A fungal nail infection (onychomycosis) occurs due to the overgrowth of fungi under, in, or on the nail. Both toenails and fingernails are susceptible to infection, that typically appears as thickening and discoloration of the nail, and crumbling edges.
Nail fungus is very common, with estimates showing that approximative 3 to 12% of the people suffer from onychomycosis on their toes or fingers to some degree.
You may have nail fungus if one or more of your nails are:
- smelling slightly foul;
- dark-colored, as a result of debris building up under your nail;
- distorted in shape;
- crumbly, brittle, or ragged;
- whitish to yellow-brown discoloration.
Onychomycosis is caused mainly by dermatophytes and less commonly by other fungi such as yeast.
You are more likely to develop a fungal nail infection if you:
- wear closed-toe shoes, like – boots or tennis shoes;
- have diabetes mellitus;
- have a weakened immune system;
- have a disease which causes poor circulation;
- have moist toes or fingers for an extended time;
- are over age 65;
- have a skin injury around the nail;
- have a nail injury;
- swim in a public swimming pool;
- wear artificial nails.
Common treatments for nail fungus include:
- nail-softening cream – it is used for 14 days to soften the nail so the infection can be scraped off;
- antifungal tablets – they are taken once or two times per day for a few months;
- antifungal nail cream – it can take up to 12 months to cure the infection;
- laser treatment – it is used by many suferrers since it is painless, safe, and has no potential liver side effects.
Note – a procedure to remove the nail completely may be recommended in severe cases.
Here is a comparison between Kerydin and Jublia, two antifungal nail creams:
It is the brand name of an alcohol solution which is used to treat a fungal infection of the nail bed and toenail. It contains the drug tavaborole, the first oxaborole antifungal agent that was approved by US FDA in July 2014.
Its active ingredient is efinaconazole, a drug that belongs to the family of medications called antifungal agents. It treats fungal infections of the toenails that are caused by Trichophyton mentagrophytes or Trichophyton rubrum.
It is painted on the affected toenail much like a nail polish. This antifungal is produced by Valeant Pharmaceuticals and was first approved by the US Food and Drug Administration in 2014.
Both antifungal creams are used for the treatment of toenail infection which typically results from fungus.
Kerydin acts by inhibiting protein synthesis in the fungus. This inhibits cytosolic leucyl-transfer RNA synthetase, an enzyme with an important role in fungal essential protein synthesis.
Jublia works by inhibiting fungal lanosterol 14 alpha-demethylase, which is involved in the biosynthesis of an essential component of fungal cell membrane.
Possible side effects of Kerydin include:
- ingrown toenail;
- burning, pain, stinging, itching, or redness at the application site.
Possible side effects of Jublia include:
- toenails and application site pain, redness, inflammation, and irritation;
- vesicles at the application site;
- ingrown toenails.
Apply these antifungal creams to the affected toenail once per day for 12 months.
Warnings & Precautions
Use this antifungal cream on your nails only. Keep out of your nose, mouth, and eyes. Do not take by mouth.
You should not take this antifungal cream if you are allergic to any ingredient in this medication. Also, it is important to wash and dry your toenails before applying this antifungal cream.
Safety and effectiveness in children have not been established. Do not use this antifungal cream in your eyes, mouth, or vagina. It is for use on nails and surrounding skin only.
Avoid the use of nail polish, pedicures, and cosmetic nail products while using this antifungal cream.
It’s unlikely that these antifungal creams interact with other drugs.
There are no known interactions between alcohol intake and these antifungal creams.
Is It Safe During Pregnancy or Breastfeeding?
You should tell your doctor if you are pregnant or breastfeeding before using these antifungal creams since there are no human studies regarding the use of these antifungals during nursing or pregnancy.
Kerydin vs Jublia – Cost & Effectiveness
Kerydin (tavaborole) topical solution is an oxaborole antifungal agent which is prescribed for the treatment of nail fungus (onychomycosis) of the toenails due to Trichophyton mentagrophytes and Trichophyton rubrum. The presence of a very small element of Boron in its structure is conferring a potent antifungal action to this antifungal agent.
Jublia (efinaconazole) topical solution is an azole antifungal agent which is prescribed for the treatment of nail fungus (onychomycosis) of the toenails due to Trichophyton mentagrophytes and Trichophyton rubrum.
According to research, efinaconazole (Jublia) and tavaborole (Kerydin) cleared up fungal nail infections for 6.5 to 17.8% of suferrers.
Regarding their cost, Jublia is approximately $606 for a supply of 4 mL, whereas the cost for Kerydin is about $639 for a supply of 4 mL.
Alternatives to Jublia and Kerydin
The best options for these antifungal creams are:
- Ciclopirox (Penlac 8%) Nail Lacquers – it targets a variety of metabolic processes in the fungal cell;
- Amorolfine (5%) Nail Lacquers – it is a topical antimycotic agent which has a fungicidal effect.
Preventing Fungal Nail Infections
You can reduce your risk of developing onychomycosis by:
- treating athlete’s foot immediately to avoid the infection spreading to your nails;
- keeping your feet and hands clean and dry;
- replacing old footwear which could be contaminated with fungi;
- using special shower shoes to protect your feet and avoid walking around barefoot in public showers, pools, and locker rooms;
- ensuring your towels are washed regularly;
- not sharing socks and towels with other people;
- not sharing scissors or clippers with other people;
- clipping your nails to keep them short;
- to allow your feet to “breathe” it is recommended to wear clean cotton socks and well-fitting shoes which are made of natural materials.
Sources http://www.jabfm.org/content/24/1/69.full https://smhs.gwu.edu/news/researchers-identify-cost-cutting-option-treating-nail-fungus-nanotechnology https://www.ncbi.nlm.nih.gov/pubmed/24850511 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459619/