23rd August 2006
I am a researcher of scientific information by profession, and I have been looking into the toenail fungus problem for a while now. I suffer from it like most of the readers/posters here.
Here's a summary of where I am in understanding how to best treat this problem.
1) Lamisil and other oral prescription drugs -- If you can afford it and do not have liver problems, it is pretty much the consensus of the medical establishment that this is the way to go.
I actually have a liver condition so I was initially told that I could not take lamisil or sporanox. But I read up on it, and convinced my doctor that weekly liver enzyme tests could prevent any serious damage (this is how desperate I was to gain back normal looking toenails). I took lamisil for 3 months and it miraculously cured the problem -- BUT the toenail fungus came back after about 6 months. So I took it again for 3 months but this time it was not nearly as effective. About 2 years later I took sporanox for 3 months and the same story, not that great. I really regret not knowing about any of the home remedies (vinegar, Vicks, etc) the first time I took lamisil, when it worked the best -- I think the combination treatment of systemic lamisil + anything topical could have staved off the return of the fungus for a lot longer.
2) Warnings about possibility of liver damage when taking lamisil, sporanox or any other oral systemic antifungal drug -- the FDA folks know what they're doing so please heed their warnings. This is only my experience for the benefit of others reading this. I have hepatitis B, and I took lamisil for 3 months, twice. Then I also took sporanox for 3 months. They say people with hepatitis should not take these medications, and I am sure they are right for virtually all hepatitis carriers. However, my experience is that my liver was tested once for baseline before taking the drug(s) and then once a week for the whole time that I was on the drugs, and for 1 month thereafter -- and my liver tests showed no abnormality or change. In fact, my liver enzyme and viral load (undetectable) are the best they have ever been after taking all those drugs. This may be a testament to my overall good health and my liver's good health other than the inactive hepatitis, so I probably got lucky. But if you do not have such counter-indications, drugs like lamisil or sporanox may give you a great start in treating or curing toenail fungus, and then you can maintain the cure with the other alternative remedies discussed on this Board.
3) I have seen reports of limited clinical testing of Vicks, which is more than what you can say about most other alternative treatments for toenail fungus. Apparently, there is some scientific/clinical merit to use of Vicks on toenail fungus. However, the thing about the nails turning temporarily brown or black seems to be true for many users, eventually. I have seen that side effect mentioned many times.
4) A development that has me most hopeful is the recent news that many pharmaceutical companies are in testing (Phase I or II) for topical formulations of lamisil, lamisil + another active drug, and others. [[COLOR="Red"]removed]
The companies are now trying to formulate and deliver already approved antifungal or fungicide drugs directly to the site of fungal infection (nail, nail bed, etc.) with better penetration additives, so I really expect smooth sailings for these clinical trials. Don't know why they did not think of doing that first since that seems safer than the oral route of delivery. It sounds to me like these new topical medicines may become available within the next several years. To me, this is great news since the really good antifungal agents could then be used without worrying about potential systemic side effects like liver damage.
5) In the meantime, there is some decent scientific clinical evidence that urea gel/cream + ciclopirox (Penlac) works OK. Penlac is the only FDA-approved topical treatment for nail fungus, so combining that with the penetrating effect of urea makes a lot of sense. The researchers who studied the combined effect reported improved results.
Bottom line, I think the new topical medicines (likely to be prescription drugs) that may become available within the next few years should give us many more options.
As for me, I have never tried any of the alternative remedies like vinegar, tea tree oil or Vicks but I will be doing so until the new topical medicines become available. I will likely use a combination of urea gel + Penlac with vinegar pretreatment or some other alternative remedy.
Here's a summary of where I am in understanding how to best treat this problem.
1) Lamisil and other oral prescription drugs -- If you can afford it and do not have liver problems, it is pretty much the consensus of the medical establishment that this is the way to go.
I actually have a liver condition so I was initially told that I could not take lamisil or sporanox. But I read up on it, and convinced my doctor that weekly liver enzyme tests could prevent any serious damage (this is how desperate I was to gain back normal looking toenails). I took lamisil for 3 months and it miraculously cured the problem -- BUT the toenail fungus came back after about 6 months. So I took it again for 3 months but this time it was not nearly as effective. About 2 years later I took sporanox for 3 months and the same story, not that great. I really regret not knowing about any of the home remedies (vinegar, Vicks, etc) the first time I took lamisil, when it worked the best -- I think the combination treatment of systemic lamisil + anything topical could have staved off the return of the fungus for a lot longer.
2) Warnings about possibility of liver damage when taking lamisil, sporanox or any other oral systemic antifungal drug -- the FDA folks know what they're doing so please heed their warnings. This is only my experience for the benefit of others reading this. I have hepatitis B, and I took lamisil for 3 months, twice. Then I also took sporanox for 3 months. They say people with hepatitis should not take these medications, and I am sure they are right for virtually all hepatitis carriers. However, my experience is that my liver was tested once for baseline before taking the drug(s) and then once a week for the whole time that I was on the drugs, and for 1 month thereafter -- and my liver tests showed no abnormality or change. In fact, my liver enzyme and viral load (undetectable) are the best they have ever been after taking all those drugs. This may be a testament to my overall good health and my liver's good health other than the inactive hepatitis, so I probably got lucky. But if you do not have such counter-indications, drugs like lamisil or sporanox may give you a great start in treating or curing toenail fungus, and then you can maintain the cure with the other alternative remedies discussed on this Board.
3) I have seen reports of limited clinical testing of Vicks, which is more than what you can say about most other alternative treatments for toenail fungus. Apparently, there is some scientific/clinical merit to use of Vicks on toenail fungus. However, the thing about the nails turning temporarily brown or black seems to be true for many users, eventually. I have seen that side effect mentioned many times.
4) A development that has me most hopeful is the recent news that many pharmaceutical companies are in testing (Phase I or II) for topical formulations of lamisil, lamisil + another active drug, and others. [[COLOR="Red"]removed]
The companies are now trying to formulate and deliver already approved antifungal or fungicide drugs directly to the site of fungal infection (nail, nail bed, etc.) with better penetration additives, so I really expect smooth sailings for these clinical trials. Don't know why they did not think of doing that first since that seems safer than the oral route of delivery. It sounds to me like these new topical medicines may become available within the next several years. To me, this is great news since the really good antifungal agents could then be used without worrying about potential systemic side effects like liver damage.
5) In the meantime, there is some decent scientific clinical evidence that urea gel/cream + ciclopirox (Penlac) works OK. Penlac is the only FDA-approved topical treatment for nail fungus, so combining that with the penetrating effect of urea makes a lot of sense. The researchers who studied the combined effect reported improved results.
Bottom line, I think the new topical medicines (likely to be prescription drugs) that may become available within the next few years should give us many more options.
As for me, I have never tried any of the alternative remedies like vinegar, tea tree oil or Vicks but I will be doing so until the new topical medicines become available. I will likely use a combination of urea gel + Penlac with vinegar pretreatment or some other alternative remedy.