Progressively eliminate the diseased nail and then treat with an antifungal for external use: good results, clinically tested, and obtained in less time.
Nail mycoses (onychomycosis) have the bad reputation of being very difficult and laborious to counteract, requiring daily treatments, repeated for long periods of time and with results that are not always satisfactory.
In fact, today, if you choose the correct antifungal intervention in many cases it is no longer so.
A recently identified strategy, able to provide rapid therapeutic results without excessive time or specific medical expertise, is based on a “dual approach” to onychomycosis, comprising two phases, illustrated in the table below and described in detail below.
| Function | Treatment | |
|---|---|---|
| Phase I | Progressive elimination of diseased nail | Cover evenly every day, for about 2-3 weeks, the diseased nail with one layer of 40% urea ointment and, therefore, protect it with a plaster |
| Phase II | Protection from pathogenic microorganisms during the regrowth of a new healthy lamina. | Apply a topical antifungal once a day for a few weeks |
Step 1: Remove contaminated foil
As soon as it has been verified that there is a colonization of the nail by dermatophyte fungi or yeasts to facilitate the removal of the contaminated portion of the lamina, you can use a specially designed kit, including a 40% urea cream to soften the nail to be removed, anatomical patches (with wings) to perfectly cover the treated nail and a plastic scraper.
In practice, the procedure provides that, every day, for about 2-3 weeks (depending on the extent of onychomycosis), the diseased nail is evenly covered with a layer of 40% urea ointment and, therefore, protected with one of the patches provided.
Ointment and plaster should be left in place for 24 hours, avoiding wetting or dirtying them.
After this period, the patch should be removed and the nail should be immersed in hot water for ten minutes (if preferred, during the daily bath or shower).
After drying gently, we move on to the “scraping” phase, facilitated by the 40% urea ointment that will have made the diseased areas of the nail more “tender” than the healthy ones.
Once this operation is finished and all the fragments have been removed, all that remains is to apply a new layer of ointment and cover with a new plaster.
Step 2: Protect the regrowing nail
When all the nail affected by the mycosis has been progressively removed in this way, which is not painful, you can move on to the second phase of treatment, which simply consists of applying a topical antifungal once a day for a few weeks, to prevent the still fragile nail in regrowth and the tissues surrounding it from being attacked again by pathogenic microorganisms.
For this purpose, an antifungal cream based on bifonazole is particularly suitable, since this compound, in addition to being very active against fungi and yeasts, also exerts an antibacterial and anti-inflammatory action that allows to avoid further infections and to reduce any pain / burning present.
The ideal is to apply it in the evening, before bedtime, and cover the nail with a common patch of adequate size.
This second phase lasts on average another 2-3 weeks, but the exact timing of treatment should be established by the doctor in relation to the severity of onychomycosis and the individual response to therapies.
Throughout the period of care, to avoid further contamination, it should be remembered that when touching a nail affected by onychomycosis (own or others) it is necessary to wear protective gloves, disinfect all the tools used (before and after use) and throw in the trash all the non-reusable material immediately after finishing.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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