What Are the Safe Treatment Options for Fungal Nail Infections in Children?

Internal Medicine, Mass General Brigham

Supervised by Suo Lee, MD

For children with fungal nail infections, safe treatments usually start with topical antifungal medications applied directly to the nail. In some cases where the infection is more severe, a doctor may consider oral antifungal medicines under careful supervision.

Explanation

When a child gets a fungal nail infection, doctors often first choose a treatment that is safe and gentle. One common option is a topical antifungal medicine. This is a cream, solution, or nail lacquer that is applied to the infected nail. The medicine helps fight the fungus without affecting the rest of the body too much. Topical treatments are preferred for kids because they usually have fewer side effects. If the infection does not improve with a topical medicine or if it is more serious, a doctor might use an oral antifungal medication. Oral treatments like terbinafine or itraconazole can work well, but they need to be used carefully because they can have side effects, and the dosage must be just right for the child’s age and weight. It is important to follow your doctor’s advice and have regular check-ups during treatment. This way, the doctor can make sure the nail improves and adjust the treatment if needed.

(References)

Feldstein S, Totri C, Friedlander SF. Antifungal therapy for onychomycosis in children. Clin Dermatol. 2015 May-Jun;33(3):333-9. doi: 10.1016/j.clindermatol.2014.12.010. Epub 2014 Dec 8. PMID: 25889135.
Eichenfield LF, Friedlander SF. Pediatric Onychomycosis: The Emerging Role of Topical Therapy. J Drugs Dermatol. 2017 Feb 1;16(2):105-109. PMID: 28300851.
Hay R. Therapy of Skin, Hair and Nail Fungal Infections. J Fungi (Basel). 2018 Aug 20;4(3):99. doi: 10.3390/jof4030099. PMID: 30127244; PMCID: PMC6162762.

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