Toenail fungus/Onychomychosis

Trichophyton rubrum is the most common fungus cause of onychomychosis

Yeasts cause 8% of infections

Non-dermatophyte molds cause 2%

It occurs more often in the elderly due to decreased blood flow to the toenails

Here is a picture of the above fungus under a microscope below

See below for treatments:

fungus2

Treatment secret that nobody is going to tell you:

There is no silver bullet for this condition.

The best thing you can do is to try and prevent it by not walking around in public showers, have socks that are antifungal socks/antisweat socks, shoes that have great airflow (not realistic in my opinion … who can wear sandals all day at work?)  I have this condition. I have tried….

Oral Lamisil for 3 to 6 months daily after a liver test. There was no change in my nails at all. You would likely need to ask for the generic for because most insurances won’t cover it because the issue of the nail fungus is not really harmful to one’s health. It is primarily an aesthetic issue.

Penlac– medicated brush on medication that requires a Doctor prescription for 10 months every day. There was a tiny bit of change to the nail but barely noticeable. Most insurances don’t pay for it so you have to ask for the generic form.

I have used nearly every nail topical ointment there is: Funginail, Lamisil topical cream on nail, Goldbond powder, Tinactin spray, Nonyx, listerine in water, nail polish removal, bleach directly on the nail (please don’t do that- I should not have done that, Comet on the nail (please don’t try that), laser therapy with UV light-it is supposed to denature the DNA, apple cider vinegar and water, nail filing,  hydrogen peroxide, and the list goes on. Not one even helped at all. Bleach looked like it helped for a day or two but when I stopped using it the nail fungus came right back and that is so dangerous. There is one product called Vics Vapor rub that is showing some promise of success from a study at University of Michigan.

I have scoured medical journals for years and the best results I have seen are from Lamisil which can really possibly damage your liver and/or the nail polish Penlac at a success rate of about 17%. There are about a dozen infomercials online that say they have a miracle cure that usually costs 300 dollars but if you buy right now it will cost 99 dollars.  Arghhh!

It is nearly impossible to cure this condition because the fungus resides under the nailbed and most topical solutions (probably all) of the medicines don’t penetrate deep enough.

Shoes provide the perfect breeding ground for these fungi- they are dark, moist, and warm– the triple threat!

The condition usually occurs in the big toes. But let me tell you a trick… the condition is often in the nails of the other toes but it is hard to see with the naked eye. Take your smart phone out and take a picture of all of the nails of the feet. Use your flash and then enhance the image and you will see the tell tale sign around the upper outer tips of the nails  that they are a bit yellow.

fungal-toes

So how can we help this condition? I had to have a paradigm shift. I have dry skin and at one point when I was a kid I realized that skin care is something that I have to work on everyday to help keep it healthy. To help your nails be looking better and not itchy and unsightly it is going to be a process you need to do everyday.

I have found some success in making my nails look more presentable if I perform daily

  1. Wash my socks with bleach– the dermatophytes stay in socks and shoes. Change my shoes of 8 months that had dermatophytes.
  2. Soak my feet/toenails daily for 10 minutes in apple vinegar and warm water.
  3. Wash between my toes daily.
  4. Use sandals that have my toes open to the air right after work.
  5. File my nails carefully. If you start getting down to the nailbed it bleeds very easily.
  6. If you have diabetes do no cut your own toe nails or file your nails. Your Podiatrist needs to work with you on this because if you have an injury it is dangerous.
  7. Trim the nails fairly short- the fungus love to reside under the nail- it is more dark, moist, warm!
  8. Use a bar of soap to scrape soap under the nails with soap-how often do we wash under our toenails? Most of us never do right?
  9. Dry between the toes after washing
  10. Use Penlac after all of these things daily
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