Wednesday, February 10, 2010

New Treatment for Fungal Toenails

Yellow, thick, crumbly, and ugly toenails are hiding behind shoes. They smell a little funky, they look a little funny, and they drive your significant other into frenzy! Toenail fungus is extremely common. As a foot doctor, I see it every day. Over the last several years, treatment for nail fungus has been getting a lot of attention. There are topical options and oral options for treating the ugly toenails. In addition, there are newer treatments that are non-harmful and very effective. My patients are always very concerned about the treatments and how they will affect their body. So let us discuss the pros and cons of the popular oral treatment, Lamisil as well as the new treatments.

Why take a pill? There are many medications that can be applied directly to the nail but they are not always effective. If the fungus is only at the tip of the nail or less than half of the nail is infected, the topical treatments can work to eliminate the fungus. This can take up to 10 months and there is a high risk of recurrence. Once the fungus has infected the entire nail the topical agents are not strong enough to kill the fungus. The nail is too thick for the medication to penetrate to under the nail, where the fungus calls home. Taking oral medication works from the inside of your body to fight the fungus and research, and in my personal experiences, has proven the pills to be more effective.

How long until the fungus is gone? The oral medications, such as Lamisil, are taken for three months. It takes a nail ten to twelve months to grow out. Thus, after three months of treatment, your nail may still look a little funny. When the fungus lives under your nail, it causes damage to the nail and will make it turn yellow and thick. As new, healthy, and uninfected nail growth takes place the ugly portion with grow out and eventually be replaced. Many of my patients get nervous after three months of treatment when their nail doesn’t look normal yet. If the part of the nail that is closest to your body looks normal, then the treatment worked and the nail will start appearing more normal over the next several months.

Is Lamisil hard on my body? Lamisil, much like Tylenol and alcohol can cause damage to the liver. Luckily, the liver unlike most organs in our body can quickly and easily repair itself form minor damage. To ensure the medication is safe for the patient, blood work is done to check the patients liver function. If the patients liver enzymes do not come back normal, then the patient is never started on the medication. If the liver is healthy, as it is in most people, the patient is started on the oral medication and blood work is repeated again after six weeks of taking the medication. If there liver enzymes are still at normal levels, then no damage to the liver is taking place. If the enzymes levels are abnormal then the patient is taken off the medications. At this time, the damage is so minor that the liver easily repairs itself after the medication is discontinued. If the drug is managed correctly by your doctor, Lamisil can be safer than Tylenol on your liver!

NEW and SAFE TREATMENTS

If you suffer from these ugly looking nails, then our new combination of Keryflex/Laser treatment can be effective. Keryflex is a resin that has an anti-fungal in it. Our laser is the K-laser. This is a cost effective, safe and painless procedure. We perform the laser treatment for seven minutes per foot and then apply the Keryflex resin. We use one or two laser treatments and apply the resin once a month for five months. Your nails will look better immediately.
Lamisil works about 80 percent of the time which is the same efficacy as the Keryflex/Laser. Due to the lack of any side effects, I prefer to recommend the application of the resin and use of the laser over the Lamisil.

So, it is time to show your feet at the beaches and no more wearing socks to bed. Besides, your feet will love you for it.