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Suggest Treatment For Fungal Infection In The Nails

Posted on Mon, 20 Feb 2017

Question: doctors, my elder brother's finger nails r not shaped. also the skin on fingers that is near the nails keeps peeling that means the skin is not even, looking good. what may be the reason for this?
this finger nails and the skin under nails looks very dirty (not in good shape looks scrumbled). I have attached the picture. today it's looking somewhat neat but tomorrow or day after it looks dirty, scrumbled again. nails on hands and nails on feet.
I have added two photos (First one is hand nails & second one is feet )

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Possibility of onychomycosis

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar (dermatologist). I have gone through your query and I have viewed the Images.

He seems to have developed fungal infection of nails i.e onychomycosis in which the nails are brittle, ill-shaped and there may be discoloration and sub ungual debris. I would suggest a KOH nail clipping (from one of the toe nail) to confirm the possibility of fungal infection.
If KOH nail clipping is positive for fingal elements I would suggest an Oral antifungal e.g terbinafine 250mg tablet, once daily for 2-3 months.
In addition topically he may use an antifungal nail lacquer e.g Loceryl nail lacquer (contains amorolfine 5%)/ once every week.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (4 hours later)

Thank you sir for the answer.
is this something to worry about or is it common

Answered by Dr. Dr. Kakkar (3 hours later)

Brief Answer:
Nothing to worry

Detailed Answer:
Hi.

Not to worry. It is a fungal infection of nails and just like fungal infection elsewhere on body it should get resolve with oral antifungals.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (38 hours later)

Thank you sir.
I have another question for you. I had pimples, left marks on my face & it got cleared. again I got pimples & left black spots on forehead, little on nose & cheeks. images attached.
I consulted a doctor,he suggested two ointments (pls see the image). I applied for a day or two. My face skin started looking darker & like the dark spots appearing more. I discontinued the ointments. I already spent hundreds of rupees for this ointments. pls help.
I went to my family doctor. he suggested Elecon Gel. I am applying a thin layer of it on my face in night, I think improvement is there. I am not sure. pls help.
image 1- my forehand, image 2- my cheeks. image 3- the doctor gave these ointments before..which I discontinued
pls give answers to all my questions step by step& help me pls

Answered by Dr. Dr. Kakkar (16 hours later)

Brief Answer:
Regarding acne and spots

Detailed Answer:
Thank you.
I have reviewed the Images.

Elocon is a steroid cream and should not be used for acne or acne spots.
I suggest you to use Adaferin gel once daily at night over the whole affected area. Wash it off after 2 hours and then apply kojic cream (contain kijic acid 2%) and leave it overnight.
During the day time you may use Clindac A 1% solution over the whole affected area. Dont apply Benzac AC 2.5% gel, it would be too irritating for face.
Wash your face with a gentle cleanser e.g cetaphil cleansing lotion, twice daily.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 hours later)

Ok sir. I will try those creams as per your advise.
As u can see in the image, I uploaded a pic of my cheeks. skin looks rough there. to touch it is soft but it looks like pores r wide open. so skin looks rough. Why skin looks like that sir ? why it looks like pores r not closed, it looks open

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
Low dose Isotretinoin can be considered for open pores

Detailed Answer:
Hi.

Oily skin has bigger pores as compared to dry skin which has barely visible pores. Though pore size is genetically determined and hence cannot be changed permanently you can take low dose oral isotretinoin* i.e 5mg capsule for a month which would shrink oil glands and refine pores as well as help acne. I suggest you to talk to your dermatologist regarding oral isotretinoin.

*Isotretinoin is contraindicated in pregnant females or in females who can get pregnant while on isotretinoin therapy as it can have fetal side effects.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (30 minutes later)

but I asked about my brother. not female. because u told something about isotretinoin in pregnant female. please explain.
also, u told to discontinue benzac ac . can it be used on forearms /neck as the skin is dark there. because he has already spenthundreds hundreds of rupees for the ointments

Answered by Dr. Dr. Kakkar (18 hours later)

Brief Answer:
Isotretinoin is safe for use in males

Detailed Answer:
Hi.

For males isotretinoin has no such contraindication.
Benzac AC is only for acne. It is not for dark skin. I suggest you upload Images of the affected areas so that I am able to guide you better.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (3 days later)

Ok sir. I have another question sir. it's about growing beard & mustache. I want to grow good shaped beard. but there is gap in some places on my cheeks. it's not joining the mustache uniformly. I have heard about gel /oils available in market for beard growth. how far those beard growth oils r safe ? if yes, how to use them ? how long to use? if they are not safe, is there any gel or oil available which helps to grow beard & I want to grow beard in French beard style.

Answered by Dr. Dr. Kakkar (15 hours later)

Brief Answer:
Try minoxidil

Detailed Answer:
Hi.

Beard shape, growth rate and density are genetically determined. However you may try minoxidil 5% application(mintop forte), twice daily. Minoxidil is a non-specific hair growth promoter. Just apply as a very thin film with the help of a cotton tipped swab/ ear bud. Dont apply too much as it can cause dryness and irritation.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (8 hours later)

Ok I will try this sir. How many days to apply this? After applying this in night while going to bed, shall I wash it with soap that I use normally?
Mine is oily skin sir. Will it work fine with oily skin?

Just a casual question about the beard growth oils in market that I asked in my last question. R those not safe? Or r they just false advertised fake oils ?
Thank you sir

Answered by Dr. Dr. Kakkar (8 hours later)

Brief Answer:
Regarding hair regrowth OTC oils

Detailed Answer:
Hi

You may apply this for a few months i.e 3-6 months. Apply once daily at night initially and keep it overnight. The solution has an alcohol base and dries immediately. Yes, it can be used on oily skin. Use it sparingly though. Oils that are advertised for hair regrowth are not approved for use and are of doubtful efficacy since their are no trials and just word of mouth to rely upon and most of these are fake advertised. I wont suggest you to use those.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar