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Toenail fungus cure?
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OK, so here's a dirty secret of the Spotmeister....I have nasty toes, specifically the nails. Are there any OTC medications that will take care of this? I'm not too keen on that crap that might hurt your liver. So far its just cosmetic, but I wonder if it could have worse consequences. I've been having some issues with a toe while running, and while I don't think its the nail, I got to wondering if there wasn't a way to get rid of this gunk.

Spot

___________________________________________________
Taco cat spelled backwards is....taco cat.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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They will do a liver profile to see if Lamisil is contrainidicated.

My podiatrist put me on it 1 week on, 3 weeks off. No problems, and my nails look great.

The OTC stuff is worthless.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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second the lamisil or the now available GENERIC. doc should do a liver fxn test, if it's normal -- i wouldn't hesitate. lamisil 30 day supply was something like $350 at the local CVS. generic version was a mere $15 at the local Costco for 30 days. you can try OTC stuff all day long but most likely won't take care of it permanently ...you need to get it from the inside.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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Tea tree oil, worked wonders for a family member that couldn't get anything else to work.

http://www.nutrasanus.com/tea-tree-oil.html

Mental toughness is to physical as 4 is to 1
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Re: Toenail fungus cure? [spot] [ In reply to ]
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Lamisil, which is a prescription, has the highest cure rate (I think) rroof, where are you?

Most healthy people won't have any liver issues, in fact the liver function test isn't even required anymore for it.

Here is what most people and dr.s don't know: the oral Lamisil will kill the fungus from the inside out, but the spores still live in your shoes and can reinfect your nails. You need to take the oral AND spray ALL of your shoes with the OTC stuff for the treatment to be effective.

Disclaimer: I used to work for Novartis, the company that makes Lamisil. I never sold it, but I heard the drug rep spiel many times.
Last edited by: QRgirl: Aug 7, 07 18:02
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Re: Toenail fungus cure? [spot] [ In reply to ]
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Here's what a friend told me, regularly file off top surface of nail (he recommended dremel tool for this) and use otc stuff. I'm using emory boards and otc stuff and my nails look much better. I'm sure they'd be even better if I filed and treated more regularly.
.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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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
Last edited by: rroof: Aug 7, 07 18:19
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Re: Toenail fungus cure? [spot] [ In reply to ]
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most of the time you need a culture first to prove it's fungal...there are other conditions with similar appearance.
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Re: Toenail fungus cure? [glo] [ In reply to ]
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Awesome, I didn't know there was a generic now. I did the Lamisil last year (thank you Canadian pharmacy), and it got all but one toe. Now, it's gradually spreading to them all again. I missed a few days taking it, though; I think that was the problem.

I'm going to go get another scrip and take it all faithfully. I hate my nails!
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Re: Toenail fungus cure? [avatar78] [ In reply to ]
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I tried Fungi-Nail, comes in a small brown bottle I found it at the foot med display at the local pharmacy. Worked very well in getting rid of the blackness on my big toe. One word of warning, it took at least a month of daily application before it went away.

I still use it once in awhile as a precaution to keep it from returning.

I personally would not use any prescription drug that might effect my liver, I'll let my daily dose of beer take care of that.

Ron W.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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Family doc/runner here, who treats a lot of gross toes.

Important points about nail fungus:

1--Absolutely not dangerous--will never go into your blood or cause any other problems. Could cause some discomfort from the nail itself getting a bit thicker and rubbing shoes.

2--Topical stuff doesn't work--you'll read about everything from oils to topical antifungals to vicks vapo-rub (my favorite). The reason is...

3--This is a nail-BED infection in addition to a nail infection--it's why shaving the nail (while it may help discomfort--we do it in our elderly sometimes) won't cure it.

4--'Cure' should be noted with a bit of caution--The Lamisils and Sporinox's of the world are decent meds, but the statistics--about 75% will have the fungus 'cured', but in the next 3 years about 50-70% will have recurrence--don't make you too excited. Just be sure to go in with realistic expectations that it might come back.

I think that's all. I don't ususally post, but when something comes up that i know about, i'm happy to chime in.

Hope this helps,

Ross
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Re: Toenail fungus cure? [rossman] [ In reply to ]
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Sorry Ross, the topical application of Fungi-Nail worked for me...

Hey, for $5 a bottle give it a try, better than messing with your liver, or living with the problem.

Ron W.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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I've had it on both of my 2nd toes for as long as I can remember. Then one toe nail recovered on its own and is normal now. So if they can spontaneously recover, maybe the cheap topical stuff can work, assuming it's better than nothing (which was enough to cure one of my toenails).
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Re: Toenail fungus cure? [rjsurfer] [ In reply to ]
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You just proved his (and mine) point.

You most likely used your bottle of "fungi nail" or whatever on something that was NOT a fungal infection, hence it grew out with the nail and improved. This then "perpetuates" the myth. Any number of things looks like it to the general population (even trained medical specialists) like: onychogryphosis, koilonychia, psoriatic nail, subungual hematoma, etc.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: Toenail fungus cure? [rroof] [ In reply to ]
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I have to agree with you, I don't know EXACTLY what I had, all I know is my big toe nail went from a dull yellow to almost black over a period of a few years and a 30 day, once a day treatment of Fungi-Nail worked for me.

I think it's worth a shot for anyone with this problem...can't kill you.


ron W.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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I used Lamisil. A bit of a struggle to get insurance to cover it. If there's a generic available now like one other ST'r said then thats great. My Dr. said one of the criteria for getting approval for insurance to pay is that you say the nail/nails are painful. FYI.
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Re: Toenail fungus cure? [spot] [ In reply to ]
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Save your cash, there's a cheaper, more effective treatment. White distilled vinegar. put two drops on the base of your infected toenails in the morning and repeat before going to bed. Vinegar doesn't kill the existing fungi, but it does prevent more from growing....so...you'll need to do this UNINTERRUPTED for about 3 months while the toenail grows out. I tried the perscription approach with bloodtest and all and was completely underwhelmed. Then I tried the vinegar and within 4 weeks I noticed a marked improvement and after 3 months or so, all was gone...not to return since. That was 4 years ago. Go buy a medicin dropper from a local drugstore and some vinegar if you don't have some already.
Last edited by: nice tri: Aug 8, 07 11:54
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Re: Toenail fungus cure? [nice tri] [ In reply to ]
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nice tri wrote:
Save your cash, there's a cheaper, more effective treatment. White distilled vinegar. put two drops on the base of your infected toenails in the morning and repeat before going to bed. Vinegar doesn't kill the existing fungi, but it does prevent more from growing....so...you'll need to do this UNINTERRUPTED for about 3 months while the toenail grows out. I tried the perscription approach with bloodtest and all and was completely underwhelmed. Then I tried the vinegar and within 4 weeks I noticed a marked improvement and after 3 months or so, all was gone...not to return since. That was 4 years ago. Go buy a medicin dropper from a local drugstore and some vinegar if you don't have some already.

This.
I'm guessing I'm probably 2-3 weeks away from my left big toenail being completely clear using this method (I use Q-tips instead of a dropper).
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Re: Toenail fungus cure? [spot] [ In reply to ]
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I had same problem for years, let it go becausei thought it was "only cosmetic". Eventually a doctor noticed it while treating an unrelated ankle problem. He was horrified I had ignored it for 20 years.

A course of Lamisil - in various forms - over a period of approx 3 months and all was cleared.

As other people have told Lamisil can cause some liver or kidney issues so I understand it is essential to monitor the function of these during the treatment to make sure the treatment is stopped quickly if any kidney or liver issues are detected.

Two years later all is still clear for me and I only wish I had bothered to sort it sooner.
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Re: Toenail fungus cure? [ironvegan] [ In reply to ]
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ironvegan wrote:
They will do a liver profile to see if Lamisil is contrainidicated.

My podiatrist put me on it 1 week on, 3 weeks off. No problems, and my nails look great.

The OTC stuff is worthless.

As a physician, +1 for this comment & Dr. Rroof's.

Many dermatologists prescribe lamisil 250mg, one week, then 3 weeks off and repeat. I do the same. Lamisil tablet is generic now & cost you little. It is a fungal "infection," so don't get discouraged if it comes back again and again.

We stopped doing the liver blood test altogether, as the liver injury happens in about one in 100,000 patients. Super rare, in other words.

Topical antifungal... it's better than nothing, but it only treats minor cases. Just don't spend a lot of money on it. I should mention that trimming the bad nails also helps a lot.
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Re: Toenail fungus cure? [rroof] [ In reply to ]
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rroof wrote:
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.


I've had it on every toenail on my right foot since I was about 30 (27 years ago). Also have cracking and dry skin on that foot. No issues at all with the left foot, and no spreading to anyone else (AFAIK). Nails are thick and not so hard, kinda yellow. Does that sound typical of toenail fungus?

Oddly my Dad had the same thing in his right foot, starting when he was about the same age. If I somehow got it from him, it didn't show up until long after I'd left home.
Last edited by: rruff: Jul 17, 17 8:53
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Re: Toenail fungus cure? [rruff] [ In reply to ]
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I explain all options to patients: oral Lamisil pulse dosing-1 week every 3 months for one year, topical use for one year, shoe sterilization and use of a laser.
The more options they follow, the higher probability of clearing the nail/nails (the term cure is inaccurate).
The more deformed the nail is, the lower the clear rate.
I also tell them that there is a possibility that they may follow all the options and not have any improvement.

Dr Jay
http://www.Tri-Pod.net
Last edited by: aikiman44: Jul 17, 17 14:27
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Re: Toenail fungus cure? [rroof] [ In reply to ]
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Does danger to liver increase if you are on Lipitor and then also go on Lamisil?
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Re: Toenail fungus cure? [rroof] [ In reply to ]
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rroof wrote:
Oh boy - the fungal nail question...

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. rance companies cover it, some require a nail plate biopsy, as it is very expensive brand name.

May be in the US, but in Canada there is another Rx med "Jublia" http://www.jubliarx.com

One of my kids got toenail fungus at swimming lessons (I think) and spread it via toenail clippers before I realized what was going on.

Tried Penlac and it didn't work. Had them put Jublia on religiously every day, and it cleared up in about 3 months. I realize that's +1 anecdotal evidence, but there it is.
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Re: Toenail fungus cure? [Durhamskier] [ In reply to ]
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Durhamskier wrote:
May be in the US, but in Canada there is another Rx med "Jublia" http://www.jubliarx.com

One of my kids got toenail fungus at swimming lessons (I think) and spread it via toenail clippers before I realized what was going on.

Tried Penlac and it didn't work. s.

Jublia is available in the US since 2016. It's the latest topical antifungal Rx, and it is the most effective, and wait for it... it is $200-300 per bottle, depending on your prescription plans. It's good for kids or someone absolutely refused to take oral antifungal meds.

Yes, it's newer and better topical drug than Penlac (older Rx), but you have to apply it every day & it's effectiveness is no where near the oral antifungal (i.e. lamisil Tablet).
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