Nail Clinic: Onychomycosis (page 2)

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Treatment
This is often a simple and inexpensive procedure, but it isn’t fail-proof. First, a doctor will typically take a sample from the nail; a visual diagnosis can be misleading. “Only about 50% of nails that look like they have fungus actually do,” Brodell says. “For the other 50%, the problem is psoriasis of the nail or another inflammatory skin condition that affects nails. It’s critical to make a diagnosis with a microscopic exam or fungal culture.”
Once the presence of the fungus is determined, Applegate says the best way to treat onychomycosis is to take an oral medication, such as Lamisil, that attacks the fungus. “When the nail grows out, the infection should stop,” he says. The nail growth process can take two months for most clients, or up to six months for the elderly.
“However, no treatment is 100% effective on everyone,” Daniel notes. “Even the best medications work just 60% to 80% of the time. The only topical FDA-approved treatment works less than 10% of the time. The nail can also be removed, but that’s no guarantee the fungus won’t come back.”
Anyone who experiences a fungal infection can also take the following steps to avoid exacerbating the problem, according to the AAFP:

  • Keep nails short and file down any thickened areas
  • Use a separate file and instruments on healthy nails vs. infected nails
  • Utilize waterproof gloves for wet work (such as washing dishes) and 100% cotton gloves for dry work
  • Wear 100% cotton socks, change them when they become damp and put on clean, dry socks every day
  • Buy shoes with good support and a wide toe area; avoid pointed shoes that press the toes together
  • Avoid walking barefoot in public areas

Keeping Services Safe
Since this fungus is highly contagious, a tech needs to remain especially vigilant when faced with onychomycosis on pedicure clients. The good news is that if you’re properly cleaning and disinfecting your instruments and keeping your work area spotless, then you shouldn’t encounter any problems. Still, some experts recommend a few extra precautions:
“Nail professionals should use both regular hand-washing [with soap and water] and alcohol-based rubs, such as Purell, between clients,” Brodell says. “It’s important to pay attention to sterilizing all equipment. Applying nail polish to cover up the problem on clients’ nails isn’t a bad idea—otherwise, these clients might avoid the pool or other activities because they don’t want others to see their nails.”
Applegate takes a more cautious approach. “You should probably say to your client, ‘Go see a doctor and get it cleared up before we do the service,’” he says. However, Applegate admits that a clean service wouldn’t lead to the spread of the condition “as long as instruments are sterilized, there shouldn’t be a problem.”
“If you suspect a client has a fungal infection, wear gloves,” Daniel advises. “She can bring her own instruments, or you can use disposable ones. For any client who you know has an infection, I would not recommend using a foot spa.” Keep a portable nonmechanized footbath on hand for these clients, preferably one with disposable liners that can be tossed after the service.
Contagious infections are always a bit scary—for many techs, passing along any kind of condition is their worst nightmare. You can do your part to help clients take an active part in prevention by retailing antifungal foot powders or creams in your salon so that they can head off the problem before it starts. You may not be able to entirely avoid coming into contact with onychomycosis, but with the right balance of client education and vigilant procedures, you can do your best to make sure it doesn’t affect you or your other clients.

Tracy Morin is a freelance writer and editor based in Oxford, MS.