A simple guide to treating fungal ailments

You may think that diabetes and heart disease are the epidemics of our day, but just as many people will fall prey to a highly annoying, albeit less dangerous, plague sometime in their lives:  fungus.

• Yes. Some studies show that over-the-counter products work just as well as prescription creams. You don't need to be a gym rat to develop athlete's foot or jock itch, though the fungi that cause these conditions do thrive in warm, damp environments, such as gyms, locker rooms and swimming pools.
• Sweat and friction (from the straps of an athletic supporter rubbing against the skin, for example) are contributors, too.
• Athlete's foot and jock itch are caused by fungi known collectively as tinea. Although its appearance and symptoms vary depending on which body part it afflicts, tinea generally causes skin to become red, itchy, scaly and cracked.
• Athlete's foot usually affects the skin between the toes but can spread and infect the nails.
• Jock itch arises in the groin.
• Over-the-counter antifungal creams, gels and sprays such as clotrimazole (Lotrimin), miconazole (Desenex) and terbinafine (Lamisil AT) can be effective treatments, though they aren't necessarily cures.
• In some studies, antifungals have eliminated symptoms and signs of tinea infections in 80 to 90 percent of users, though in other studies, the products seemed to work about half the time.
• A recent review determined that terbinafine may be the most effective choice for athlete's foot.

• No. These treatments don't penetrate the surface of the nail, so they have little or no effect.
• The same family of fungi that causes athlete's foot is the culprit behind the stubborn nail disorder known as onychomycosis, which leaves fingernails and toenails yellowed, thickened and brittle.
• So if you can clear up athlete's foot with antifungal cream, getting rid of a nail infection should be a snap, right? Wrong.
• Unfortunately, fungus infects nails beneath the hard exterior, which creams can't penetrate.
• Most dermatologists agree that fungus treatments have no effect on nail infections. (Truth-in-advertising alert: some fungus treatments that have the word nail in their names state in small print on their labels that they are not effective for nail infections.)
• What does work? The prescription antifungal ciclopirox (Penlac), a lacquer that's painted onto the nail and seems to penetrate the surface, may provide short-term relief if applied daily. But you must be persistent — it may take months before you see any improvement.
• Ciclopirox doesn't prevent nail infections from returning, which they often do.
• Prescription pills containing fungus-fighting medication are more effective, eliminating about 50 percent of nail infections. However, these drugs can cause unpleasant side effects, such as headaches, nausea and insomnia, and can even harm the liver.
• Antifungal medications can interact with several drugs, too, including blood thinners and birth control pills. To prevent nail infections, keep your hands and feet clean and dry.

Although these ailments are both uncomfortable and inconvenient, there is always a safe and healthy way to deal with the problem. If over-the-counter medications or creams do not work, be sure to contact a doctor.