I have severe toe nail fungus with yellow, thickened toenails. I was wondering about the new laser treatment.
– Mary, Bend
Yellow, thickened toenails are usually caused by toenail fungus. The medical term for this condition is onychomycosis.
A healthcare provider usually can look at the toenails and make a diagnosis, but sometimes a culture is required. Half of Americans over 40 have onychomycosis.
There are a few different treatment to consider. You can try over-the-counter antifungal creams, but they only have an 8 percent cure rate. There has been some success with alternative remedies such as soaking your feet in either Clorox (a mixture of 80 percent water, 20 percent Clorox), Vicks VapoRub, vinegar, Listerine, or tea tree oil.
Or, there’s oral antifungal medication prescribed by a healthcare provider, such as Lamisil. However, it must be taken for at least three months and can be toxic to the liver, so regular blood tests should be performed to monitor the liver function. According to Lamisil’s FDA-approved prescribing information, 3.3 percent of patients in clinical trials had abnormal levels of liver enzymes, a possible warning sign of liver damage.
There also is a relatively new laser treatment, although one campany – PinPointe USA Inc. – has received Food and Drug Administration clearance. It’s supposed to be painless without any side effects. The cost can range from $750-$1,500 per treatment, and isn’t generally covered by insurance.
A study published last year in the Journal of the American Podiatric Medical Association looked at 34 patients. After four laser treatments, 85 percent of the nails showed new growth without fungus. Keep in mind that this was a very small study, and was funded by one of the laser companies.
For any of the therapies it takes about 10-12 months for the new, healthy nail to grow in. Other infected members of the family may need to be treated because it is contagious (particularly when using the same shower). To prevent fungus recurrence you must follow a diligent hygiene program which includes: anti-fungal spray for feet and shoes, not going barefoot, keeping feet clean and dry, changing socks daily, and throwing out old flip-flops and sandals.
– Dr. Phyllis Ritchie is an infectious-disease specialist.
Correction added Nov. 11, 2011: Soaking your feet in a mixture of 80 percent water and 20 percent Clorox has been used as an alternative treatment for toenail fungus. A story in Wednesday’s Living section did not specify diluting the Clorox.
Original Article: Here