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Posted (edited)

Hi all,

I've got ingrown fungal toenails which hurt badly when I walk. I'd like a doctor (podiatrist?) in BKK who'd pull the toenails completely off so I could begin an antifungal treatment on the nail bed, as in this youtube video:

 

 

 

If you know of any better/easier treatments, please let me know.

P.S. At Bumrungrad they advised to bad-for-the-liver treatment (Lamasil?) and at Bangcock Hospital the grinding of your nails every two weeks for a year and you apply an expensive liquid each day for the year.

Edited by dblaisde
Posted

Regarding fungal infection:

 

The toxic effects of Lamisil you refer to are limited to its oral use, not topical application. Topical lamisil would be the "expensive liquid" Bkk Hospital referred to. Grinding the nails helps ensure absorption.

 

Complete removal of the nail = a year at least to fully grow back during which time the nail bed will be extremely sensitive so it is not in fact a short cut insofar as treating fungal infections goes.

 

However I am confused by your statement that it is ingrown since the treatments recommended by the 2 hospitals do not reflect that fact but rather are the standard treatment fior fungal infection only.  Are you sure they are ingrown and were they so when you went to these 2 places? As for ingrown nail, at least partial removal of the nail is pretty standard.

 

Podiatrists are few and far between in Thailand, probably the scarcest specialty of all. You could try this place

 

http://www.mft-thailand.com/index.html

 

 

Posted

Nail dystrophy might look just like fungal infection, a common mistake. Has your infection been confirmed with positive culture or microscopy? Because the only way to get rid of big toe nail fungus infection is Terbinafin(Lamisil) tablets for 3 months so better be sure.

 

If you have ingrowing nails it should be treated surgically with partial avulsion and matrix phenolisation. The border of the nails are cut of and the phenole treatment makes sure the lateral part never grows out again. But no way extract the nail completely, if someone suggest that, id be suspicious.

  • Like 1
Posted

I got it on one toe but it's not so bad, just a little yellow, and it seems to be disappearing. I just keep clipping it down.  It's easy to get in Thailand if you walk in the ricefields or any other muddy dirty area. A whole lot of farmers have basically lost their toenails to this. One farmer friend had it bad and it was very painfully ingrown I guess so he went to the local hospital upcountry and they were going to give him some sort of injection then cut half the nail off. As a farmer, it's almost impossible to ever have normal toenails since your life is about walking in that paddy field mud.

 

There seem to be various sites online offering home remedies. Youtube has some too.

 

 

Posted

"colloidal silver" may possibly help to kill the fungus, not only from outside but mostly from inside your body, though its not a medicine in its sense. i personally had some issues with viruses and fungus too, its all gone after a week .

 

  • Like 1
Posted
17 minutes ago, Alive said:

I got it on one toe but it's not so bad, just a little yellow, and it seems to be disappearing. I just keep clipping it down.  It's easy to get in Thailand if you walk in the ricefields or any other muddy dirty area. A whole lot of farmers have basically lost their toenails to this. One farmer friend had it bad and it was very painfully ingrown I guess so he went to the local hospital upcountry and they were going to give him some sort of injection then cut half the nail off. As a farmer, it's almost impossible to ever have normal toenails since your life is about walking in that paddy field mud.

 

There seem to be various sites online offering home remedies. Youtube has some too.

 

 

The injection you mention is probably local anestetic (Xylocain)which is injected in the base of the toe prior to surgery. As much as half of the nail do not need to be cut of, the outer most 3-5 mm is  usually enough.  If the nail matrix (the cells that produces the nail tissue) is not extracted surgically or "killed" with phenole, the outermost part of the nail will eventually grow out again, and the problem will reoccur.

 

I think most ortopedic surgeons knows this procedures very will, as its a common problem.

  • Like 1
Posted
4 hours ago, chopin2 said:

Nail dystrophy might look just like fungal infection, a common mistake. Has your infection been confirmed with positive culture or microscopy? Because the only way to get rid of big toe nail fungus infection is Terbinafin(Lamisil) tablets for 3 months so better be sure.

 

If you have ingrowing nails it should be treated surgically with partial avulsion and matrix phenolisation. The border of the nails are cut of and the phenole treatment makes sure the lateral part never grows out again. But no way extract the nail completely, if someone suggest that, id be suspicious.

 

That is what the doctor at the local hospital told me and 20 minutes and several pain killing injections later, there it was, gone.

 

It has grown back again but I go to the local village clinic every 2 or 3 months and they trim it for me for free. It only hurts now if I leave it too long between trimmings.

 

It started back in the UK in 1995 when the doctor there took a slice of it and told me that it would never grow again. He lied.

Posted
 

I think most ortopedic surgeons knows this procedures very will, as its a common problem.



LOL. . I REALLY DOUBT an orthopedic surgeon would give a rats ass about ingrown toenails. Orthopedic surgeons deal with bones ... not feet.

You mean a podiatrist. And, they are not surgeons.


I'm a blowfish!

Posted

Orthopedic surgeons deal with conditions involving the musculoskeletal system, including the feet.

 

Ingrowing nail is managed by a wide variety of healthcare professionals including general practitioners, podiatrists, dermatologists, general surgeons, AND orthopedic surgeons.

 

Your choice.

 

 

 

  • Like 1
Posted
On 8/5/2016 at 10:04 PM, Sheryl said:

Regarding fungal infection:

 

The toxic effects of Lamisil you refer to are limited to its oral use, not topical application. Topical lamisil would be the "expensive liquid" Bkk Hospital referred to. Grinding the nails helps ensure absorption.

 

Complete removal of the nail = a year at least to fully grow back during which time the nail bed will be extremely sensitive so it is not in fact a short cut insofar as treating fungal infections goes.

 

However I am confused by your statement that it is ingrown since the treatments recommended by the 2 hospitals do not reflect that fact but rather are the standard treatment fior fungal infection only.  Are you sure they are ingrown and were they so when you went to these 2 places? As for ingrown nail, at least partial removal of the nail is pretty standard.

 

Podiatrists are few and far between in Thailand, probably the scarcest specialty of all. You could try this place

 

http://www.mft-thailand.com/index.html

 

 

I got one treatment there at Bangkok hospital, no doubt with the doc people are talking about here. A woman went at my yellow gray puffed up toenails with a drill with a special conical cutting tip. After that I was given a kit of Loceryl, a toenail paint to be applied daily for a year. All totaled it was about 4500B including the Loceryl (about 2000B). I was told to come in every week for the drilling (debridement, I guess it's called). The process takes about a year. I asked the doc if the Loceryl had to be applied after the year finished. He shrugged and laughed but didn't answer the question. I thought leaving the place: this is a good money maker: every two weeks hand over 2000/2500 (can't remember exactly) for a year. I've also heard that the process has only a moderate success rate (maybe 40-50%, success defined as "never returned").

 

Yes, I do have ingrown toenails too. I forget if I complained specifically about that (though I probably did). I my case the fungus seems to force the nails to "ingrow" because the nail becomes so inflated. I'm forced (osteoporosis) to wear shoes here so the fabric of the shoe sometimes bears down on the nail, pushing the nail into the bed.

 

I've never heard of Lamasil being applied topically. Is it effective?

 

The doctor in the youtube clip I attached said to the patient that he'd give him a topical ointment to put on for 2 or 3 months. I named it, but the sound quality wasn't so good so I missed it.

 

It seems logical that direct exposure of the full nail bed would make the antifungal more efficent, and decrease the time needed to kill the fungus. (But what do I know??)

 

Thanks for the help. :)

Posted
20 hours ago, billd766 said:

 

That is what the doctor at the local hospital told me and 20 minutes and several pain killing injections later, there it was, gone.

 

It has grown back again but I go to the local village clinic every 2 or 3 months and they trim it for me for free. It only hurts now if I leave it too long between trimmings.

 

It started back in the UK in 1995 when the doctor there took a slice of it and told me that it would never grow again. He lied.

 

On 8/6/2016 at 8:59 AM, chopin2 said:

Nail dystrophy might look just like fungal infection, a common mistake. Has your infection been confirmed with positive culture or microscopy? Because the only way to get rid of big toe nail fungus infection is Terbinafin(Lamisil) tablets for 3 months so better be sure.

 

If you have ingrowing nails it should be treated surgically with partial avulsion and matrix phenolisation. The border of the nails are cut of and the phenole treatment makes sure the lateral part never grows out again. But no way extract the nail completely, if someone suggest that, id be suspicious.

Thanks. It took me a few google searches to find out what you were talking about. I downloaded some videos and will read them soon. Thanks.

Posted

Right now the idea of removing both toenails and poisoning the bed so they never grow back is appealing, though there might be "side effects". I'm not sure if the nail has any function beyond protecting the toe. I have shoes for that.

Posted
37 minutes ago, dblaisde said:

Right now the idea of removing both toenails and poisoning the bed so they never grow back is appealing, though there might be "side effects". I'm not sure if the nail has any function beyond protecting the toe. I have shoes for that.

 

I had one of my toe nails removed when I was 14. Never grew back and has never been a problem.

  • Like 1
Posted
18 hours ago, cocteau2x said:

 


LOL. . I REALLY DOUBT an orthopedic surgeon would give a rats ass about ingrown toenails. Orthopedic surgeons deal with bones ... not feet.

You mean a podiatrist. And, they are not surgeons.


I'm a blowfish!
 

 

 

Is your real name Hootie?

  • 6 months later...
Posted (edited)
On 8/6/2016 at 1:25 PM, billd766 said:

 

That is what the doctor at the local hospital told me and 20 minutes and several pain killing injections later, there it was, gone.

 

It has grown back again but I go to the local village clinic every 2 or 3 months and they trim it for me for free. It only hurts now if I leave it too long between trimmings.

 

It started back in the UK in 1995 when the doctor there took a slice of it and told me that it would never grow again. He lied.

 
 
 

After dealing with this for over a decade in SE Asia, i.e. having the nails butchered by various "nail salon girls" every couple of months and more times than not having them infected, I'd finally had enough. I had it surgically taken care of at a podiatry clinic in Australia on one of my trips back. That was removal (avulsion) of the ingrowing section of toenail and application of a caustic chemical to destroy the nail matrix (matricectomy).

 

It's not a perfect science. I had to have 2 sides touched up before I was finally done with it. My clinic covers any follow-up surgery free of charge if any part of your nail grows back.

 

It was money well spent and I wish I'd had it down many years earlier. The funny thing is that it was my wife who pushed me to do it because she disliked the nail salon woman that used to cut my nails LOL.

 

Here's some detailed information about the surgery and even some photos of it being performed:

 

http://www.racgp.org.au/your-practice/guidelines/handi/interventions/other/partial-nail-avulsion-and-matricectomy-for-ingrown-toenails/

Edited by tropo
Posted
2 hours ago, lorein0688 said:

Ingrown toenails could be extremely throbbing and inconvenient. This is very painful and also easily gets infected with the fungus, this is very frustrating. So, it is important to treat the ingrown toenail that has befallen contaminated, with some appropriate method of treating. This will aid avoiding circumstance from deterioration. Having correct steps, you can cure toe and recover your foots health. Follow few tips like:

 

  • Soak your toe into soapy, warm water thrice every day.

     

  • Prop up edge of nail

     

  • Wear open-toed shoes

     

  • Apply antibacterial gel.

     

 

Good luck with that... none of that will help anyone with "real" ingrown toenails. They grow sideways right near the base of the nail literally growing into the skin sideways. You have to dig in deep with cutters to cut out the sideways-growing portion of the nail and keep cutting it every month or so as it grows back again. If you have a very experienced nail technician or docter, they can do this, but you'll have to do it for life unless you get the surgery I detailed in my post above.

  • Like 2
  • 2 weeks later...
Posted
Orthopedic surgeons deal with conditions involving the musculoskeletal system, including the feet.
 
Ingrowing nail is managed by a wide variety of healthcare professionals including general practitioners, podiatrists, dermatologists, general surgeons, AND orthopedic surgeons.
 
Your choice.
 
 
 

Lol ... an orthopaedic surgeon .. dude. They wouldn't waste their time. I work with many of them in surgery .. we all had a good laugh at that one.

University of Iowa Hospitals and Clinics

Sent from my SM-G930F using Tapatalk

Posted
50 minutes ago, namasata said:


Lol ... an orthopaedic surgeon .. dude. They wouldn't waste their time. I work with many of them in surgery .. we all had a good laugh at that one.

University of Iowa Hospitals and Clinics

Sent from my SM-G930F using Tapatalk
 

Here you go, some useful reading from British Medical Journal:

"The condition is managed by a wide variety of healthcare professionals including general practitioners, podiatrists, dermatologists, general surgeons, and orthopaedic surgeons."

 

http://www.bmj.com/content/344/bmj.e2089

 

 

Posted

Lol .. well IN REAL LIFE .. we are laughing at you.
I suppose orthopaedic surgeons deal with teeth in the UK too? .. Lol..

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Posted
11 minutes ago, namasata said:

Lol .. well IN REAL LIFE .. we are laughing at you.
I suppose orthopaedic surgeons deal with teeth in the UK too? .. Lol..

Sent from my SM-G930F using Tapatalk
 

So you suggest that we all should trust your anecdotal information rather than relying on facts from proper sources like BMJ?

 

Have a good one

Posted

Gp type care is very weak in the Thai private medical sector and many things one would expect not to be done by specialist in the west, is specialist practice here.

Government hospitals are a bit different, and GPs/ ER docs in govt hospitals handle a much wider range.

Cost considerations drive this in both cases. Public facilities are under strong pressure to contain costs. Private facilities are under no such and indeed, have a pretty free hand to seek to maximize costs and hence profits.


Posted
47 minutes ago, Sheryl said:

Gp type care is very weak in the Thai private medical sector and many things one would expect not to be done by specialist in the west, is specialist practice here.

Government hospitals are a bit different, and GPs/ ER docs in govt hospitals handle a much wider range.

Cost considerations drive this in both cases. Public facilities are under strong pressure to contain costs. Private facilities are under no such and indeed, have a pretty free hand to seek to maximize costs and hence profits.

 

Yes, why would any specialist turn down an easy job, you pay them! Some have a romantic and naive belief that specialists only seek to take on the heavy and complicated cases, but it's not how it works in real life.  I believe minimal effort with maximum profit is more attractive.

 

 

 

 

 

  • 2 weeks later...
Posted

Lol . ... an orthopedic surgeon is a SURGEON you dope. If you want an ortho surgeon to rip off your toenail be my guest. Lol .. I guess I just Wouldn't let an ortho surgeon that is so down on his luck that he is relegated to toenails work on any part off my body.
.lol .
Lol ... hahaha ... maybe in England and Thailand I guess.
But, in the USA an orthosurgeon would laugh you out of the clinic and point you to a podiatrist.

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Posted
4 hours ago, namasata said:


But, in the USA an orthosurgeon would laugh you out of the clinic and point you to a podiatrist.
 

But, in the USA there *are* podiatrists.  No such folks in Thailand.

Posted (edited)

I've had 3 laser treatments in the USA by a podiatrist. It's pretty reasonable I think $250 per treatment and he has a motor driven grinder he used on me once. I prob have 2 more treatments in me and then maybe 1 per year to keep it gone. No way I would let a doc rip off my toenails. Just get a Rx for one of the new drugs like Jublia until you find somebody w a laser and have a podiatrist grind your nails down which you could easily do yourself w a Dremel.  

 

 

Edited by Mark Roberts
Inserted video
Posted (edited)

Finally some one I can actually help. Before retiring I was involved on developing Medical Lasers.  You need to locate a Dermatologist that has a "Q" Switched 532/1064Nm ND:YAG Laser. (The industry is exploring other wavelengths but 562/1064 Works.)  It gets rather technical so it is important you find a Doctor that has done this treatment. No many that I found.

 

Check the big malls that have Skin care Offices or check with one of the bigger hospitals. You may have to do some searching as I did.  I found my Doctor at the Bangkok Hospital in Korat. She has since gone into private practice. What I found 1 year ago, was most Doctors do not have experience in using a laser to cure nail fungus. So I had to literally teach my Doctor how to do it. It helped that she actually had the exact laser model I developed.  Each "Brand" of laser will be very similar in power output J, pulse time.  The Doctor should know how to set this. Always err to the side of safety if uncertain start at a lower power setting.  Should be around 15Joles, 9ms.  Time is dependent of the spot size.

 

If you find a Doctor who has done this procedure it should be completely painless. At most you will feel a slow warming which fades quickly at every pulse. It should never burn or sting. If that happens the power is too high.  1064Nm kills the Fungus instantly. The 532Nm makes the discoloration go away. Tgey do not do both at the same time. They should make a series of overlapping passes over the nail dependent of spot size and nail size.  It will also take "two" treatments minimum two weeks apart although theoretically it is done the first time. Three times for severe conditions.  It takes a long time for the nails to grow out. So results are not immediate but should be quiet noticeable in a week.

 

Cost for me was 5,000B at the Hospital to do all ten nails. I did all ten just as a precaution because Fungus grows slowly and spreads easily.  There is also no guaranty you won't get infected again.  I probably set my own price too. 

 

Here's a link to follow up on and give you some more background information.  Good luck in your search for a Doctor. You now know what to be asking for. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875102/

Edited by Mrjlh
  • 8 months later...
Posted

Ingrown nail or toenail fungus infection can be easily removed if you apply these below home remedies:

· Lemon: To use lemon for ingrown toenail, cut slices of lemons and soak them in warm water soak your feet daily for half an hour. The acidity of lemon cure the infection and the warm water relieves the pain also softens the toenail and near areas.

· Hydrogen Peroxide: You need to add a cup of hydrogen peroxide to a bowl of Luke warm water and soak your foot in for the peaceful home treatment of ingrown toenails. This ingrown toenail fungus home remedy will prevent further infection as well as reduces the irritation of the affected toenails.

· Tea Tree Oil: You can apply tea tree oil to the affected area directly many times a day for providing relief and curing the infection. For best result wrap the toe up with a bandage to retain the oil overnight.

These home remedies can be applied to treat ingrown toenail fungus easily at home. These are very effective to treat toenail fungus infection.

Posted
On 2/23/2017 at 9:09 AM, namasata said:

Lol .. well IN REAL LIFE .. we are laughing at you.
I suppose orthopaedic surgeons deal with teeth in the UK too? .. Lol..

Sent from my SM-G930F using Tapatalk
 

If you somehow get your choppers stuck in someone's hip joint.. Then yes! 

Posted
5 hours ago, carol123 said:

Ingrown nail or toenail fungus infection can be easily removed if you apply these below home remedies:

· Lemon: To use lemon for ingrown toenail, cut slices of lemons and soak them in warm water soak your feet daily for half an hour. The acidity of lemon cure the infection and the warm water relieves the pain also softens the toenail and near areas.

· Hydrogen Peroxide: You need to add a cup of hydrogen peroxide to a bowl of Luke warm water and soak your foot in for the peaceful home treatment of ingrown toenails. This ingrown toenail fungus home remedy will prevent further infection as well as reduces the irritation of the affected toenails.

· Tea Tree Oil: You can apply tea tree oil to the affected area directly many times a day for providing relief and curing the infection. For best result wrap the toe up with a bandage to retain the oil overnight.

These home remedies can be applied to treat ingrown toenail fungus easily at home. These are very effective to treat toenail fungus infection.

Major Fail.. They don't work.  Only work to sell more herbal remedies to gullible people 

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