerns or if the situation does not improve, seeking professional medical advice, even through telehealth, would be beneficial. Your health and peace of mind are important, and addressing these issues proactively can help you maintain healthy feet moving forward.

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