Toe Nail Fail
June 3, 2010 2:31 PM   Subscribe

My left foot...has a bad case of toe nail fungus. Yuck. YANMD/YANML/YANMPodiatriast, but I'd welcome some advice on how to best solve this problem.

Sometimes, ignoring something doesn't make it go away. Case in point: the toe nails on my left foot, which are yellow, gross, fungal, and obviously not getting better on their own.

Background: I've had a fungal problem with the nails on my left foot for several years now. Yeah, I know, not exactly brilliant on my part, but also easy to ignore. And still easy -- I'm ignoring it now, as it's not causing me any pain or discomfort. But it's gross, and it's obviously not getting better on its own, and, well, enough is enough.

Several years ago I sought advice from my (now previous) primary care doctor/family practitioner, but he wasn't very encouraging. Basically, his advice was, "remove the toe nails or live with it; the oral meds are too dangerous and offer no real promise of success." Thanks, Doc.

I did make a half-hearted attempt to treat it with OTC fungicide last year, but I wasn't persuaded that the treatment was doing any good, and I also I wasn't very dedicated. So that effort...lapsed.

I have health care and could approach my current primary care doc about this, but I haven't done so yet, I think in part because my previous attempt yielded such a "meh" response. So that's still an option, but I guess I'd like to crowdsource this a bit first.

I read this thread from 2004, and before it descended into a discussion on the efficacy of homeopathy, it had some useful tips. I'm wondering if the state of the art for treating toe nail fungus has advanced any since 2004?

If any of you MeFites have successfully battled this unpleasant situation, please, tell me how you did it!

Anyone wanting to offer advice anonymously can reach me at toenailfail@gmail.com
posted by anonymous to Health & Fitness (17 answers total) 14 users marked this as a favorite
 
Several members of my family (though not me, yet, thankfully) have had success getting rid of toenail fungus after a course of medicine prescribed by either a primary care physician or a podiatrist. Toenail fungus is a pain. If your current PCP turns out to be insufficiently attentive, seek care from another physician. Treatment is definitely doable, but as far as I'm aware requires a significantly longer period of medication than the layperson would expect from experiences with athlete's foot. Anyway, good luck.
posted by Inspector.Gadget at 3:31 PM on June 3, 2010


Several years?

No, it won't get better on it's own. I can't speak from personal experience, but from what I understand, the over the counter stuff will work if you use it properly. The infection will not just disappear. You need to apply the stuff once or twice a day until the nail grows out, which may take up to six months or more for the big toe. I believe you should be able to see new non fungal nail growth as the old icky nail grows out.

I'm sorry your previous doctor was so useless. You should be able to get excellent free advice and OTC medication from a pharmacist. You do realise these things are contagious? Please be patient and make the effort to get rid of this.

Ugh, OK, I just had a look at the previous thread you linked to.
Even if you don't live with other people (but especially if you do) I'd get a plastic spray bottle and mix up a bleach solution and use it to disinfect the base of your shower after each use. I'd also ask the pharmacist if your socks & shoes aren't spreading the infection.
posted by goshling at 3:33 PM on June 3, 2010


Talk to your doctor. I have a messed-up toenail that I kept forgetting to ask about with my GP, and when I finally did mention it at first he did the "meh" bit. But then I mentioned that it had been bugging me for THREE years and the OTC creams didn't make a dent in it, and he looked up from his notes and gave me a prescription anti-fungal cream. It was a pretty resilient infection, so it's not cleared up completely yet, but I just went back to him and got some even stronger stuff (still a cream) which seems to be completing the go-the-hell-away-fungus process. Just thought it would be useful to know that there are several levels of big guns that the docs can bring in before they give you pills that might mess with your liver.
posted by colfax at 3:52 PM on June 3, 2010


my OH had this on one large toe-nail and he tried everything, dedicated three times a day creming it, having rasped the nail with a metal thing to make the nailbed more receptive, I mean dedicated, for one whole year. Even on holidays.

Result, Nada, Zip, Nothing, minor cosmetic improvement but only from rasping the nail.

So he took the meds for 6 months. They worked.
posted by Wilder at 3:55 PM on June 3, 2010 [1 favorite]


I have the same problem. I had toenail fungus on two toes several years ago, and went to the doctor. He prescribed me Lamisil, which I had to take every day for about three months--long enough for new, fungus-free nail to grow out. It worked, and I didn't experience any side effects, but some people do.

As luck would have it, I have a relapse and my fungus is back, on the same two toes. There's a lot of anecdotal evidence on the interwebs that Vick's VaboRub will kill toenail fungus. Rather than take medicine, I tried the Vick's technique but had zero success. Topical, OTC treatments probably won't work if your nails are too thick and gnarly. And if they do work, it's because you applied the ointment many times a day, everyday.

I'm totally sick of them--one of these days I'll see if I can just get them removed.
posted by zardoz at 4:46 PM on June 3, 2010


the oral meds are too dangerous and offer no real promise of success."

Rubbish. You need a new doctor. Oral meds are the only thing that works. I had fungal nails for over a decade and Lamisil cleared it right up in less than two months! It's kind of expensive, even with insurance, but I'd probably spent at least that much in useless OTC stuff over the years.

I got my prescription from a dermatologist.
posted by Violet Hour at 4:52 PM on June 3, 2010 [1 favorite]


I was the author of the 2004 question.

I still have it. I'm trying the prescription nail polish now, but it's not making a dent. I tried the prescription pills...but they gave me allergic reaction. Frankly, I gave up.
posted by spinifex23 at 5:35 PM on June 3, 2010 [2 favorites]


My own doctor recommended vick's vapor rub. Had to use it for a long time but it did eventually help. But I don't know if my problem was as bad as yours.
posted by St. Alia of the Bunnies at 5:52 PM on June 3, 2010


I finally had the nail pulled (painlessly, by the way), and started applying ciclopirox cream .77% twice a day to the nail bed and the nail as it grew back out. So far, no reappearance of the fungus and I'm wearing flip-flops this summer for the first time in years.

The podiatrist offered to pull the nail and then burn the root so it wouldn't grow back - I decided to give it one more try and so far so good.

And just after I had it done I read about someone's success in treating toe fungus with Vicks VapoRub. Imagine that!
posted by DandyRandy at 5:53 PM on June 3, 2010


White distilled vinegar. Soak your toes in it twice a week for 15 minutes. Brush/spray on every morning and night (be religious about it). This stuff will work and is probably the only thing OTC that will make a dent in the infection. If the vinegar dries out the nail too much, mix 1 part olive oil and 1 part tea tree oil and brush on with swab once or twice a week.

If you want to be hardcore, I'd suggest throwing away all your socks and shoes. And just generally taking your foot hygiene up a notch.

Other than that, if you are otherwise healthy, the oral medication (Lamisil) is very effective and the risk is minimal.
posted by whiskeyspider at 6:08 PM on June 3, 2010 [3 favorites]


I have had this problem, and took the oral medication twice without success.

Eventually I took matters into my own hands: Get yourself a bottle of Fungi Cure [a liquid anti-fungal], and a syringe. I used a syringe with a blunt dispensing needle that I filed a bevel on the end. If you use a regular hypo, it might pay to blunt the end a bit so you don't penetrate skin.

Fill up the syringe with Fungi Cure, and slide the needle under the toenail through the spongy fungal material to the base of the toenail [this should be completely painless], then press the plunger until the underneath of the toenail is *completely* saturated with liquid - change position of the needle if necessary to get everywhere. Any area left dry will allow the fungus to survive.

Repeat this procedure daily for 2-3 weeks. Once you're satisfied you've killed the fungus, allow the nail to grow out - it should return to normal.

This procedure is effective [I've been fungus-free for 8 years now] and cheap.

Good luck.
posted by HiroProtagonist at 7:19 PM on June 3, 2010 [4 favorites]


I had the same issue several years ago. My doctor didn't prescribe the oral medicine because she said it was expensive and had a very low probability of working, and when it does work, it often takes multiple courses. And most over the counter anti-fungals are not for use on nails. So there was pretty much nothing she could recommend, except to wait it out.

My fungus cleared up on its own, but it took over a year, maybe two. Eventually, as new fungus-free toenails grew in, the old yucky toenails started to fall off. This wasn't painful at all, but one of my nails did get ripped off by accident, I kept the old toenail trimmed down a bit. I just kept my feet clean, and made sure they were totally dry before putting on socks. Also, I stopped going sockless, except when wearing sandals (which wasn't often, because I had gross fungus toenails). Every so often, I would get under the nail and scrape some of the fungus off with a nail file. I'm not sure if this really helps, but I figured it could prevent the fungus from spreading to the new growth. This is, of course, entirely anecdotal, and I have no science to back up my claims.
posted by lexicakes at 7:21 PM on June 3, 2010


My doctor, who I do trust, told me: oral medications will clear up the toenail fungus, but the risk of relapse is great (60%) and the medications have serious side effects. He said I should just live with the nails and cover them with nail polish. Ugh, I really want to get rid of this fungus too.
posted by fifilaru at 7:30 PM on June 3, 2010


Years ago, I got rid of it by dousing the toe in hydrogen peroxide a few times a day, and then afterward, drenching it in baby powder to keep it dry. I would even cram as much baby powder as possible underneath the nail. I would put a bunch of powder in my sock, too.

If I had to deal with it again, I'd also eat a lot of garlic, and also rub cut raw garlic all over it before bed, because garlic has been shown to have anti-fungal properties.
posted by MexicanYenta at 7:34 PM on June 3, 2010


Here's some info from my husband:

"For nail fungus, I was prescribed a medication called Tineacide. It seems to work. Otherwise, apparently there is a laser treatment specifically for nail fungus."

I can attest that the Tineacide did work. Also, he went through a lot of doctors dealing with this. AND our insurance dropped him because of this as well - yes - because of freaking toenail fungus. But that's another story. (F-You Athem Blue Cross.)
posted by Kloryne at 7:38 PM on June 3, 2010 [1 favorite]


I had terrible fungus on my big left toenail, which I spent years keeping covered with nail polish... and then I slipped off my surfboard one day, went feet first into the ocean and my toe nail got torn up badly on a rock. Don't ever fall feet-first into the ocean. It hurt really bad.

But the doctor I went to see decided to remove the nail entirely, since it was split half-way down the nail bed anyway. It was kind of weird not having a big toe nail... IIRC, it took a while to grow back -- maybe 6 months? But the pleasant side-effect was that the fungus was gone, it never came back, and the only drugs I had to take were some antibiotics to prevent infection. So maybe your doctor has a point?
posted by kaudio at 8:55 PM on June 3, 2010


I've never dealt with a whole foot full of nail fungus, just one nail at a time. Here's what my podiatrist told me to do.

1. Use a special emery board that you only use on the infected nail to file it down.
2. Apply tineacide, let it dry.
3. Apply tea tree oil, let it dry. (Both of these are available in your local drugstore.)
4. Do this twice a day.

5. Spray the inside of your shoes with Tinactin or a similar athletes foot aerosol spray.

It will probably take at least 8 weeks to see any improvement.

Use hot water and bleach to wash your socks.

Do not cut your toenails extremely short. Leave a little bit of length. (When they grow back in.)

Best of luck.
posted by FergieBelle at 7:51 AM on June 4, 2010 [2 favorites]


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