Yet Another Cycling Forum

General Category => The Knowledge => Health & Fitness => Topic started by: Charlotte on October 01, 2008, 01:47:02 pm

Title: Toenail fungus
Post by: Charlotte on October 01, 2008, 01:47:02 pm
This could be me if I don't do something about my crabby feet... (http://i239.photobucket.com/albums/ff176/muskratsally2/toenail-fungus-worst.jpg)

I've had manky feet for a while now.  Probably much to do with cycling too much in wet shoes and not looking after them well enough.  I've got calloused heels which have got so tough that they sometimes split apart like a dried up river bed and hurt something rotten.

I've also got toenails which are thickened and brittle and in the case of my right big toe, detaching from the nail bed.  My ploy thus far was to varnish them and pretend that they were okay.

Well they aren't and I need to do something about them before they get any worse.  I'll see my doctor about it of course, but I was wondering if anyone has any advice on products or medications that they've used to successfully treat foot-rot themselves?  Topical stuff looks like a better idea than oral medications.

The tinterweb is full of useful suggestions, such as soaking them in tea tree oil or Listerine - even taping a pealed clove of garlic to your nail every night before bed.  I think I'd rather just use a proven medicine of some kind...
Title: Re: Toenail fungus
Post by: Eccentrica Gallumbits on October 01, 2008, 01:51:36 pm
Tea tree oil is good for fungal infections, so that might be worth trying. For your manky cracked heels (mine get pretty bad too), I recommend Lush's cuticle cream, which I forget the name of but it's very lemony. Slather your feet in it last thing at night, put your socks on and go to bed. In the morning you'll have soft fragrant heels. Lemony Flutter, that's it.

Might be worth forking out some dosh to see a podiatrist to get them properly cleaned up and then you can start again. GPs can prescribe some medication taken orally for fungal toenails but it can have nasty side-effects and you need to go back for follow-up visits to make sure you're still ok.
Title: Re: Toenail fungus
Post by: Jacomus on October 01, 2008, 01:51:52 pm
First of all, I'd just like to say

That pic + me eating lunch =  :sick:

Now thats out of the way... Tea Tree works wonders - seriously, try it.

Oh, and no more pics like that without a NLS* tag k? :)





*Not Lunch Safe

Title: Re: Toenail fungus
Post by: Clare on October 01, 2008, 01:52:42 pm
Go and ask your doctor to refer you to a chiropodist, you're better off seeing somebody who has spent 3 years studying feet than somebody who has spent five years studying the entire body.

I believe that nowadays to set up as a chiropodist one must be qualified, it used to be that anybody could set up as one, but your doctor should have some recommendations just in case this is still the case.

Title: Re: Toenail fungus
Post by: hellymedic on October 01, 2008, 01:53:55 pm
I had ten manky toenails. I was on oral anti-fungals for several months and I'm now cured.
All of the skin on the soles of my feet was also infected.
No amount of nail paint would have cured that.
It's lovely to have feet that don't itch and nails that don't make me look like a tramp.
Go for months of oral, you know it makes sense...
Title: Re: Toenail fungus
Post by: epa611 on October 01, 2008, 01:56:26 pm
What's the difference between a chiropodist and podiatrist (if any) ??? ???
Title: Re: Toenail fungus
Post by: Regulator on October 01, 2008, 01:58:05 pm
You don't need a doctor's referral to a chiropodist or podiatrist these days  - they all have to be registered with the Health Professions Council (http://www.hpc-uk.org) -  but I would agree with Clare that they should be your first stop.

Your feet are extremely important and I agree entirely with Clare that you're best talking to a chiropodist/podiatrist than your GP.
Title: Re: Toenail fungus
Post by: Regulator on October 01, 2008, 01:59:32 pm
What's the difference between a chiropodist and podiatrist (if any) ??? ???

Same profession - different names.  'Podiatrist' is the American term for chiropodist.
Title: Re: Toenail fungus
Post by: Ian H on October 01, 2008, 02:00:25 pm
I'm told I have very nice feet.



Sorry, not much help.
Title: Re: Toenail fungus
Post by: Clare on October 01, 2008, 02:08:54 pm
You don't need a doctor's referral to a chiropodist or podiatrist these days  - they all have to be registered with the Health Professions Council (http://www.hpc-uk.org) -  but I would agree with Clare that they should be your first stop.


Do you still need a referal to get any work done on the NHS or has that all changed now?

Title: Re: Toenail fungus
Post by: Regulator on October 01, 2008, 02:11:21 pm
You don't need a doctor's referral to a chiropodist or podiatrist these days  - they all have to be registered with the Health Professions Council (http://www.hpc-uk.org) -  but I would agree with Clare that they should be your first stop.


Do you still need a referal to get any work done on the NHS or has that all changed now?



You don't necessarily need a referral.  Some chiropodists hold a direct service contract with the NHS.

However, NHS funded provision is strictly limited and available only to those with long term medical conditions (such as diabetics) or those on low incomes/benefits... and the NHS cover for these groups is sketchy to say the least - despite the clear clinical indications.

Chiropodists' charges for private treatment don't tend to be extortionate though.
Title: Re: Toenail fungus
Post by: Eccentrica Gallumbits on October 01, 2008, 02:13:33 pm
What's the difference between a chiropodist and podiatrist (if any) ??? ???

Same profession - different names.  'Podiatrist' is the American term for chiropodist.

Not any more. Those of that profession were known as chiropodists here but a few years ago they decided to change their name to podiatrist and everyone who qualified since whatever date is now known as a podiatrist. People who qualified before that date are still known as chiropodists. I don't know why they didn't all change their name, seeing as the job didn't change when the name changed, but for some reason that wasn't allowed.

You can find a podiatrist by using this site Find a local Chiropodist or Podiatrist (http://www.feetforlife.org/cgi-site/chiropodist.cgi)

Oooh look Fungal Infections - 14 July 2006 (http://www.feetforlife.org/cgi-bin/item.cgi?id=682&d=96&h=24&f=46)

Most NHS podiatry clinics will accept self-referral as far as I know - they do round here anyway, but you'd need a GP referral if you were wanting them to come and see you at home. Google podiatry within your health board and you might get lucky.
Title: Re: Toenail fungus
Post by: FatBloke on October 01, 2008, 02:13:38 pm
To prevent the heel cracking there is only one solution.

Limit your wearing of sandals!   :-[

I had cracking heels. I was told to stop wearing sandals. I did! (ish). Heels healed.  
Title: Re: Toenail fungus
Post by: Che on October 01, 2008, 02:15:23 pm
I've periodically had a very mild form of dishydrosis on my feet in the past. Something my dad's had all his life, but unquestioningly assumed was athlete's foot. Feet have been a-okay for a good while now, though.
Title: Re: Toenail fungus
Post by: mrcharly-YHT on October 01, 2008, 02:19:26 pm
ime, tea tree oil is good for stopping the spread of fungus, but not eliminating it. It has a side-benefit of disinfecting your footwear.

Over-the-counter creams work ok. You have to keep reapplying them throughout the day.

Allegedly fungus doesn't like salt, so I once tried putting sea salt between my toes. fungus went, but I got very sore toes!
Title: Re: Toenail fungus
Post by: Wowbagger on October 01, 2008, 02:28:43 pm
I have been diagnosed with nail fungus. I took a sample of toenail to the doc and some weeks later the result came back.

My own doctor didn't recommend tablets. His view was that, because they are so toxic (you are swallowing a fungicide) that they are best avoided (liver damage) and topical treatment used instead. When I returned to the doc after the results, a locum was there and he immediately said he would prescribe tablets without once mentioning possible side effects. On the basis of what my own doc had said I told him I would prefer an ointment. He ended up prescribing Lamisil athlete's foot ointment, which he told me wouldn't work and I found out at the chemist's was cheaper to buy over the counter anyway.

I have seen some much more expensive over the counter stuff in lloyds' pharmacy at about £17 a tube and that was what I was hoping he would prescribe for me. Next time I'm there, I'll find out what it's called.

I have used tea tree oil which is good for keeping your tootsies sweet and keeping athlete's foot at bay, but I don't think will touch nail fungus.

Regarding Mr Charly's comment about salt, I had hoped to spend a good deal of this summer in the sea, but sadly the summer didn't arrive and I only swam about 4 times.
Title: Re: Toenail fungus
Post by: hellymedic on October 01, 2008, 02:30:54 pm
Before I went on the anti-fungals, I'd had nearly three decades of athlete's foot, manky nails,  treatment with Whitfield's Ointment, Mycota, Mycil, Daktarin, Canesten, griseofulvin etc. As far as I am concerned oral anti-fungals rock and the rest are a waste of time. They cured my sister too and my father (probably the original source of infection) has just started taking them. He has manky fingernails too...
Title: Re: Toenail fungus
Post by: little miss mac on October 01, 2008, 02:40:08 pm
I suppose it's horses for courses. Applications of Daktarin for a prolonged period cleared up toenail-rot for both me and my dad.

Ghastly to have awful feet, isn't it. I'm so pleased mine are back to normal.
Title: Re: Toenail fungus
Post by: Notsototalnewbie on October 01, 2008, 03:08:32 pm
I can recommend a really good chiropodist (near Bikefix on Lambs Conduit Street.)

My GP was fairly useless when I had an involuted toenail (a relation of the ingrown toenail), but this guy was just fab and sorted it out really well. And threw in a foot massage at the end.

The FOOTPAD: home page (http://www.footpad.co.uk/index.htm)
Title: Re: Toenail fungus
Post by: clarion on October 01, 2008, 04:13:15 pm
Try canesten cream.  No - seriously.  I think Daktarin is broadly the same thing anyway.

Because of massive amounts of inhaled steroid, I've had a problem with systemic thrush for many years, which can break out in the usual ways, but also as throat infections and foot Bad Stuff, but it's now pretty much under control.  A bit of canesten round the toes certainly helped me.

YMMV
Title: Re: Toenail fungus
Post by: Tiger on October 01, 2008, 06:29:16 pm
This is a useful thread. My nails are so horrid I can't wear sandals - sound just like a couple of the others mentioned. 45 year history of athletes foot and way beyond any over the counter creams to deal with.
Do I have to see a doctor to get these oral antifungals for a prolonged course? (one off canestan pills and creams don't beat this beast).
Title: Re: Toenail fungus
Post by: hellymedic on October 01, 2008, 06:48:28 pm
This is a useful thread. My nails are so horrid I can't wear sandals - sound just like a couple of the others mentioned. 45 year history of athletes foot and way beyond any over the counter creams to deal with.
Do I have to see a doctor to get these oral antifungals for a prolonged course? (one off canestan pills and creams don't beat this beast).

Yes.
You may well have toenail clippings sent for fungal culture to confirm and possible baseline blood tests to check your liver etc.
One GP referred me to a Community Dermatologist. Systemic antifungal treatment is not simple, cheap, quick or without risks. But it ROCKS.

Consider giving up alcohohohohol for a while before seeking anti-fungals and during treatment.
Title: Re: Toenail fungus
Post by: TimO on October 01, 2008, 06:59:33 pm
I had a slight problem with fungus on a toe, and topical stuff had no significant impact, oral fungicides took a while to work, but did cure it ultimately.

I'd also second tea-tree oil for reducing the pong, one of my previous flatmates had feet that were best avoided, but he started using tea-tree oil on them, and boy did it cure the stink. :thumbsup:
Title: Re: Toenail fungus
Post by: velocipede on October 01, 2008, 07:24:05 pm
Coconut oil is what I am currently using- I find I prefer it to tea tree, but take great care with bathroom tiles and wooden floors or....... whoops!

Apparently it does have some antifungal properties, I think it smells better, and is more softening than tea tree oil. Works for me if I use it regularly.

Of course, wont deal with the nails..... thats a tablet job I'm afraid.
Most ethnic and health food shops sell it cheaply in bottles for culinary/ multi-purposes. I melt it on the radiator and decant into smaller pot for ease of use.
Title: Re: Toenail fungus
Post by: little miss mac on October 01, 2008, 08:24:20 pm
Wow, it all comes out, doesn't it. Just how many of us have had terrible toes and foul feet - we could do a whole episode of Embarrassing Illnesses solely on foot-rot  :sick: ;D

I wonder what the collective noun is - a crumble of rot?
Title: Re: Toenail fungus
Post by: Mike J on October 01, 2008, 08:35:32 pm
I have lovely feet, apart from one toe, that has given me problems recently - this has now been solved by making sure my shoes fit properly.  I also get athletes foot in summer and I just spray with athletes foot spray for a few weeks and it goes away.

I might give tea tree a go though  :)
Title: Re: Toenail fungus
Post by: blackburnrod on October 01, 2008, 09:27:55 pm
 About 20 years ago I was occupational physician in an industry which required 2000 operatives to wear rubber boots.These were used communally and over 60% of users were shown to have fungal infections by microscopy of skin scrapings.I initiated a simple clinical trial comparing the efficiency of the commonly available over the counter medications.The ranking order was 1 Monphytol,2 Daktarin 3 Mycota. (*) Monphytol is a liquid to be painted on the affected area (as it is alcohol based it stings for a few seconds if there is a break in the skin).It was also cheaper than all its competitors.At that time it was packaged in pink which did not go down well with the all male workforce but became acceptable when at our suggestion the manufacturer changed to green.Although it works well on skin fungal infection it is ineffective for nail fungus for which oral medication is the only reliable treatment.Nail fungus usually is preceded by skin infection ,which should be treated prevent the much more difficult to treat nail problem.Other important factors are daily washing,thorough drying,clean socks and no shared towels or bathmats.
(*) this was before the introduction of the conozole group of drugs
Title: Re: Toenail fungus
Post by: peliroja on October 01, 2008, 09:49:34 pm
The skin on my feet is as soft as a baby's bottom.

I'm not helping, am I.

Carry on.
Title: Re: Toenail fungus
Post by: RJ on October 03, 2008, 01:22:19 pm
Before I went on the anti-fungals, I'd had nearly three decades of athlete's foot, manky nails,  treatment with Whitfield's Ointment, Mycota, Mycil, Daktarin, Canesten, griseofulvin etc. As far as I am concerned oral anti-fungals rock and the rest are a waste of time. They cured my sister too and my father (probably the original source of infection) has just started taking them. He has manky fingernails too...

Tablets sorted my (finger and toe) nails out too.  Needed two blood tests before and after the first month of treatement, to check for any effect on liver function, followed by another two months of tablets.  No side effects and healthy nails as a result.

This (too) followed years of mucking about with topical treatements that didn't really work.  Once the fungus is embedded enough it seems to take some shifting.

I'd recommend going directly to a GP, for rapidest results.
Title: Re: Toenail fungus
Post by: Glosbiker on October 03, 2008, 03:20:54 pm
  I've got calloused heels which have got so tough that they sometimes split apart like a dried up river bed and hurt something rotten.


As one inveterate sandal wearer to another, the best cure for cracked heels that I've so far found is the Rocky Mountain Soap Company Foot Butter

Rocky Mountain Soap Company - 100% Natural Skin Care (http://www.rockymountainsoap.com)

You rub the butter on your heels before going to bed, slip a pair of socks on (so not to ruin the bedding, I suspect) and after a few days all the cracks just go.  It is simply brilliant.

I know it's based in Canada but we were told whilst over in their Banff shop this year that they've started doing very reasonably priced mail order to the UK.

The company uses almost exclusively natural products and we've been very impressed with the quality and effectiveness of their products
Title: Re: Toenail fungus
Post by: BornAgainCyclist on October 06, 2008, 02:45:45 pm
. . . I've got calloused heels which have got so tough that they sometimes split apart like a dried up river bed and hurt something rotten . . .

Aquas cream (Generic) from your pharmacy is the stuff for this, it's as cheap as chips, comes in a big tub and works. Apply after bathing or showering.

After many years of paddling around sailing club changing rooms on feet that have been soaking in turgid water all day, I have suffered the consequences and haven't found any externally applied medication that works.  The pills worked for me with no after affects even though I still drank alcohol (sometimes in moderation).  I still have big-toe nails that look as they have a fungal infection, but after having clippings tested, I am assured by my quack, that it is a result of nail bed damage and not a fungal enfection.
Title: Re: Toenail fungus
Post by: Hummers on October 07, 2008, 03:28:54 am
A helpful thread indeed.

I shall try nail varnish.

Perhaps black.

H
Title: Re: Toenail fungus
Post by: numbnuts on October 08, 2008, 05:34:10 pm
for cracked heels I use sandpaper and then apply lots of vaseline put on a pair of socks and after a few hours the heel is soft again
Title: Re: Toenail fungus
Post by: Valiant on October 17, 2008, 10:31:10 pm
Bengali old wives remedy. Clove and Mustard Oil applied to the area last thing at night.
Title: Re: Toenail fungus
Post by: andygates on October 18, 2008, 09:27:06 am
Lots of barefooting and seawater makes for supple leathery feets.  I think it's the UV as much as the fresh air...
Title: Re: Toenail fungus
Post by: Charlotte on October 18, 2008, 06:29:48 pm
Well, I've been to the doctor and I'm having some toenail clippings off to the lab.  I'm also having blood tests...
Title: Re: Toenail fungus
Post by: rogerzilla on October 18, 2008, 06:32:59 pm
There's some beeswax stuff advertised in the CTC rag which claims to sort out cracked hands, and probably also works on feet.
Title: Re: Toenail fungus
Post by: hellymedic on October 18, 2008, 08:15:30 pm
Does the Body Shop stiill sell 'Elbow Grease'?  ;D

It might be just the thing for cracked feet!

Seriously, pussy-footing with these things can be a waste of time.

Good luck with the anti-fungals!
Title: Re: Toenail fungus
Post by: andygates on October 18, 2008, 08:26:24 pm
Badger Balm is beeswax based and is nice for cracked hard bits.  From good chemists. :thumbsup:
Title: Re: Toenail fungus
Post by: peliroja on October 19, 2008, 11:31:04 am
Woolly's experimenting with tea tree oil for his couple of dodgy toenails.

My feet remain soft as a baby's bottom. This worries me. Will they one day take a sudden turn for the worse, or does this just mean I'm a lazy thing who doesn't walk enough? :-/
Title: Re: Toenail fungus
Post by: hellymedic on October 19, 2008, 01:12:44 pm
A previous boyfriend of mine said his feet always went soft if he did a lot of cycling.
They toughened up when he got back to 'normal life' which entailed more standing and walking.
Title: Re: Toenail fungus
Post by: Valiant on October 20, 2008, 02:48:02 am
My feet go hard when cycling and my cycling shoes have great ventilation. Walking on beeches etc does soften them :) But the best thing to do is to apply baby oil/moisturising creams straight after a shower/bath while still damp. Baby oil works it's way in and stays soft for days.
Title: Re: Toenail fungus
Post by: Wowbagger on July 23, 2009, 11:43:05 am
I've been back to the doc today and he's prescribed Loceryl nail lacquer.

I've just read the instructions and it looks as though I am about to start a new hobby bordering on full-time occupation.

We discussed oral antifungals and he was quite adamant that he wouldn't take them and even did me the favour of showing me his stunted big toe nail, a result of years of nail fungus. I'm quite keen not to swallow a load of fungicide for what is more of a cosmetic problem than an irritant, especially since I'm already swallowing a load of other poison in the form of methotrexate to keep the bloody arthritis at bay.
Title: Re: Toenail fungus
Post by: hellymedic on July 23, 2009, 01:09:01 pm
In wow's shoes, I wouldn't take oral antifungals, in mine, I did and it was wonderful.

I had forgotten how much my feet itched, tilll they stopped.
It was nice to have feet that did not look like they belonged to a tramp.
It was good not to have lots of little fungal blisters.

The problem was not just cosmetic, though it was hardly serious.

My Dad is now on anti-fungals. He had it in his fingernails and his hands are looking much better.
Title: Re: Toenail fungus
Post by: Valiant on July 26, 2009, 03:20:51 pm
Charlotte, how are your feet coming along?
Title: Re: Toenail fungus
Post by: PaulF on July 26, 2009, 04:10:38 pm
I've been back to the doc today and he's prescribed Loceryl nail lacquer.

I've just read the instructions and it looks as though I am about to start a new hobby bordering on full-time occupation.


Loceryl works well but you need to be patient. Two tips:

Let it dry before you go to bed or put on socks else your feet will get stuck to the fabric (don't ask how I know this)

Clean off the old layers so that you're treating nails and not the laquer
Title: Re: Toenail fungus
Post by: Charlotte on July 26, 2009, 05:34:11 pm
Charlotte, how are your feet coming along?

Getting there.  I didn't start the pills 'till a few months ago because my doc wanted me to finish a course of something else I was taking first.  No side-effects and they appear to be working.  In as much as the nail bed seems to be less manky and the new nail that's growing isn't all mungy.

I suspect I'm going to be on them until Christmas or beyond, though.  I want rid of this once and for all...
Title: Re: Toenail fungus
Post by: Zoidburg on July 26, 2009, 06:22:20 pm
I didn't tell you this BTW.

Keep the foot lurgy at bay by pissing on your feet in the shower

*Revulsion ensues...*

Title: Re: Toenail fungus
Post by: Charlotte on July 26, 2009, 09:18:31 pm
Thanks for that, Zoiders.  You're full of useful information...

*pukes inna hedge*
Title: Re: Toenail fungus
Post by: nuttycyclist on July 27, 2009, 12:37:55 am
Nought wrong with pissing on the feets.


tis good for cleaning cuts too.
Title: Re: Toenail fungus
Post by: PaulF on July 27, 2009, 08:08:38 am
Nought wrong with pissing on the feets.


tis good for cleaning cuts too.

And jellyfish stings.  A friend of mine got stung on the, er,  chest but she declined my 'remedy' ??? saying that the pain wasn't too bad and she'd just lie in the shade a while.

Never worked out why :demon:
Title: Re: Toenail fungus
Post by: Charlotte on February 08, 2010, 09:24:27 am
Update:  After six months on the anti-mank pills, I have lovely feet once more.

As Helly said:

Systemic antifungal treatment is not simple, cheap, quick or without risks. But it ROCKS.
Title: Re: Toenail fungus
Post by: Martin109 on February 08, 2010, 09:36:04 am
I've been back to the doc today and he's prescribed Loceryl nail lacquer.

I've just read the instructions and it looks as though I am about to start a new hobby bordering on full-time occupation.


Loceryl works well but you need to be patient. Two tips:

Let it dry before you go to bed or put on socks else your feet will get stuck to the fabric (don't ask how I know this)

Clean off the old layers so that you're treating nails and not the laquer

I've been doing this for about the last 6 months and it's working.  The two nails I'm using it on are starting to emerge clean from the nailbed.  Well worth the weekly faff.
Title: Re: Toenail fungus
Post by: hellymedic on February 08, 2010, 01:23:52 pm
Update:  After six months on the anti-mank pills, I have lovely feet once more.

As Helly said:

Systemic antifungal treatment is not simple, cheap, quick or without risks. But it ROCKS.

Wonderful, isn't it?
>5 years on, I'm still mank-free. Given how awkward foot care is now for me, I am very pleased.
Title: Re: Toenail fungus
Post by: Gattopardo on July 25, 2010, 11:31:35 pm
Well I have athletes foot for the first time in my life, currently on a daktacort cream.

Now wondering where it came from and what should I do to stop its reappearance.  What  would you put in shoes to kill any possible re infection also how would you wash sock to make sure that I'm not re infecting myself.

Thanks
Title: Re: Toenail fungus
Post by: hellymedic on July 26, 2010, 12:35:25 am
I am not aware of any way to kill fungi in shoes, though I supose you could paint them with copper sulphate solution.
Washing socks at 60°c may kill both fungi and socks.
I think the fungi that cause atthlete's foot are common; you might have caught the in a bathroom/swimming pool/changing room or may have tried infected shoes at a shoe shop. I think there might be fungal spores in the environment anyway.
Try to keep feet clean, cool and dry.
Daktacort contains a sterod and an antifungal. Whilst the steroid is good for reducing inflammation in the short term, it can help fungi replicate. I'd suggest switching to a straight antifungal (Daktarin/Canesten etc) after a fortnight.
Fungi love sugar; keep yours under tight control.
Title: Re: Toenail fungus
Post by: Wowbagger on May 22, 2014, 10:14:18 pm
How time flies!

My nail fungus has been pretty much unchanged since I last posted on this thread - until today.

Since December I have been giving my size 12 tootsies a real treat in that they now mostly wear quality woollen sock from Bridgedale. Tonight I cut my toe nails. They gave the distinct impression that my nail fungus had retreated rather, especially in my left foot. Far too early to draw any firm conclusions, but I will report back when I next get the clippers out.
Title: Re: Toenail fungus
Post by: hellymedic on May 22, 2014, 10:50:35 pm
There was some recent article in the BMJ about toenail fungus. I can't remember what it said; naughty girl will have to reread...
Title: Re: Toenail fungus
Post by: hellymedic on May 22, 2014, 11:13:25 pm
False negative test for fungal nails are common and test should be repeated if fungi are suspected.
Systemic treatment should not start until there has been laboratory confirmation of fungal infection.

Terbinafine has fewer drug interactions than itraconazole and is recommended as first line systemic treatment.

Creams might be OK for kids with fast-growing, thin nails.



Wow's on other meds which might cause trouble.

My nails are manky again but the skin's OK. ICnBA to do anything yet.
Title: Re: Toenail fungus
Post by: sojournermike on May 23, 2014, 10:46:13 pm
I have nails that get periodically manky. I did 6 months of terminating and it was effective. I tend to use lamisil if it seems to come back 'too much'. As I like to go out for a run sometimes, if it gets a hold the nails get uncomfortable and bruise easily.

It's a right pain, but I suspect it it's ongoing nature is to some extent the result of my pragmatic prioritisation ..

Mike
Title: Re: Toenail fungus
Post by: Vince on May 23, 2014, 11:26:15 pm
I had a fungal infection under my big toe's nail. Once I decided it wouldn't grow out, I got Becur Naloc from the chemist. Paint it on once a day, especially around the edges of the nail. A marked improvement after about 2 months.

(Whilst hunting for the tube to get the name, I found my multi tool and external phone battery. :thumbsup:)
Title: Re: Toenail fungus
Post by: Greenbank on March 05, 2019, 10:27:53 am
Tried the topical treatment for the last few months and it's making a bit of a difference but I think the skin on the foot is infected too so I've booked a GP appointment on the 19th to discuss oral fungicides.

Consider giving up alcohohohohol for a while before seeking anti-fungals and during treatment.

Completely? Or just cutting down lots?

I've avoiding booze for quite a bit of this year (drank during a week long skiing holiday and I've had one other night so far in 2019 where I had a whole 6 units) but I was planning on returning to normal drinking (20+ units/week) come the end of April.
Title: Re: Toenail fungus
Post by: CrazyEnglishTriathlete on March 05, 2019, 10:41:56 am
In getting my other foot problem diagnosed, the podiatrist also pointed out that the hard skin on my heels which I've been managing with urea based creams for the last ten years was almost certainly caused by a fungal infection.  I also struggled with fungal infections on my toe nails that I have kept at bay with Scholl's expensive liquid - it's almost impossible to eradicate as I have a slow growing toenail (they took the nailbed out to solve an ingrown nail problem on my right big toe, but they didn't get it all - it grows very slowly and is therefore more susceptible to fungal infection).

That all aside - the podiatrist pointed out that a habit of encasing feet in cycling shoes and overshoes and riding around for extreme distances in the wet was almost certain to cause fungal problems, so it was probably an occupational hazard, probably starting around PBP 2007 and exacerbated by LEL2009.  So, faced with a choice of having soft skin on my feet or carrying on cycling, I'll just choose to manage somewhat manky feet.   :facepalm: ;D
Title: Re: Toenail fungus
Post by: hellymedic on March 05, 2019, 11:41:48 am
Tried the topical treatment for the last few months and it's making a bit of a difference but I think the skin on the foot is infected too so I've booked a GP appointment on the 19th to discuss oral fungicides.
Consider giving up alcohohohohol for a while before seeking anti-fungals and during treatment.
Completely? Or just cutting down lots?
I've avoiding booze for quite a bit of this year (drank during a week long skiing holiday and I've had one other night so far in 2019 where I had a whole 6 units) but I was planning on returning to normal drinking (20+ units/week) come the end of April.

Livers vary enormously in their capacity to handle the stuff and any deviation from the norm can be a reason to avoid oral antifungals. There is NO evidence base for this suggestion; just my feeling that
1) GPs can be reluctant to prescribe.
2) Livers can be weird.

FWIW my toenails need another round of antifungals but I've been SO deterred by the runaround I had last time I tried to get them that I'l keep waiting till David can't cope.
Title: Re: Toenail fungus
Post by: hellymedic on March 05, 2019, 12:03:00 pm
Update:  After six months on the anti-mank pills, I have lovely feet once more.

As Helly said:

Systemic antifungal treatment is not simple, cheap, quick or without risks. But it ROCKS.

I am no longer mank-free.
Several toenails and probably my fingernails have signs.

I would have liked another round of treatment many years ago but the GP sent me to the Community Dermatologist in the Community Hospital. He took clippings, which grew no fungus. (Infected nails don't always grow fungi, as I found out years later.) He therefore decided not to treat.

David's most recent encounters with the Community Dermatologist were at another location miles away.

Suspect getting my nails treated would entail multiple consultations at distant venues.

I can't face the hassle.

Wonderful, isn't it?
>5 years on, I'm still mank-free. Given how awkward foot care is now for me, I am very pleased.
Title: Re: Toenail fungus
Post by: Greenbank on March 18, 2019, 01:44:16 pm
Tried the topical treatment for the last few months and it's making a bit of a difference but I think the skin on the foot is infected too so I've booked a GP appointment on the 19th to discuss oral fungicides.
Consider giving up alcohohohohol for a while before seeking anti-fungals and during treatment.
Completely? Or just cutting down lots?
I've avoiding booze for quite a bit of this year (drank during a week long skiing holiday and I've had one other night so far in 2019 where I had a whole 6 units) but I was planning on returning to normal drinking (20+ units/week) come the end of April.

Livers vary enormously in their capacity to handle the stuff and any deviation from the norm can be a reason to avoid oral antifungals. There is NO evidence base for this suggestion; just my feeling that
1) GPs can be reluctant to prescribe.
2) Livers can be weird.

OK, thanks. I'll guess I'll see what the GP says tomorrow. I'm happy to use it as an excuse to extend my booze vacation for even longer. I had planned to be mostly off it until late April anyway but I can push that out as required.
Title: Re: Toenail fungus
Post by: Greenbank on March 19, 2019, 09:26:16 am
I'll guess I'll see what the GP says tomorrow.

GP wasn't hesitant to prescribe at all, to the point that he gave me the prescription for 12 weeks worth of terbinafine along with the sample jar for some toenail clippings and a form for a liver function test. He did say to wait for the test results before starting the medication though (I'll wait until I've got the results before filling the prescription). 3 monthly liver function tests from then on.

No specific warnings about booze although I did say that I was keeping an eye on my drinking and keeping it down to more reasonable levels.

No point using the topical nail paint stuff now as it isn't going to get under the nail properly or do anything for the skin on my feet.

8.30am appointment, walked out of the surgery at 8.43am having had the doctors appointment and being seen straight away by the practice nurse to give a blood sample (and a quick checkup for weight/smoking/booze/BP). Amazing when it works like this!
Title: Re: Toenail fungus
Post by: Ben T on March 19, 2019, 09:47:39 am
If I had been to the docs, sent clippings, prescribed amorolfine, but it did nothing, is there any point going back to the docs again?
Title: Re: Toenail fungus
Post by: Greenbank on March 20, 2019, 12:21:22 am
In the absence of proper medical training, and what has been posted in the thread so far, I'd say yes.
Title: Re: Toenail fungus
Post by: Greenbank on March 27, 2019, 01:20:08 pm
Called up and liver test results were "normal, no action" so I'll get the prescription filled this afternoon and off I go.
Title: Re: Toenail fungus
Post by: hellymedic on March 27, 2019, 02:23:13 pm
Excellent! Persistence pays off.

It's a LONG business...

(Mind you, this thread is pretty ancient too...)
Title: Re: Toenail fungus
Post by: Redjeep! on April 10, 2019, 10:29:28 pm
I get it on both my thumb nails. I find that it goes away after regular (at least daily) dosing of Vic's Vapour Rub onto the nail.

It tends to come back after a year or so if I forget to apply it once in a while (say once or twice a month), once it's gone.
Title: Re: Toenail fungus
Post by: Greenbank on June 12, 2019, 11:00:23 am
Coming up to 3 months on terbinafine. Off to the phlebotomist later today[1] to get the liver enzymes checked and, if all ok, will fill the repeat prescription I've been given.

It's definitely affected my drinking. I get worse hangovers and from fewer drinks now. Not that that's a bad thing as it is a good reason to cut down a bit, if only I'd remember that the night before the morning after.

1. 30 minute wait at the local hospital, the earliest appointment I could have got to have to taken by the nurse at my GP surgery was 9 days away!
Title: Re: Toenail fungus
Post by: Greenbank on June 14, 2019, 02:56:31 pm
Off to the phlebotomist later today[1] to get the liver enzymes checked and, if all ok, will fill the repeat prescription I've been given.

Blood test at hospital midday on a Wednesday. Text from doctor at 6pm the next day (Thursday) to say that test results are good and I can continue to take terbinafine. Prescription for another 84 days filled. Just need to make a note in the diary for ~3 months time to book another doc appt.
Title: Re: Toenail fungus
Post by: hellymedic on June 14, 2019, 03:13:53 pm
Great news!
Title: Re: Toenail fungus
Post by: Ben T on June 20, 2019, 01:05:42 pm
Off to the phlebotomist later today[1] to get the liver enzymes checked and, if all ok, will fill the repeat prescription I've been given.

Blood test at hospital midday on a Wednesday. Text from doctor at 6pm the next day (Thursday) to say that test results are good and I can continue to take terbinafine. Prescription for another 84 days filled. Just need to make a note in the diary for ~3 months time to book another doc appt.

I have just picked up my 3rd batch of 28 making it 84 in total I have had so far (just coming to the end of the second batch).
The 3rd batch contains another repeat prescription, which doesn't say anything about having to back and have a liver function test.

Did they tell you you're only allowed 3 batches before getting the liver function test, or did you opt for that yourself?

I'm sure it has had an effect, as last week, on the most affected one with the deepest infection, the nail basically fell off completely. It started with a crack fairly near the base, then the crack propogated to down the middle like an upside-down T shape, then each half (left and right) basically came away. Skin beneath looks a bit brown and scabby but hopefully it is free of fungus, and hopefully a new healthy nail will grow in its place.
Title: Re: Toenail fungus
Post by: Greenbank on June 21, 2019, 09:29:21 am
Did they tell you you're only allowed 3 batches before getting the liver function test, or did you opt for that yourself?

Each prescription I get is for 84 tablets (12 weeks worth).

Liver enzyme test before taking first one. (I was given the prescription but told not to fill it until I got the ok with the results of the liver test.)

Told to book another doctors appointment a week or so before those first 84 tables were due to run out.

2nd Doctors appointment was just to check everything was going ok (a quick look at the nails, and check that I'm not turning yellow and no unexplained abdominal pain, etc). Given another prescription and a referral for another blood test. Again told not to fill prescription until given the all clear from the latest blood test.

I'll book another doctors appointment a week or so before this next batch of tablets is due to run out (i.e. day 160 or so). I expect it'll be another quick check that everything is ok, a look at the nails to see if I need another 12 weeks, prescription, blood test referral and told not to fill prescription until results.

I never asked for the liver tests, they've been a condition of me getting the prescriptions. The pharmacist also asked whether I'd had a recent liver test before filling the prescriptions (both times).

So, 3 months in and I've got about 9mm of it left on my big toe, the nail on my middle toe is taking longer than expected as that nail is raised/arched and I guess the fungus was deep in the nail bed. Wouldn't be surprised if I have to go the full 12 months on it to get rid of it completely. Joy.

Title: Re: Toenail fungus
Post by: Greenbank on September 03, 2019, 09:42:51 am
I'll book another doctors appointment a week or so before this next batch of tablets is due to run out (i.e. day 160 or so). I expect it'll be another quick check that everything is ok, a look at the nails to see if I need another 12 weeks, prescription, blood test referral and told not to fill prescription until results.

Almost exactly that. Quick check of nails, blood test referral (good as I have to go to the hospital to chase up the physio referral) and the doc sent the prescription to my designated pharmacy (no need to get a hardcopy prescription any more).

The only change was that he said that since I've been on it for 6 months with no problems (and two good liver test results) I can collect the prescription and continue with the next batch of tablets without waiting for the ok - he'll just ring me if there's a reason to stop taking them (before that they would ring to tell me it was ok to start taking them).

Still about 4mm-5mm of nail on the big toe that's cloudy and there's still a bit of crumbliness on my middle toenail (the other one that was infected). Might be done in the next 3 months but may possibly require a further 3 months (i.e. 12 months in total) to be sure, will know more next time. Will set up a reminder to book appointments in 12 weeks time.
Title: Re: Toenail fungus
Post by: simonp on November 21, 2019, 11:37:44 pm
I’m nearly 5 weeks in. They only gave me 6 weeks supply and I have to have follow up bloods at 4-6 weeks so that is booked for next week. I have one 4th nail fully discoloured and both big toe nails down one side. I lost both big nails after a 600k and I think they were susceptible during regrowth.

Terbinafine is actually pretty safe compared to older drugs but although I don’t drink much these days I’m staying off the booze entirely during treatment. I’ve seen advice to avoid caffeine. Nope.  :hand:
Title: Re: Toenail fungus
Post by: Greenbank on November 22, 2019, 08:31:49 am
Good reminder. My doc appt earlier this week was cancelled on the day as the doctor was ill, rebooked for 2 weeks' time (the day before my latest 12 week batch runs out).

I expect to get another 12 weeks worth (and another blood test) as it is still not all done. That'll be 48 weeks if that happens.

Terbinafine is actually pretty safe compared to older drugs but although I don’t drink much these days I’m staying off the booze entirely during treatment. I’ve seen advice to avoid caffeine. Nope.  :hand:

Haven't noticed any other changes though, but I'll be glad not to be taking the tablet every day (I'm lucky in that I don't have to take any other tablets at all). Horrible chalky things that taste disgusting if they don't go down with the first gulp of water.

I've cut down a bit on booze (mostly because I haven't been playing 5-a-side for the last 4 months due to ankle injury) and I gave up caffeinated coffee 10 years ago for LEL, so that's not a problem for me.
Title: Re: Toenail fungus
Post by: simonp on November 30, 2019, 12:31:43 pm
I had blood test on Wednesday which came back fine. They only seem to want to give me 6 weeks supply at a time at my surgery, with instructions for another test in 4-6 weeks. I didn't see the doctor, just had blood taken and then repeat prescription issued direct to the local pharmacy.
Title: Re: Toenail fungus
Post by: Greenbank on November 30, 2019, 01:00:11 pm
It'll cost you twice as much then.
Title: Re: Toenail fungus
Post by: simonp on November 30, 2019, 08:57:47 pm
It'll cost you twice as much then.

Indeed it will - could cost almost £80 if it takes a year. Is it worth it?!

Title: Re: Toenail fungus
Post by: Greenbank on November 30, 2019, 10:43:34 pm
It'll cost you twice as much then.

Indeed it will - could cost almost £80 if it takes a year. Is it worth it?!

I'd ask them specifically about getting a 12 week prescription, even if they still want you to have blood tests every 6 weeks. (There may be a specific reason why they want this for you.)

I'll be looking at £36 for my 48 weeks (assuming I get another 12 weeks when I see the doc on Tuesday).

My local chiropodist had "Fungal nail complete treatment" at £310 on their price list but I'm guessing this includes a lot of in person treatment (even if they still just give you terbinafine) and might be assuming it's multiple nails infected.
Title: Re: Toenail fungus
Post by: Greenbank on December 03, 2019, 09:09:37 am
I expect to get another 12 weeks worth (and another blood test) as it is still not all done. That'll be 48 weeks if that happens.

Another 12 weeks for me (I think, haven't seen the prescription as it gets sent to the pharmacy directly) but it's almost gone so the doc said to take it until the last of it has disappeared from the nail and then I can stop, so hopefully only another month or two. Another blood test (handily have a physio appt for my ankle next week at the local hospital so I can combine the two).

If I remember later I'll post before/current pics (behind spoiler tags...)
Title: Re: Toenail fungus
Post by: simonp on December 03, 2019, 12:54:03 pm
4-6 weeks monitoring is what is suggested by emc: https://www.medicines.org.uk/emc/product/1031/smpc

However, the FDA actually removed the monitoring requirement from the drug label in 2001

I'm not bothered about the cost TBF, it's just a minor inconvenience to get retested and refill the prescription.
Title: Re: Toenail fungus
Post by: Redjeep! on December 30, 2019, 11:52:05 pm
Vic's Vapour Rub works quite well too. Apply a thin film a couple of times a day. Worked on my thumb nails.

Takes ages, but then so does everything else ( maybe not the tablets) as they all seem to rely on growing new, unaffected nail at the rate of about 1.5 mm per month.
Title: Re: Toenail fungus
Post by: Greenbank on December 31, 2019, 11:57:04 am
Tablets take ages too (I'm almost done after 10 months of daily 250mb terbinafine, probably need another 4-6 weeks), but tablets are generally for the cases where the fungus has got right down into the nail bed, many mm away from the visible parts of the nail and so topical treatments are far less likely to work (if they do kill off the visible fungus then you just end up waging a constant battle against the fungus that slowly grows out with the new nail).

If you start the topical treatments before the fungus gets out of sight then they work quite well. I just faffed around not doing anything for too long before I finally got around to sorting mine out. Not going to miss the daily tablets (I'm lucky in that I don't have to take any regular medicine).