Toe nail infection and nail removal (onychomycosis)

r m wrote: For a while on one foot 2 smallest nails were infected...Then a third. So I went down the path of topical treatment, then oral (terbinafine) but that made me sick, so I went down the mechanical debridement and laser treatment. That made things slightly better, but not a cure. Then it spread to my big toe...Went down the laser route again, this time it's done about nothing that I can tell. I gather if you get nails removed they just grow back infected. Has anyone had their nails removed and the nail matrix destroyed? I wish I'd had that done on the 2 smallest nails, before it spread to the others. Has anyone had their big toe nail permanently removed? How's that working out? Any problems with climbing shoes, or long distance walks? I figure no nail is probably better than the severely f***ed nail that's a pain to take care off, often hurts, and poses a risk to all my other nails by harboring an infection.

This is a procedure I perform regularly. If you have a fungal infection (not everything that looks like one is – get the culture to be sure it's onychomycosis, not onychogryphosis, they look similar but are very different) the topical treatments have a very limited success rate and the oral ones maybe 2/3 if you can tolerate them. Many can't.

Yes, some people swear by tea tree oil, VapoRub, etc., as they've "seen it work." Yeah, for one or two people. See a few hundred of them, and you get a better picture. That's where I sit. That said, VapoRub is cheap and easy. Even if it doesn't work very often, it's worth a shot. Costs nothing but three bucks and some time to try.

Complete removal of the nail is curative, but only if the germinal matrix (from which the nail grows) is ablated. The safest way to do that is 89% aqueous phenol. There's a particular technique to it, and the best description is in Pfenninger & Fowler's textbook. If your doc doesn't know it, suggest they check. You don't need any super-specialist, it's easy for any experienced family doc to do once they've read it. If they won't, best to find one who will. Digital block anesthesia is all you need, being put under is unnecessary and an unjustified risk, but insist they use bupivacaine or mepivacaine (longer duration than lidocaine).

Have had both big toe nails removed permanently and do not regret it at all. Climbing shoes caused  the nail problems and no problems with shoes after removal.

Been taking itraconazole lately, pretty expensive and quite a long course (>6 months), has made a big difference. Not totally clear though.

Might get whatever that is left infected permanently removed.

Lee Green wrote:

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Digital block anesthesia is all you need, being put under is unnecessary and an unjustified risk, but insist they use bupivacaine or mepivacaine (longer duration than lidocaine).

Interesting. I sometimes semi involuntarily jerk my foot about in response to pain applied to my toes and also can get a bit ticklish, does this go away with the nerve block? I've noticed sometimes anesthetic at the dentist doesn't help much, seemingly related to certain kinds of pain (burning gums back with a laser, or teeth removal), leads to twitching a little bit. But generally the dentist isn't holding anything super sharp so it's not a big deal.

I was told By Dr. that to get rid of Fungus using topical or pills you also needed to throw away ALL your footwear and not buy new footwear until fully cured... hah, I did the math on replacing all my La Sportivas and said screw that! 

After decades of TNF which was bad enough that I trimmed parts of my nails back to nearly the nail bed, I found two topical treatments that improved the situation: I used Fungi Cure for a couple/several years, and over time the good part of my nails grew out some from the nail bed. I've been using Pro Clear Z for about a year now, and even more of my nails are somewhat natural and the good parts are even farther from the nail bed. For me, these treatments have not been close to a cure, but they've improved the nails from "heavily infected/impaired and painful" to a "managed condition with minor discomfort". FYI, it seems that Pro Clear Z is only available on line, and be aware that prices vary by 3X.

Marc801 C wrote:

Exactly what home remedies have actually cured toenail fungus?

I pissed on my feet in the shower, and washed them good. Got rid of it.

Eddie Purcell wrote:

I pissed on my feet in the shower, and washed them good. Got rid of it.

I'm told this remedy also works on sea urchin spines...

• All right everybody listen up. I have defeated my foot fungus using a pretty new treatment method. I've had my fungus for at least 10 years and  got it when I was on a extended climbing trip at Indian Creek. It's not a nail fungus , it's a particular type of fungus that grows in between your toes , specifically your pinky toe. The product of bad hygiene and lots of crack climbing , without going into the details. Here is the regiment. You need a photosensitive reagent of some sort , I used methyl blue solution 1% , I found it on Amazon. You saturate the fungal area with this solution, you need it to soak in as much as possible , and then you zap it with an infrared light , also available on Amazon. I stumbled Upon A write-up of this treatment in a scientific journal , also if you search " infrared fungal treatment" on YouTube there is one video up. This treatment is available at certain podiatrist office , and will become more popular once people realize that it actually works on fungus which is notoriously hard to kill. I gave myself half a dozen treatments just to be on the safe side but possible you could have success in as little as three treatments . I don't have a nail fungus, so I can't speak to that personally, but it's possible you could use this method to get rid of a nail fungus, as long as you put a lot of effort into removing the affected nail and dead skin in  the vicinity, to get the reagent to all of the affected areas so that when you apply the light to it, it releases the radiation that breaks down the cell walls of the fungus nearby.