Toenails

Top: left foot treated with amorolfine nail lacquer.




Left big toe, Amorolfine nail lacquer. Note how still-infected thicker nail has grown out halfway.

Right foot, daily application of lamisil single-dose 1 % solution, same stuff that left my fingernails 99% cured in about 4 months.

Right toenail, lamisil. Thick nail has grown out halfway. The red dots are marks from going a bit hard with the grinding machine

Will file them down again (not excited about it, it is a boring and tiring process) and continue treatment. The treatment that is least successful I will discontinue and I will keep doing what works, be it amorolfine or terbinafine. On the foot that is not doing best I will try a new treatment, not sure what yet. We'll see.


EDIT: I checked out my first post from august 2009 with pictures from then. I had forgotten how bad it was, my toenails have actually come a looong way! Both feet, although still infected, have improved enormously. Fantastic. :D

Popular and heavily advertised fungus remedies

There are many "alternative treatments" around that you see advertised everywhere whenever you browse the web to read on the subject of onychomycosis, ringworm of the nail, or whatever one chooses to call one's nail fungus. Examples include funginix, zetaclear and nonyx nail gel. Let's look at a couple of these.

Nonyx nail gel is manufactured by the Xenna corporation and seems to sell quite well. Here are the ingredients according to their own website:

* Deionized Water,
* Ethanoic Acid,
* Xanthan Gum,
* Fragrance

Deionized sounds fancy, but the thing is it is basically just clean water. Water that has gone through filters to remove any minerals in it, it is about as clean as distilled water but cheaper to produce in large quantities.

In short: it’s just water.

Ethanoic acid also sound fancy. Thing is: it is just another name for acetic acid. And acetic acid happens to be:

Household vinegar. So they could have just written “vinegar”.

Xanthan gum sounds really interesting and I had to check it out. This happens to be a normal, common food additive that is used for raising the viscosity of a fluid, in simple words: It is used for making stuff thicker. Kinda like gelatine in jello.

So what we are supposed to pay for here is really: Water, vinegar, thickener, all of which you probably have in your kitchen. And some perfume for the scent… 30-40 dollars for this.

I would not call this a scam since vinegar actually does clear away keratin debris buildup and seems to be able to kill fungal spores in the nail. But it is ridiculously expensive for a water-vinegar mixture and it is obvious why they choose not to write "common vinegar" on the bottle.

Zetaclear:

Zetaclear is a huge presence in the googlesphere, but as any other of these "treatments" it is not proven to be efficient in any studies whatsoever, consumers have nothing to base their opinion upon except the company's own information, and that information is false.

And there is a problem: Zetaclear is being marketed extremely aggressively and in a dishonest way. Google "zetaclear" and you get dozens (!) of URLs such as www.zetaclearwarning.com and www.zetaclearreviewssite.com . All of these are scams and it is very obvious as the so-called "reviews" are extremely shameless in their praise of the product. you can also find tests that claim to be objective but they also are manufactured to make Zetaclear look good. The internet image of Zetaclear is carefully designed to make it seem like it gets everything from ecstatic tales of success from customers to sound and sensible positive feedback from serious sources. Look around, browse around, it is ridiculous, the energy and time the people behind zetaclear has put in to create all these websites.


AND it is a homeopathic remedy. As most people know by now, homeopathic treatments are water with no active substance in it, and it 100 % unsuccessful in treating anything apart from its placebo-effect. If you think it will cure your muscle tensions, you may relax, and praise the treatment. But it is still just water, and you are fooled. They are always diluted to the point that you would need to drink the atlantic ocean full of the liquid to get even one molecule of the claimed ingredients in your mouth.

It does actually contain something though, 10 % Undecylenic Acid, which is an older substance and not as effective as newer stuff like griseofulvin and terbinafine, but at least it is there, and can be effective. http://faculty.swosu.edu/scott.long/phcl/antifung.htm


Not much more to say about it, Zetaclear is the most obvious scam of them all. On http://lee.org/blog/2009/05/02/zetaclear/ there is a discussion between people who are frustrated by this shameless and elaborate scam, drop by and comment. The company behind zetaclear are making a profit off people's desperate wishes to get well.

Pics

These pics happen to be 3 weeks old but nothing has changed since. On the pointer finger there is some persistent fungus to one side but it does not seem to grow so I leave it for now. I keep treating all fingers every day, the treatment is simple and only takes seconds so it is not any more hassle than it is brushing one's teeth in the evening.



Although I would like to eradicate the last tiny parts of fungus also I am extremely pleased and relieved with now having normal nails. It became a spare-time obsession/hobby to find a procedure that worked for me and be able to have clear nails again, and now I have the same nails I had 5 years ago. Success!

Nail fungus sufferers get various degrees of infection and it shows itself in different ways. Sometimes it does, as in my case, get ugly and nails are not only discolored and thickened but very deformed and loosened from the nail bed. When they are like this and stay like this for years you may get the idea that the nail has "forgotten" how to grow normally and will forever grow abnormally. This is not the case. The nail grows in a genetically coded manner just like skin and hair, and fungus only disturbs its pattern, it does not destroy it. Remember this when you treat your nails because it helps your motivation: they can be completely normal again.

As far as treatments go: the query "nail fungus treatment" gives 623 000 hits on google as I type this. Hundreds of millions of people worldwide probably have onychomycosis, it is a condition that is not harmful (it really isn't) so it is not at the top of the medical community's agenda, but it is a cosmetical problem for very, very many people. AND the available drugs are not yet perfect, oral Lamisil only cures about 50 % of the clients, so the market for so called "alternative" remedies is enormous. Very lucrative.

Very lucrative indeed.

And where there is money there will always be crooks. I mentioned this in an earlier post:
I estimate at least 90 % of those to be either useless or flat-out cons. It is sooo easy to mix up some stuff and call it a "nail fungus remedy" and mix in some reassuring words like "all natural", "proven to work" (implying it has been scientifically tested and verified which it never has, and if it was, it was proven to be completely ineffective), "thousands of satisfied customers" (show me the evidence), "guaranteed to cure nail fungus" (if it IS guaranteed, then YOU, as manufacturer are guaranteed to make a huge fortune, so why do you mess about on an obscure website?), "contains essential oils" etc etc etc....

For example, oil of oregano is a popular ingredient in many such remedies, on the basis that it is an all-round cure for pretty much everything and have been used by everybody since forever. Still, there is not ONE scientific study that shows that it has any antifungal properties apart from that when you keep it concentrated in a test tube and you toss fungal spores in there, yeah, the spores die. On the skin or nails it has shown no efficacy at all in studies.


Know this: conventional medicine has the best chance to help you, because it has by far the best track record. Even if a conventional drug only gives you 50 %, the alternative drug will give you a much lower chance of success. Remember:

If the alternative remedy was tremendously effective, it would be an instant hit and it would be all over the world in months. If you have an astonishing product you will not NEED to advertise on obscure websites.




Moral of the story is: IF you choose to use alternative treatments, consider using them in conjunction with treatments that are actually proven to actually be effective.

Just dropping by

I have been lazy for some strange reason, I should be really active now that I have something to show off, but sometimes it happens that way.

I still pursue the treatment, Amorolfine nail laquer on left foot, lamisil on right foot, and lamisil on fingernails. Although my ambition is twice-a-day application it turns out to be once a day normally.
This is actually something you should keep in mind when analyzing your results from treatments: be honest to yourselves. If you did not use the remedy as recommended or as often as recommended, then you cannot comment on the efficacy of this remedy. You could, but it would be irrelevant. You can only give an educated opinion on the results of the drug after NOT being used in the recommended way. If you were told to apply NalioClean twice a day for 6 months and you only did it for 3 months, then you can say "it works!" if it unexpectedly did work after that short time, but you cannot say that "it didn't work", because you did not follow the guidelines.

I will not post any pictures tonight either, but within one week they should be online. Verbal description: Not 100 % clear, but extremely close. Two of my fingers have tiny lines that show fungus 1-2 mm behind the nail edge now. I cant bring myself to wear the nails down more, I will see what happens. If the fungus grows, I will get aggressive again, but for now it seems to occupy a small area and maybe it will go away with continuous treatment and no further nail debridement.

Gotta go now, back soon!

On with the show

Still going with the procedure, my ring finger is now 100 % and looks like it was never infected. When the infection is so bad that the nail is not attached to the nail bed it tends to become elevated and rise from the nail bed. I thought maybe it would stay mis-shaped even after being cured but it is really completely symmetrical. So bear that in mind, the naisl do remember how to grow normally!

On the other 3 fingers I noticed the fungus was getting hold once more at the tips, so I filed that away. It kinda sucks when you are so close to the end but there is no way but the hard way, take away the bad, or it will keep infecting the good. What is a few more weeks when you have had the problem for years? And although the lamisil gel (NOT the cream) is expensive it really last for a long time, 14 nails I have been able to treat for over a month with 1 tube which is about 25 USD.

My toenails I filed down completely once more as the treatment was not as successful there. I could not bring myself to take them away completely. It is damn hard work to file down all the way to the nail bed since you want to be careful not to hurt yourself, and it is a time-consuming procedure as it is. But they are thin, thin now, and I treat my right foot twice a day now with the Lamisil. On my loeft foot I use Amorolfine nail laquer, mostly because I still have half a bottle left and I should use it up since it cost a fortune. When it is all out I will evaluate which foot has had the most progress.


In my next post I will post before- and afterpictures of the filing process and some pointers on how to go about it.

My procedure

So this is what finally got me progress, after using it in a creative and not doctor-recommended way. It is late and I will only make a quick update here by pasting some of what I have written in the awesome information source that is Lee's blog at http://lee.org/blog/2009/05/14/nonyx-nail-gel-part-2/comment-page-1/#comment-291999 . Forgive me if this post seems like a cut and paste job....

For years the look of my horrible nails have made me feel bad about myself. A couple of months ago I did something radical: I took my microdrill, put a sand tip on it (for marking tools and stuff) and slowly but surely, for hours and hours, wore all my toenails down to nothing, and also my thumbnail. This nail was horrific at the time as it had rapidly gotten worse and was more or less loose all the way back to the base. With drills, knives and the motor drill with different tips I methodically wore it down till I was on bare skin. A few times it hurt and there was some minor bloodshed when I got overexcited but it is really possible if you take the time!

On the bare nail bed I have since then applied 2-3 times a day Lamisil single dose, the FOOT fungus solution that contains terbinafine and is supposed to only be used once and not to be repeated. =) My toenails I cannot judge yet (though the nail bed looks nice) but my thumb IS ALMOST COMPLETELY GROWN OUT ALL HEALTHY. After all these years!

I firmly believe the lamisil is responsible for the improvement I see. I have not used itraconazole for over a month (although I must say the itraconazole seemed to have some independent success with the other nails as I tried this out only on the thumb to start with. As my success with the thumbnail was instantaneous and obvious I went on with the other nails in the same way) but the nails keep getting better. The stuff works like a charm now that I expose the nail bed to it.

The stuff is expensive by weight, but it lasts for a long time…. I have now used less than 1,5 tubes in the last 2 months, and I applied it on 10 toenails pretty much every day and on 4 fingernails 2 times every day. The tubes are about 25 USD a piece, and 4 grams. You could make a tube last 2 months which by this price would cost you maybe 13 bucks a month, surely you can spend that?

After a while the layer can turn a shiny greyish colour, especially on small depressions in the nail, but that is no problem, it only shows that you have a nice and thick layer of the stuff working constantly.

From time to time, maybe every 2 weeks I scrape the rubbery grey stuff off and clean the nail, this only takes seconds, then I just stick with the process.

There you go. =)

New pictures

Success!

After all these years I am now having tremendous success with my fingernail fungus treatment. I am super excited about seeing more and more healthy nails grow out, within 1 month I expect them to be back to normal!

I will make an extensive post with pics and descriptions of what has worked tonight.


Much love

Fungus

Lasers

I am unhappy with my situation.

My doctor took me off Terbinafine after 6 months saying that it simply did not work. He was correct, because it didn't. My nails did not really get any better. Had it been my decision I would have stuck with it because I did not feel bad from it and I want to do everything I can to fight this infection, even if we can't say if one particular part in a multi-treatment works at all. If it doesn's harm me, let me stick with it.

After that nothing much happened for a couple of months. But now things are getting worse.... My thumbnail is horrible, almost completely loose. It is uncomfortable and it is actually painful. This has never been painful before. There is a numbing sensation of pain where the loosened nail meets the finger. As of now, I still stick to my amorolfine nail lacquer once a week, and terbinafine cream every day. I dropped vinegar again because I suspect it may not be good for my nails (what do I know) and back to sodium benzoate. It feels more gentle on the skin and does not produce that tingling sensation that vinegar does, I don't know if maybe the vinegar has been too hard on the nail bed, actually helping the infection.


Lasers are quite hot at the moment (haha). PinPointe and Nomir claim extraordinary results with their laser treatments for onychomycosis. However, these treatments are yet to be proven effective in quality independent studies. Nomir with their Noveon foot laser expected approval from the north american food and drug-administration in 2009, but so far no luck as far as one can see on their webpage.

Pinpointe boast with extraordinary claims, and I think one should expect these treatments to be effective to some extent, because if they did not do anything whatsoever they should not be around still. However, we don't know HOW effective they are until scientific independent studies have been done to a larger extent. As of now the treatments are fairly new (a couple of years) and the claims should be taken with a grain of salt.


That being said, I would gladly try it out for 1000 US$ if it was available in my neighbourhood. It looks rather promising on paper, and if it is effective it has huge potential considering it is non-toxic and it does not demand much of the patient when it comes to long-term labor.... Stay clean and disinfect your clothes and shoes, sounds better than for example soaking your feet in vinegar for several minutes twice a day......

Other things in development

Another similar substance under development is TDT-067 by Celtic Pharma. A press release from 2009 can be viewed at http://www.drugs.com/clinical_trials/celtic-pharma-successful-outcome-phase-ii-trial-topical-onychomycosis-6910.html . The substance as described by the company itself:

"Innovative drug carriers called Transfersomes® have been developed for the non?invasive delivery of agents into or through the skin. Transfersome® preparations consist of complex lipid vesicles, which are able to cross the skin permeability barrier, the stratum corneum, driven by the transcutaneous water gradient. TDT-067 (terbinafine in Transfersomes®) is a novel, epicutaneously applied carrier-based dosage form of terbinafine in development for the treatment of onychomycosis of the toenail and fingernail."

This does not seem to work with nanoparticles but instead with various substances that should work as carriers, penetrating the skin and transporting terbinafine with it to the seat of the fungal infection. Sounds interesting, and is now in phase 3 trials.


IDP-108 is being developed by Dow Pharmaceutical Sciences and is in phase 3 trials. Little can be found about this one, but initial reports from the manufacturer looks good, for what that's worth. Remember that things may look extra good in the beginning. But then again, if it did not work at all, they would not keep investing in it.

Studies have been done on the tolerability of stronger terbinafine solutions, 10 % as opposed to lamisil cream that carries 1 % terbinafine, the study can be seen at http://www.clinicaltrials.gov/show/NCT00443898, although the results cannot be viewed there.



I will keep posting useful links and also provide more extensive info on the mentioned treatments and substances.

Nanoparticles to battle nail fungus

I spend quite a bit of time online gathering information on this topic. I am searching high and low for a new and more effective treatment, none seem to be on the market yet, although a couple of things are are under development, such as the NB-002 drug, by NanoBio corporation. You can read for yourselves here http://www.nanobio.com/Dermatology/Onychomycosis.html .

This substance apparently uses droplets of oil that are super-tiny, to put it mildly. It is nanotechnology we are talking about, and these nanoparticles are supposed to, due to their small size, be able to enter the skin through pores and follicles around the nail, carrying with them dissolved terbinafine.

This sounds good, since the number one problem is actually getting the drug to the fungus, which is in the nail bed, safely hidden behind the nail. Research so far looks promising. One must rememeber that the first studies on a new drug are always conducted by the producers themselves, so the results may be biased, but still, the results look promising. One study can be viewed at http://www.drugs.com/clinical_trials/nanobio-corporation-completes-interim-analysis-phase-2-clinical-trial-onychomycosis-3624.html .

Another one is here, and it reports on the cure rates:

http://www.newslettersonline.com/user/user.fas/s=563/fp=20/tp=37?T=open_summary,50032714&P=summary


This drug is in phase 3 trials, meaning testing on human subjects in a larger scale, and it is the last phase before hitting the pharmacies (in some cases it can be sold and used outside of the clinical trial environemnt even before ending phase 3 trials, but so far NB-002 cannot be obtained over the counter).



When it hits the shelves, if I am still not problem-free, I will give it a try.

New photos

So these are my nails as of today (ish. two weeks ago.).


My index finger has significantly more healthy nail than it had some time ago, that has improved. My 4th finger looks really bad, but is unchanged really. My pointer finger developed an elevated ridge on the side that was rather sharp, but after filing it down to nothing, letting it grow out, and cleaning out excess keratin from underneath it, it is now less elevated. No healthy nail seems to be growing out though. Also on the other side of the nail fungus has been starting to grow inwards.

The thumb is horrible. A couple of times it has grown out to its full length in the middle, only being loose to the sides, but I just need to bump into something to loosen it from the finger again. It has also started to look worse on one side, fungus has grown back all the way to the cuticle on one side now (Ok, so it originates from the nail bed, but you get the picture). The part of the nail that is loose and yellow, it is now closer to the nail bed on one side.

On the bright side: six months ago my nails grew out very deformed with sharp ridges in them, almost parralel to the direction they grew, from the side it looked like hills and valleys. This is gone now and they are growing without change in a slightly "swollen" fashion, a little bit up and then down to the fingertip again.

My thumb of course is quite deformed but has been worse.

As of now I treat my toenails sporadically with sodium benzoate but my focus in on the fingernails. I have started yet again using vinegar on these. The smell is not that bad, on the toenails it is out of the question since your socks and shoes get a most horrible odour. I apply it 2-3 times a day using a big syringe, pure vinegar.


I shift back and forth but I believe it is useful as long as I do it every day, so that the fungus continually lives in an unfriendly environment. I want to go back on oral terbinafine and combine it with other treatments but I might go online instead of going back to my doctor, he blankly said it does not work on me and we should not do it if it doesn't work.

I am unable to hook my camera to my computer at the moment, I will post some new pics in my next post. Although things are pretty much the same after my efforts I like seeing a couple of things actually looking better than they did before (some spots are worse...).

It can be difficult to scrape keratin out from under the nail depending on how the infection looks. In my pointer finger for example I have now two 2-mm wide canals of yellow keratin where the nail is detached from the nail bed, almost all the way back to the cuticle. I tried something unusual:

A microdrill. A small hand-drill for household and industry purposes which I happen to have drills for that are tiny. I don't know, but maybe 0,20 mm thick. With this, I went to work....

With the drill on low to medium speed I inserted it under the nail, directed along the underside of the nail. With some care I went from side to side, and further in. I scraped the underside of the nail and the top of the naked finger. When the nail is detached from the finger you kind of have two nails growing. On the finger you get a semi-soft skin tissue that grows along with the nail, and eventually you can tear the tip off just like you do cut the nail. I rubbed the drill on this surface, scraping off tissue until, well, it was uncomfortable. I also went back as far as I could from the fingertip and scraped until it felt uncomfortable, then I knew I was about to get into healthy tissue with functioning nerves. The drill worked excellently by continuously pulling loose tissue back and out, I have sworn by the vinegar soak before, but now I got LOTS of stuff out that I couldnt get to before.


Happy with having no unnecessary goo hanging around under my nails, I altered my daily treatment slightly. For a couple of months I have used a used small glass dispenser to apply pure vinegar on the nails and also underneath, since it fills up the empty area I am hoping for some of it to spread to the nail matrix and battle the infection there. Anyway, I noticed a couple of depressions in the outgrowing nail surface and suspected the pure vinegar may be too much for the nail.

I switched to a household preservative that has some good words for it when it comes to battling nail fungus, sodium benzoate. It is not acidic, it is on the "wrong" end of the PH scale, but it is a presevative and keeps moulds and fungus off jam and beetroot, so I figured it would be an excellent choice for keeping fungus busy.

After many outbursts of rage over disappearing text I have now concluded that if you change the settings to "edit HTML" you are indeed able to copy and paste text, and thereby staying safe throughout the writing process. I am now content again....


I am sitting with my toes in plastic. As I said before, in worse cases of fungus keratin is likely to build up under the nail, lifting it from the toe and causing it to grow upwards in an angle. 4 of my toenails are growing abnormally, 4 and 5 one could say, if the big toes are no. 1 and one counts outwards. 2 are rather bad, one is bent badly and both are growing in a 45-degree angle. It has been a few months since my last procedure and it is time again.


What I do: I cut fingers off disposable plastic bags and fill them with PURE vinegar (not balsamic, it stains the nails). I put them on my toes and wrap up with rubber bands. It has been sitting for like 20 mins now and I usually leave it for close to an hour. What it does is it softens up the keratin and enables you to scrape it out using a toothpick, needle, nail, match, whatever. It sounds icky, and kinda is, but it relieves the nail of pressure and enables topical medicines to more easily get under the nail. I really recommend this procedure. Even though I mentioned it before, I do so again. The excess keratin should simply not be there and it is not good for the treatments.

Vinegar is good for this purpose. Some use it with success for long-term treatment of the fungus infection itself, applying it daily on the nail. It is a very logical treatment, considering the PH of vinegar and how acidic environments are unfriendly to fungi, so this is no scam, even though it may not be as potent as some people say. But vinegar smells, and combined with feet that sweat throoughout the day, it is not very nice. It smells very sour, and I take my hat off to those who can keep this up for many months. I would probably lose my motivation, considering the drawbacks.



This post is only for stating the usefulness of vinegar as a part of a treatment. More to come. My treatment is underway, and some bright spots csn be seen (my right middle finger show less infection than it did 12 months ago). Also on the medical side, there are a couple of new treatments in research that look rather promising. I will look into that in my upcoming posts.









Fungus

Firstly I must say I am rather annoyed with Blogger's ability to make text disappear, and also it's ability to automatically save posts, but without including the text, so you are left with nothing and need to start all over again. Anyway, let's go at it again.

So I have not posted for a long time, that is how it happens sometimes. Anyway I am glad I put these pictures up for me to be able to monitor my progress, and I plan to post frequently from now on. This will be an informative post, and my personal progress will be reviewed in a later post.

I think people should know one thing about Alternative Medicine. What makes it alternative is not it's magical efficacy, not it's east asian (or any romantic sounding) origin. What makes it alternative is the fact that it is not scientifically proven to be effective.

So in medicine, "alternative" actually means "not proven to be working". Once an alternative medication has been proven effective, it CEASES to be alternative medicine. It simply becomes medicine.

With that in mind. With that in mind..... You should gather as much information as you can about a particular subject or medication before investing money or time in it. If you see a webpage advertising a miraculous cure for nail fungus that makes wonders within 14 days, don't create an opinion from that page only. Go to a search engine like google and look that word up. If there are not many relevant hits, it may be safe to assume that the "opinion" that this cure is miraculous belongs to it's creators only, and few if any actual users.

Getting rid of my nail fungus has become quite a bit of a hobby of mine, and I have spent days and nights in front of the computer because of my problem. Let me share this with you: Google "nail fungus", "fungus cure" or anything like that, and you WILL find tons and tons of resources and sites offering help.

Maybe 5 % of this information has any value at all, or is sincere and correct. I would say about 85 % is complete horseshit, ungrounded claims and false statements, false information that tells you to buy a product or try a home remedy (the former is of course most common).


There are ways to get rid of nail fungus, but it is not easy, and many never does. Figures vary, but between 5-20 % of the world's population seem to suffer from any form of nail fungus. That is why there is huge money in this, and where there is money, there will always be crooks.....

Remember that. And stay tuned for my next post!


Fungus