UKC

Not a very nice subject title this!
I've been climbing a lot recently and perhaps my shoes don't get chance to air out properly before the next use, although I do clean them fairly regularly, as well as keeping my nails cut and clean. I'm thinking to start alternating between two pairs so they have chance to dry. But now I seem to have a fungus appearing under one of my big toe nails. Does anyone know of a good remedy for this? It does seem to be a common thing amongst climbers.

In reply to leeoftroy:

Go to the doc for some antifungal cream or buy Canestan over the counter. Get the thrush version because it has 2% active as against 1% in the athlete's foot version.

Get to work on it now because it will spread and it's apparently very hard to eradicate in toenails. Also buy a can of antifungal spray for your shoes and treat ALL your shoes twice at one week intervals. Clean socks every day too.

In reply to Rigid Raider: I was lead to believe that only an oral drug taken over a long period will actaully get rid of it i.e. it's not the same fungus as athlete's foot.

In reply to leeoftroy:

Deal with it now as it will only get worse if you dont' treat it. I tried all sorts, including the oral drugs but GP's aren't keen to leave you on this for the length of time it takes as these drugs have some sort of effect on your liver. what worked for me in the end was painting my toenails every day with tea tree oil. Give that a go but you'll be at it for a long time if the infection is well into your nail.

It's a horrible little infection that appears as if it would survive a nuclear winter, but happily not a daily dose of tea tree oil.

Tom

In reply to leeoftroy:
I saw the doctor and got some tablets was on them for about 9 months. I had 5 toes infected but cleared up thankfully.

In reply to leeoftroy: tea tree oil will help if it is still quite localised,
also useful for a lot of other minor ailments

In reply to leeoftroy: I got rid of mine when my approach shoes broke on the Aonach Eagach, meaning my toenails were constantly bashing the end of my shoe the whole way down. I lost my big toenails, but they grew back fungus free!

Before then, I was having some success by cutting them really short and using an old toothbrush to scrub teatree oil up under the nail.

In reply to leeoftroy:

Human saliva! Get your significant other to suck your big toe for 10 minutes every night and 10 minutes every morning before work. Worked for me.

E

In reply to leeoftroy: will take 6/12 months to cure. Oral medication is more effective than topical. Neem oil soap, a bit difficult to get hold of and stinks to high heaven is brill for foot maladies. Powder ALL your footwear with athletes foot powder regularly. If not got rid it'll be thickened nails catching,digging into toes. Allum block either crushed into powder and dusted on feet after drying or just rub the block over them. This will dry out the skin

In reply to leeoftroy:

Had it for years. Don't give a shit about it, frankly, it doesn't hurt.

In reply to Jon Stewart:

This will sort it out:
http://www.ftape.com/media/wp-content/uploads/2010/01/American-Apparel-Nail...

E

In reply to leeoftroy:

A podiatrist friend suggests:

"A range of over the counter products are available - but go for one that contains 'terbinafine' and apply according to instructions which usually includes applying 3 times a day for at least three months. The secret of success is consistent application; it only takes a few spores to spread the fungal infection. Regular application of tea tree oil to the affected nail(s) can also be effective. Oral anti fungal medication is hard on the liver and GPs are increasingly reluctant to prescribe it."

Hope this helps.

In reply to leeoftroy:
Treatment depends on killing, or at least containing, the fungus while the nail grows out so takes time. Not treating is also an option, as Jon says, if its not getting worse.
Oral meds are more likely (but not 100%) to work, but take time and there is a small but significant risk of some serious side effects (liver toxicity is the most common serious complication). Worth using if extensive infection or not responding to other treatment.
Topical treatment does work and if it were me I'd try this for a good amount of time (weeks-months) first especially if the infection is limited to one nail. Creams are probably not superior to nail paint but some people find them more convenient. Nail paints aren't usually available on the NHS if you want to go to your doctor for a prescription but topical treatments are mostly available over the counter anyway. Worth discussing topical options with a pharmacist.
Patient UK has a reasonably good information leaflet: http://www.patient.co.uk/health/fungal-nail-infections-leaflet

In reply to Enty:

Do I have to buy all those colours? Think I'll leave it.

In reply to Jon Stewart:

You need to know the genus of the fungus. Reds work well for dermatophytes, blues for yeasts, and greens for moulds.

In reply to leeoftroy: I had the same. It then spread to all the other toe nails and then to my finger nails. That looked so bad, especially when meeting clients at work, that I badgered my gp until he stopped saying it was cosmetic only and agreed to the Turbufine tablets or some such name. But he only agreed after doing a blood test to see whether the liver would cope. Had those for 3 months. Not particularly nice as made my stomach feel a bit wierd but I stuck with it. Gp refused to prescribe any more because he said the tablets would kill the fungus and new nail growth would push out the dead nail and crap beneath it. I thought he was talking rubbish but thankfully that's what happoened (although there's a tiny bit of dead stuff left in one toe nail). Everything else is fine though.

In reply to leeoftroy:

Cider Vineger.

Soak don't cotton wool in some, duck tape it to your toe and leave overnight, repeat the following evening. Do this for a week or two and you'll be fungus-free!

In reply to leeoftroy:

Yes remove as much of the infected nail as you can with nail clippers and buy one of these:
http://www.amazon.co.uk/BATRAFEN-Lacquer-treatment-fungal-infections-yeasts...

You could also possibly get it in pills but I think the above is probably better - bit expensive but does the job. Make sure you read the instructions and follow them...

In reply to Simos:

(Just to be clear, the above is for fungus IN/OF the toe nail itself, not on the skin. For the skin I'd think some Athlete's foot over the counter spray etc should work. There's also some kind of anti-fungal powder you can put in your shoes but I don't know whether it'll make your foot slip - should be ok if your shoes are reasonably tight)

In reply to leeoftroy:

I think you should get a diagnosis from the doctor before anything, but if fungal infection of the nails, the traditional medical therapy is to use pulse oral medication (perhaps one week per month) as the drugs have a very high affinity for nail tissue and hang around for a long period. Ciclopirox as mentioned above has been used for athletes foot and various skin infections and has a 54% cure rate (mycological cure) in nail disease on one open ( Journal of the American Podiatric Medical Association 97, 195-202, Skin therapy letter 10, 1-3 if you like looking these things up on Pubmed)

In reply to leeoftroy: An important way to treat this as others have said is to file down and reduce the nail thickness before any treatment with oils etc.

In reply to leeoftroy:

I have been using Clearzal for about a year and it is working well.

www.clearzal.com/‎

It needs to be applied twice a day, every day and you need to be quite strict with yourself about that.

Also, file the nails short and thin as this allows the treatment to reach the fungal infection.

It is not a short term treatment but does work. My toenails are no longer painful when wearing climbing shoes or thick and yellow.

Rich.

In reply to Jon Stewart:

That is a disgraceful attitude. It is a disgusting ailment. My children caught it from their grandmother who had the same attitude as you and it took years to get rid of. Nail funguses are highly contagious via carpets, changing rooms and clothing/slippers, same as verucas. I wonder how many people you have infected?

As a dermatologist, I would have to say that topical treatments i.e. creams or paints, for true fungal nail infection are a complete waste of time. The nail is essentially acting like an umbrella and protects, in this case, the fungal spores which are hiding underneath it. Oral medication is required for clearance, and even in some scenarios nail removal also, if there is too great a store of fungus for the medication to eradicate. Then again as its a non-serious infection there is an argument for saying leave it alone. As someone has already mentioned, if treating you should start on oral terbinafine 250mg once/daily for 3-6months. If this failed I would suggest 'pulsed itraconazole' which is taking an anti fungal for 1wk each month for at least 3months. Liver tests should be checked by GP prescribing.

In reply to Simon Reid:


Interesting comment. There's a whole industry devoted to the production and marketing of those things. Are you saying it's completely unscientific and bogus?

In reply to abcdefg:

I was prescribed a topical anti fungal cream by my doctor for a nasty looking toenail infection. Seems to be working. FWIW it can take months to fully grow out but does seem to be doing so.

Neil

In reply to leeoftroy:
You can also get lazer treatment at £500 a session!! (normally takes 2-3 sessions)
If you have private health care it may be covered by that.

In reply to leeoftroy:

I've had this all my life from the age of about 15. I'd say that you need to snap it in the bud, or you'll never get rid of it.

I am also prone to Athlete's Foot, but there I have better news. I have found something much more effective than the anti-fungal creams, sprays and powders, and that is Scholl's cracked heel cream, which is not intended for this purpose. I think it works mechanically rather than medicinally: it just seems to remove the fungally infected skin and, bingo, the infection is gone!

There is a big industry for the topicals as they can be sold over-the-counter (unlike the potentially toxic oral preparations) to a very large potential market but will likely only benefit those with very limited nail infection (primarily the distal nail edge) where some of the paint can be worked in. There was never any convincing studies of topicals efficacy last time I looked! And when they fail public will assume its just their nail infection is too stubborn and they will probably not question the preparation. Then comes the oral agents and they will work for the vast majority.

In reply to Simon Reid:

Have you ever known it to clear up naturally? I've had it in about half my toenails for 14ish years. Been ill for 10 months with what is now Chronic Fatigue Syndrome and for some reason my nails are clearing up... It's not a great trade-off though, to be honest!

In reply to abcdefg:

There is also a market for homeopathy. No scientific knowledge to back this up.

In reply to dapoy:

Of course.

I wasn't arguing with Simon Reid; to the contrary, I was asking for his honest assessment, which he's now kindly given.

In reply to freerangecat:

I've had a tiny bit on the edge of one of my big toes for years. Usually just keep cutting the edge of the nail right down and it's never spread and never caused me any problems, but this thread has finally made me go and buy some paint on treatment - not cheap at £20 a go for a tiny tube.

A question for those medical folks that might know - I have had a sore big toe joint in the same toe (bit swollen, red and hot sometimes, and painful on occasion) as the infection. Could there be any connection? I have alternately though it might be a bunion or arthritis, but not totally convinced about them. And no, I've not seen a doctor! I know, I know...

In reply to freerangecat: tinea unguim to use the proper name should not resolve spontaneously but rather tends to be progressive with worsening effect of infected nails and also spreading to involve other nails. If its melted away it might make me think of an alternate cause such as a yeast infection (such as candida) which may look somewhat similar. But then again its important to realise that not all nail deformities are related to fungus/yeasts, and may actually be localised psoriasis or lichen planus or rarer causes and some of these may burn themselves out eventually!

In reply to abcdefg:

Agreed, Simon sounds like the most knowledgeable person in the conversation. I was just making a point that just because there is an industry devoted to something doesn't mean that it works.

In reply to Simon Reid:

That's interesting, thanks.

In reply to Simon Reid:

Interesting stuff. I've had this for twenty years and it now affects fifteen of my nails. I've tried most things over the years, including a three month course of Lamisil (which had no effect whatsoever despite the condition being much less advanced than it is now). Not tried the pulsed itraconazole - does it have a better success rate? (lamisil is 50-60% I think?) Is my GP likely to know much about this or is there another route/ specialist you would recommend?

In reply to JayPee630:


Im not a medical bod, but do get gout. Sounds like it could be that.

In reply to leeoftroy

I have cured mine completely using Ciclochem Uñas, a clear topical ointment you can get from pharmacies in Spain.

I had tried some useless ointment my gp prescribed and baulked at the month long course of medication she suggested.

My toenails went from looking hideous and falling apart to perfect within months (once the unaffected nails had groen through).

My sister who lives in Spain is bringing some more over soon as a friend of mine has it really bad tried some of the stuff I had left and it worked for her too.

In reply to leeoftroy: if the toenail falls off/is removed, will it grow back infected?

In reply to leeoftroy:
I had manky finger nails and some toe nails were constantly breaking off. I had to give the doctor some nail snippings for examination and then I was prescribed some nail polish which came in a kit with some sandpaper and sticks for painting it on daily. A few people took the mick for having shiny nails but after about 3 months it was clear that it wasn't working. No idea what the active ingredient was, but the solvent smelt good

I was then prescribed terbinafine tablets which worked well and the treatment course (2 months IIRC) cleared up the finger nails perfectly and the toenails were getting better too. I asked for a bit more to finish off the toe nails (finger nails seem to grow quicker than toe nails) but was refused more for the liver reasons others have stated above.

This was 8 years ago, perhaps now there is some other treatment. For me, the nail polish was a waste of time. These days my finger nails remain fine and toe nails are adequate but stable.

In reply to leeoftroy:

Best take off and nuke the site from orbit, it's the only way to be sure.

In reply to leeoftroy:
vicks vapour rub or poundland vapour rub are both very good at controlling/curing toenail fungi and athletes foot, has anyone else tried this?

In reply to richard_hopkins:

I think nail lacquers probably work if you catch things early - pills are more effective but have their downsides too so might be worth giving the lacquers a chance first. Doctor should be able to advise.

I've had luck with Batrafen Nail Lacquer in the past on my big toe - I did catch it early though and managed to remove a big part of the infected area first with clippers, the I aggressively 'sanded' the remaining and used the lacquer regularly in conjunction with trying to keep feet dry, well aerated etc.

I am not actually sure if the fungus died or not but it certainly stopped spreading and essentially as my toe nail grew I was able to clip the rest of the infected part.

In reply to Adam Long:

For years I had what I thought was a nail fungus infection. None of the recommended cures worked. Because I was trying lots of things I eventually found that Athlete's Foot ointment (either Scholl or Boots) had a strong effect after a few weeks of application. The infection, in my case it seems, was to the skin under the nails. About 5 months ago the toenail on my left foot literally fell off. I kept applying the athlete's foot ointment, and now the toenail seems to be growing back healthily with no sign of further infection. Most other (5) affected toes are also not nearly as bad as they were. I wonder if your problem is the same?

In reply to rocky iv:

Seems to be working for me, if a little slowly!

In reply to leeoftroy:

The application of Tea Tree oil to the affected area might help. But then again it might not. It worked for me but not my mate. Two things to bear in mind: the oil has a pretty pungent smell which may draw unwanted attention and in my case, it took about a year of diligence before I noticed any significant improvement. Further perseverance and my big toes no longer disgust me.

In reply to Rigid Raider:
Daktarin Plus cream has worked for my toenail infection. Slap it on twice a day. It's for athletes foot, but fungus is fungus, right? Available over the counter, and better than Canestan or other creams I've tried. My rock shoes still smell like a pile of dead rats, but it was ever thus.

In reply to leeoftroy:

I had it in all toes but when it affected some fingernails I took tablets (terbafine I think) for 6-9 months. After a couple of months the fingers were clear. I don't think I continued quite long enough though because currently I've got it in one of my toes and my little finger.

I find I can keep it in check - not curing it though - by occasionally using Curanail. You sand down the nail and apply like nail varnish, it's a clear lacquer.

In reply to leeoftroy:

Heard this being discussed on Radio 4 this afternoon (Inside Health). Might be worth a listen on iPlayer.