Onychomycosis Or Nail Fungus:

An Overview Of Past Treatments

Most people do not think of nail fungus or Onychomycosis as a disease or infection. They mistakenly believe that it could be because of their genes or because of age.

This indeed is a problem in treating Onychomycosis or nail fungus.

It was in the mid 1900’s that oral medicines for treating nail fungus came on the scene. These were antifungal drugs. Until then mainly topical medications were used. Topical medications are the ones that are applied on the skin. Let us take a look at these medications used in earlier times.

Sandpaper

Using sandpaper obviously seems a crude method to treat nail fungus. The fungus that causes the infection eats away the keratin on the shiny top surface of the nail as well as the keratin in the skin of the nail bed. By scrubbing away the shiny top layer of the nail using sandpaper the fungus does not get an opportunity to feed on the keratin. If it cannot feed on the keratin the fungus cannot multiply and spread. Sandpaper was one of the earlier remedies to treat nail fungus infection.

Potassium permanganate soaks

Potassium permanganate or Condy’s crystal is a disinfectant, deodorizer and an oxidizing agent. A solution of 1 part of potassium permanganate in 1000 parts of water can be used to treat nail fungus. This has been found to be very effective. But it leaves a brownish stain on the skin and nails.

Castellani Carbofuchsin paint

This is a generic solution with ingredients like 4.5% phenol along with resorcinol, acetone, alcohol and the dye basic fuchsin. This medicine has fungicidal, anesthetic and bactericidal properties. It is usually applied 3 times a day after washing the area with soap and water. Since modern topical medicines are available now, Castellani Carbofuchsin paint treatment is seldom used these days.

Disinfection of shoes using formaldehyde vapor

For years formaldehyde vapor has been used to disinfect footwear. It helps in halting the spread of nail fungus infection. Here are a few reasons for using formaldehyde for disinfecting shoes.

• Nail fungus infection could be a source of infection for the feet as well. Fumigation with formaldehyde can prevent this as it works as a powerful disinfectant. Disinfection with formaldehyde vapor can control other fungal infections of the skin.
• Increased sweating could make the nail fungus resistant to treatment. This means the nail fungus may not respond to topical and oral medicines. Fumigation could help prevent this to some extent.

Oral anti-fungal agents

The first oral anti-fungal agents became available in the 1960s. This was the drug griseofulvin. But griseofulvin has to be used for a long time to be effective for treating nail fungus.

Next to come on the scene were drugs belonging to the azole group. An example is medications that contain the drug ketoconazole. It became available in the US in 1981 and finds use in fungus infections including nail fungus. Ketoconazole differs from griseofulvin in that it has better absorption and is effective when used in shorter dosing periods. However, on the negative side it could cause liver problems. With the availability of newer  antifungals medications containing ketoconazole have ceased to be front line treatment for nail fungus.