Proximal Subungual Onychomycosis is one of the rarest fungal infections out there. Most typically associated with HIV, it can also be the outcome of damage being done to the nail. Most commonly, the fungus which causes Proximal Subungual Onychomycosis is Trichophyton rubrum. Other causes may include Trichophyton megninii, Trichophyton tonsiurans, Trichophyton mentagrophytes, Trichophyton schoenleinii and Epidermophyton floccosum.
Diagnosis is usually made because of unusual location which the infection usually attacks, usually in the nail bed closest to the hand. The exact diagnosis is made by looking at a sample of the fungus under a microscope.
Proximal Subungual Onychomycosis can cause nails to become dull, thick, brittle and fragile. Pain can occur when the fungi starts to lift the nail away from the nail bed. The infection can then get progressively worse, causing the person to lose more nail. It can also spread to other nails and if gone untreated, you may lose all of your nails.
Treatment of Proximal Subungual Onychomycosis is usually treated by oral medications prescribed by a doctor. Surgical removal is also a possibility as well as using a prescribed topical ointment. Patients can expect to apply the ointments for up to six months before seeing results.
Some unlucky patients experience permanent loss and some treatments may prove to be painful. Patients are usually suggested to remove debris from underneath the infected nails daily to avoid further infection.
Patients who are participating in a long term oral medication regimen should be aware that side effects from long term use may occur. Side effects include skin rashes and in some severe cases, liver damage. It’s not recommended that people with congestive heart failure or liver disease take these medications.
If nail fungus is extreme and painful, a doctor may suggest that the nail be removed. In these cases, a new nail typically grows back in its place. The replacement nail may take excessively long to grow back (as long as a year), but this is a typical timeframe for people experiencing nail fungus issues.
Antifungal lacquer is used to treat mild to moderate nail fungus infections. It’s applied much like a nail polish and is generally prescribed by a doctor. The lacquer is painted on the nail and on the skin surrounding the nail once a day for seven days. The patient is then instructed to wipe the layers clean with rubbing alcohol and to start the daily painting process over again. Daily use for approximately one year is usually needed for positive results.
Topical medications are sometimes used in conjunction with over-the-counter lotion containing urea, which may help speed up absorption. Topical medications are not a cure, but usually used with oral medications for complete treatment.