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Fungal toe nail

 
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  • Answered by:NJPharmacist
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Customer Question

I have had problem with my toe nail for over 10 years. Let me tell you what happened with that nail. When I was 8 years old, my cabinet's mirror dropped on it. It damaged my nail. After the wood was cured, my nail hasn't recovered. The nail is very ugly. The nail has malformation. I went to consult doctors. They said I had fungal nail. I was prescribed to use Amycor to remove the nail. Now i am using Clotrimazole 1% lotion.  However, nothing is better. Do you think Ciclopirox can help me ? It is possible if I send you a photo of my nail?

 

Optional Information:
Person's Gender: Female
Person's Age: 26

Submitted: 281 days and 10 hours ago.
Category: Pharmacy
Value: $15
Status: CLOSED
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Expert:  NJPharmacist replied 281 days and 8 hours ago.


NJPharmacist :

Hey how are you? Sorry no one has answered your question yet! I was busy myself with work and such.

NJPharmacist :

Here is the problem with Fungal infections of the foot- They are very difficult to treat especially if you have risk factors, such as diabetes, poor circulation, or even if you are on your feet all day, sweating, with heavy socks on.

NJPharmacist :

The problem with topical antibiotics- They aren't really effective. Let's take this step by step..

NJPharmacist :

First thing you should be doing is keeping any type of risk factors under control. Try to wear socks/shoes with good ventilation.

NJPharmacist :

If you have diabetes, or other medical conditions, you need to get those under control as well. This would include diabetes, HIV, anything that really disrupts your natural immune system and circulation.

NJPharmacist :

The next step, is to most likely try oral medications.

NJPharmacist :

Ciclopirox isn't too effective to be honest, and it really is for very mild fungal infections of the foot.

NJPharmacist :

The topical creams you are using help, but they cannot be primary treatment.

NJPharmacist :

The topical treatments really well help the oral medications. You may use both.

NJPharmacist :

Some doctors may tell you to use a Urea based lotion to help speed up absorption of the creams as well. This may be useful information for you.

NJPharmacist :

Surgery is usually last line if it is painful as well.

NJPharmacist :

Let me link you to a nice article from the mayo-clinic regarding lifestyle modifications as well-

NJPharmacist :

http://www.mayoclinic.com/health/nail-fungus/DS00084/DSECTION=prevention

NJPharmacist :

Very good accurate information there.

NJPharmacist :

Oral medications do have a decent amount of toxicity associated with them, and also have many interactions, so always check with a pharmacist before taking any type of medication.

NJPharmacist :

It takes quite a long time to treat a toenail infection as well- Up to 12 weeks in some cases, and the fungus isn't completely gone until a new , healthy nail has grown back in it's place. You need to have a new nail grow back completely.

NJPharmacist :

In short, to answer your question, I don't think Ciclopirox will be too effective.

NJPharmacist :

If the nail was removed, be sure to look at those "lifestyle changes" I have sent you via that link, and oral medications may be indicated in this case

NJPharmacist :

If you have any questions please reply. Anything else you need at all, let me know. I strive for your "great service " rating, so in order for me to achieve this, let me know how I can make sure you are 100% satisified. I hope you have a good day.

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Expert:  NJPharmacist replied 281 days and 8 hours ago.

Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.

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Expert:  NJPharmacist replied 281 days and 8 hours ago.

Just in case you are having trouble viewing the above chat answer, here it is

 

 

Hey how are you? Sorry no one has answered your question yet! I was busy myself with work and such.

6:28 AM

Here is the problem with Fungal infections of the foot- They are very difficult to treat especially if you have risk factors, such as diabetes, poor circulation, or even if you are on your feet all day, sweating, with heavy socks on.

6:29 AM

The problem with topical antibiotics- They aren't really effective. Let's take this step by step..

6:29 AM

First thing you should be doing is keeping any type of risk factors under control. Try to wear socks/shoes with good ventilation.

6:30 AM

If you have diabetes, or other medical conditions, you need to get those under control as well. This would include diabetes, HIV, anything that really disrupts your natural immune system and circulation.

6:31 AM

The next step, is to most likely try oral medications.

6:31 AM

Ciclopirox isn't too effective to be honest, and it really is for very mild fungal infections of the foot.

6:32 AM

The topical creams you are using help, but they cannot be primary treatment.

6:32 AM

The topical treatments really well help the oral medications. You may use both.

6:32 AM

Some doctors may tell you to use a Urea based lotion to help speed up absorption of the creams as well. This may be useful information for you.

6:33 AM

Surgery is usually last line if it is painful as well.

6:34 AM

Let me link you to a nice article from the mayo-clinic regarding lifestyle modifications as well-

6:34 AM

http://www.mayoclinic.com/health/nail-fungus/DS00084/DSECTION=prevention

6:34 AM

Very good accurate information there.

6:35 AM

Oral medications do have a decent amount of toxicity associated with them, and also have many interactions, so always check with a pharmacist before taking any type of medication.

6:36 AM

It takes quite a long time to treat a toenail infection as well- Up to 12 weeks in some cases, and the fungus isn't completely gone until a new , healthy nail has grown back in it's place. You need to have a new nail grow back completely.

6:36 AM

In short, to answer your question, I don't think Ciclopirox will be too effective.

6:36 AM

If the nail was removed, be sure to look at those "lifestyle changes" I have sent you via that link, and oral medications may be indicated in this case

6:37 AM

If you have any questions please reply. Anything else you need at all, let me know. I strive for your "great service " rating, so in order for me to achieve this, let me know how I can make sure you are 100% satisified. I hope you have a good day.

Expert TypePharmacist
Category: Pharmacy
Pos. Feedback: 98.3 %
Accepts: 113
Answered: 7/4/2012

Experience: Hospital Pharmacist, with solid clinical knowledge.

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Expert:  NJPharmacist replied 281 days and 6 hours ago.

If you aren't 100%satisfied, you can certainly see if another expert wants to add anything else. You really need oral therapy. I have also laid out all the guidelines for fungal infection regarding the toe. What else would you like to know?

Customer replied 279 days and 6 hours ago.

Do you think it is infected by fungal ?


Do I need to take oral therapy for a long time? It affects liver very much. For the local treatment, what should I take?

Picture
Expert:  NJPharmacist replied 279 days ago.

Yes, oral therapy does tend to affect the liver very much, however, compared to local/topical treatment, it is better.. Topical treatment isn't so effective, it really is used best when combined with oral therapy..

It sure does look like it could be. The picture isn't 100% clear on my end, but I do see that a good portion of your nail is missing.. And you claimed you had removed the nail, correct ?

Picture
Expert:  NJPharmacist replied 278 days and 15 hours ago.

Let me see if DocPhilMD could take a look into this for ya, and also see the picture and see what his opinion is on the matter. I'm going to link this over to him.

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Expert:  NJPharmacist replied 277 days and 23 hours ago.

I spoke with another doctor on the website. He mentioned that it isn't fungal just due to the fact that dropping something heavy on it at a young age, can damage the growth plate of the nail. However, I think there was some confusion because I had to take your doctor's word for it- he said it was a fungal nail, and he certainly has more experience than I do in diagnosing and he can even see the nail up close..

As you can see there are conflicting opinions, but I really try DocPhilMD. I would stop the medications and topical therapy until you get a second opinion. I do think, though, DocPhilMD is right with his opinion.

Reply back with any more comments or questions.

 
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