What is the organism that causes   this unsightly disease? Onychomycosis is caused by dermatophytes in the cooler climes and candida in hot and humid countries. Treatment of toenail fungus is a long drawn out process as the infection lies underneath the nail, which is a hard place to reach. Therefore it normally takes six months to a whole year to cure this fungus effectively.

Your podiatrist will judge if the infection is superficial or deep. For the superficial cases a course with nail lacquer with either amorofine or ciclopirox is effective. The nail paint needs to be applied nightly. This should be done for seven days, then wiped off, and then the whole process is to be repeated.

For a more deep-seated infection the patient needs to take oral anti fungal medicine such medication. The trouble with oral medications such as Lamisil are the side effects. A podiatrist will take blood tests called LFTs before starting this medication. This is to be certain that there are no signs of liver damage before the initiation of treatment. Liver function tests will be taken right through the treatment course to make sure there is no harm to the liver. Lamisil can sometimes cause heart problems too and has to be used under strict medical supervision. 

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