Fungal nail infections

[RandolphGB]

I've had fungal nail infections for a couple of years - the three middle toe nails on each foot. 

 

The NHS in the UK gave a six-month course of antibiotics which, I admit, I didn't stick to. A second visit to a doctor, and he told how he had the same thing himself and it cleared up ''while backpacking in Australia where he was wearing flip-flops''.

 

The Podology Center Bangkok - Chiang Mai has quoted me 2000 - 3-500 as the start price for the first appointment and although they have good reviews, I'm guessing this bill will run to the tens of thousands with additional treatments, medicines, follow-ups etc etc. 

 

Does anybody have experience of being treated for this in Thailand? Either at the above mentioned clinic or else where and how much it should cost? 

 

Thanks

 

 

[Sheryl]

The problem with  fungal nail infections is that the absorption of topical antifungal meds is very poor through the nails so it is often necessary to use a machine to thin the nail first. And, the medications are imported and  expensive .

 

I had treatment at a foot clinic in Bangkok some years back, where they sort of ground down the nail using a machine (painless) then applied the antifungal, the idea being to thin the nail layer so that the topical antifungal is better absorbed.  Each treatment cost about 2000 baht and that was years ago so would be more now, i.e. similiar to what you have been quoted. It did work but took a number of treatments...I don't remember exactly but at least 5, and if I recall the medication cost was additional to that (applied the medication between sessions as well).

 

No matter what you do it is a slow process and it will take months for enough healthy nail to grow in to replace the diseased nail.

 

Systemic antifungal medications are an alternative but have to be taken for 6 weeks at least and can  have significant side effects.

 

Some things you can do on your own that will greatly help:

 

1- wear only open toed sandals, no closed shoes and definitely no socks. Fungus thrives in dark damp environments. Sun exposure is also helpful.

 

2 - soak the toe in vinegar after each bath and if you can, apply vinegar during the day - funguses do not grow well in acidic environments. Contrary to what some faddish web sites will claim there is no need or advantage in using apple cider vinegar for this purpose, ordinary 20 baht a bottle white vinegar from the market or grocery store works fine.

 

In addition to the above you can buy topical antifungal solution over the counter and apply it and see how it goes: brand name Loprox.  You will need to apply regularly twice a day (after washing and the vinegar soak) and for many weeks.

 

You could start off with these measures on your own but if no improvement then clinic treatment where they first thin the nail for you to allow more absorption of the medication may be necessary, and it will be costly.

[RandolphGB]

Thanks for the reply, Sheryl. Looks like I'll be wearing flip-flops from now on. I've booked an appointment for Thursday with a foot doctor. Better to get it fixed once and for all!

[faraday]

Had this many years ago, wouldn't clear up & my Chiropodist at the time recommend Terbinifine.

Took about 6 months to fix & didn't return.

[tonray]

Nail removal and killing of the nail bed so it does not grow back is another option

[jerry921]

On 2/4/2018 at 7:29 AM, faraday said:

Had this many years ago, wouldn't clear up & my Chiropodist at the time recommend Terbinifine.

Took about 6 months to fix & didn't return.

Yes, I tore my little toenail partway off and instead of seeing a doctor I just taped it up. Ended up with toenail fungus under the nail. Tried a few over the counter and home remedies, eventually went to see a dermatologist. Dermatologist said the only thing effective is to take a pill. There are apparently two different medicines, I also was on Terbinafine.  It upset my stomach, so I had to take it with food - that was the only side effect I suffered. And I had to take it for months. You have to keep taking it until the toenail(s) completely grow out. It will be obvious after one month whether it's working since you'll see a new normal-colored part (pink if you're caucasian) at the base of the toenail. You have to stay on it until that part grows all the way out - completely new toenail growth from base to tip. No shortcuts. But once it's completely gone, it's gone.

 

If one of the two medicines doesn't work, I guess you try the other. Terbinafine comes in various brand names, I don't remember what the other medicine is called,

 

I wasn't getting my treatment in Thailand, but in Mexico. Cost me around US$35 for each of two visits to the Dermatologist (English speaking!). First one to prescribe it, the second visit to verify it was working, and tell me to keep going. The medicine wasn't overly expensive, something like US$1 per pill, one a day. Don't know what it would cost in Thailand, but I would think about the same. Anyway, if it ends up costing you US$200 for medicine altogether, at least you get 3 toenails fixed for the price of one.

 

But if you can't stay on an antibiotic for two weeks, I don't know as I would take odds you'll take this every day for six months. But maybe now you're motivated.

 

https://en.wikipedia.org/wiki/Terbinafine

[myprivate]

My wife had this problem on her fingernails for months, they looked terrible, probably picked it up getting her nails done at one of the salons here. She went to various dermatologists at the big hospitals in BKK but nothing helped. Then one day we were in Villa Supermarket on Sukhumvit (near 33) and she happened to show her hands to the women at the counter in the pharmacy (small pharmacy inside Villa). She gave some pills, I remember they were specifically for fungus as I looked them up on the net. They were amazing and it cleared up quickly. Sorry I can't remember the name of the fungus pills, but I think the same lady still works there so you could show her your nails (or a photo). Worth a try.

[mommysboy]

On 15/02/2018 at 2:36 PM, myprivate said:

My wife had this problem on her fingernails for months, they looked terrible, probably picked it up getting her nails done at one of the salons here. She went to various dermatologists at the big hospitals in BKK but nothing helped. Then one day we were in Villa Supermarket on Sukhumvit (near 33) and she happened to show her hands to the women at the counter in the pharmacy (small pharmacy inside Villa). She gave some pills, I remember they were specifically for fungus as I looked them up on the net. They were amazing and it cleared up quickly. Sorry I can't remember the name of the fungus pills, but I think the same lady still works there so you could show her your nails (or a photo). Worth a try.

 

Yup... the only sure way to shift a deep fungal infection is with pills, but really this should be under medical supervision as there can be side effects. 

[danasutton]

• I have been in Thailand for two years and I have dealt with bad fingernails. My left hand had all my nails infected. I used many types of drops I bought from the Pharmacies here. I now have LOROX. It does not seem to do much. I did was soak my nails in vinegar and they finally healed. The edges would turn black under the nails and the edges would die. They would turn red around and in the nails and hurt. Pus would come out. After that my nails would gradually get better. My right hand is now infected. I have been using  the red liquid Bentadine and that seems to help. I have also been rubbing Snake Brand Prickly Heat powder on and under my nails and putting a glove on and that seems to help. I also put Bethasone N cream on my nails and I put gauze over them with medical tape or a band aid to saturate the nail and that is working the best at healing my nails. I have taken anti biotics here for a sliver that I had removed from my toe but they made me feel bad so I stopped taking them. I think also a good diet of mostly fruit and no or low meat and dairy intake will help. Exercise and sun is also good. No drinking or smoking. I hope this helps.

[faraday]

Have you actually seen a Dr; it all sounds rather worrying?

[KittenKong]

On 2/4/2018 at 2:12 PM, RandolphGB said:

The NHS in the UK gave a six-month course of antibiotics which, I admit, I didn't stick to.

The NHS really prescribed antibiotics for a fungal infection? Are you sure?

 

Much more likely that they prescribed some antifungal treatment and, had you done the full course, it would probably have worked.

 

As for stopping antibiotics before the end of the course, that merely serves to make the target globally more resistant to the treatment and is extremely stupid.

[evadgib]

Apple cider vinegar footbath or on a cotton bud worked for me.

HTH

[jumbo]

Buddy of mine had the same problem. Put vicks vaporub on his effected toenails morning and evening. Took a while but after 5 or 6 months the fungus was gone and not a problem since I understand

[soleddy]

Loceryl liquid is like a nail varnish which is transparent but contains an anti-fungal. It comes like a kit, in a box with emery sticks, swabs and applicators. It is expensive (French import) although has a good reputation. You only need to put it on weekly.

 

Every pharmacy I know, has never heard of it, but I get it from my dermatologist or from Dr Cherdpong the foot specialist.

 

Loprox I find to be useless. It also turns the nail yellow. I have heard about vinegar, although the derm doctor says it is no good as a cure.

[john1588]

Before doctor’s consulting and admitted to the hospital, you can take prevention so that fungal nail infections don’t grow further.

It is better to apply herbal treatment for your fungal nail infections as it has no side effect and easy to apply it.

Vinegar Nail Soak

You need to take white or cider vinegar for treating fungal nail infections.

Then pour 1 cup of vinegar in a basin filled with good quantity of warm water.

And now soak down your affected nail in this mixture for 15-20 minutes and continue this method for few months.

[dick dasterdly]

I started losing all my finger and toenails a few years ago...

 

Tests by the dermatology clinic at Phuket International hospital revealed only a mild fungal infection, so the doctor was nonplussed at why the problem was so acute and had affected ALL nails.

 

I went back many times and was prescribed different medications each time, but nothing worked and so after several months I eventually gave up and hoped it would eventually sort itself out.  It didn't, and so I resigned myself to embarrassing nails.

 

A few months ago I started applying Ellgy cracked heel cream (can't remember why), and was very suprised when the nails and beds started to recover - and after a while I had virtually a full set of nails again!  Unfortunately, I then stopped using the cream/lotion - and they've all disintegrated again.....  It could of course just be coincedence that they recovered whilst I was using this product and the problem reasserted itself when I stopped, but time will tell as I've started applying it again.

[mommysboy]

On 2/4/2018 at 3:19 PM, Sheryl said:

The problem with  fungal nail infections is that the absorption of topical antifungal meds is very poor through the nails so it is often necessary to use a machine to thin the nail first. And, the medications are imported and  expensive .

 

I had treatment at a foot clinic in Bangkok some years back, where they sort of ground down the nail using a machine (painless) then applied the antifungal, the idea being to thin the nail layer so that the topical antifungal is better absorbed.  Each treatment cost about 2000 baht and that was years ago so would be more now, i.e. similiar to what you have been quoted. It did work but took a number of treatments...I don't remember exactly but at least 5, and if I recall the medication cost was additional to that (applied the medication between sessions as well).

 

No matter what you do it is a slow process and it will take months for enough healthy nail to grow in to replace the diseased nail.

 

Systemic antifungal medications are an alternative but have to be taken for 6 weeks at least and can  have significant side effects.

 

Some things you can do on your own that will greatly help:

 

1- wear only open toed sandals, no closed shoes and definitely no socks. Fungus thrives in dark damp environments. Sun exposure is also helpful.

 

2 - soak the toe in vinegar after each bath and if you can, apply vinegar during the day - funguses do not grow well in acidic environments. Contrary to what some faddish web sites will claim there is no need or advantage in using apple cider vinegar for this purpose, ordinary 20 baht a bottle white vinegar from the market or grocery store works fine.

 

In addition to the above you can buy topical antifungal solution over the counter and apply it and see how it goes: brand name Loprox.  You will need to apply regularly twice a day (after washing and the vinegar soak) and for many weeks.

 

You could start off with these measures on your own but if no improvement then clinic treatment where they first thin the nail for you to allow more absorption of the medication may be necessary, and it will be costly.

I doubt there will be an improvement unless OP goes for real treatment.  Those topical treatments are useless.

[dick dasterdly]

2 hours ago, mommysboy said:

I doubt there will be an improvement unless OP goes for real treatment.  Those topical treatments are useless.

In my case, sadly going for "real" treatment was also useless, whilst costing me many thousand bht!

 

Having said this, I do agree that expert treatment should be sought for a few months - as I'm sure it is likely to result in a cure for most cases.