Oh boy - the fungal nail question...
Well, you have 4 options:
1) Live with it - it will not hurt you. BUT: it will spread (to other nails, family members perhaps, etc.). And, it will NOT go away without treatment. It will not invade your body though and mostly just looks awful.
2) Remove the toenail - sounds awful, but most of us runner have lost many a toenail before. This is done neatly, cleanly and painless in the office of course. This is really only an option if just 1 or 2 nails are involved though. This can be done on a temporary or permanent basis.
3) Topical meds. There is ONE Rx med - Penlac nail lacquer (FDA data in studies show an 8%-20% success rate, depending upon what you read or believe). There are multiple OTC "remedies" like Vinegar, Tea tree oil, Vicks, etc. I've seen any number of things like that work, but it completely anecdotal and I can't exactly recommend it to patients.
4) Oral medications. There are currently 5 FDA approved oral meds for onychomycosis (nail fungus). Lamisil (terbinafine) is by far the most popular with (I think) over 35 million scripts filled worldwide. I've written probably over 2,000 (seriously) and I can remember only about 8 cases of transient LFT increases (the Liver profile study). Side effects are extremely mild (rarely at all) and the "liver damage" thing is hilariously overblown and misunderstood by the general public. In fact, most cholesterol lowering drugs (i.e. statins like Lipitor, et al.) have the exact same effect on the liver, yet people happily take these for years on end or perhaps the rest of their life, yet are "afraid" of Lamisil for 60-90 days. Novartis even removed the "black box" warning and I don't even run 6 week LFTs any longer for otherwise young, healthy people on no other meds. Even if your liver enzymes increase (like they do EVERY TIME when drinking alcohol - far more damaging long term), you simply stop the drug and they go back down.
Yes, it is now generic (just in the last few months actually). Most insurance companies cover it, some require a nail plate biopsy, as it is very expensive brand name.
PM me if you want any more details.
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
Well, you have 4 options:
1) Live with it - it will not hurt you. BUT: it will spread (to other nails, family members perhaps, etc.). And, it will NOT go away without treatment. It will not invade your body though and mostly just looks awful.
2) Remove the toenail - sounds awful, but most of us runner have lost many a toenail before. This is done neatly, cleanly and painless in the office of course. This is really only an option if just 1 or 2 nails are involved though. This can be done on a temporary or permanent basis.
3) Topical meds. There is ONE Rx med - Penlac nail lacquer (FDA data in studies show an 8%-20% success rate, depending upon what you read or believe). There are multiple OTC "remedies" like Vinegar, Tea tree oil, Vicks, etc. I've seen any number of things like that work, but it completely anecdotal and I can't exactly recommend it to patients.
4) Oral medications. There are currently 5 FDA approved oral meds for onychomycosis (nail fungus). Lamisil (terbinafine) is by far the most popular with (I think) over 35 million scripts filled worldwide. I've written probably over 2,000 (seriously) and I can remember only about 8 cases of transient LFT increases (the Liver profile study). Side effects are extremely mild (rarely at all) and the "liver damage" thing is hilariously overblown and misunderstood by the general public. In fact, most cholesterol lowering drugs (i.e. statins like Lipitor, et al.) have the exact same effect on the liver, yet people happily take these for years on end or perhaps the rest of their life, yet are "afraid" of Lamisil for 60-90 days. Novartis even removed the "black box" warning and I don't even run 6 week LFTs any longer for otherwise young, healthy people on no other meds. Even if your liver enzymes increase (like they do EVERY TIME when drinking alcohol - far more damaging long term), you simply stop the drug and they go back down.
Yes, it is now generic (just in the last few months actually). Most insurance companies cover it, some require a nail plate biopsy, as it is very expensive brand name.
PM me if you want any more details.
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD