How many times do you think I’ve heard someone say “I think I’ve got toe nail fungus, its ugly and I hate it”?
Would you be surprised if I told you it’s quite a lot? Nail fungus is far more common than you’d think! Around 80% of the population suffering some form of fungal infection at some point in their lives, and approximately 20% having some kind of fungus related problems at any one time.
I’m sharing this case study with you so that you can see how we can help to diagnose and resolve this issue. I want to give you back your freedom so you can wear your sandals once again, without feeling self-conscious.
In October an active lady in her early 40s came to see me, feeling very down about the appearance of her toenails. She told me she damaged her big toenail about 20 years previously and it had never ‘grown right’ after that. She had been prone to getting Athletes foot on her skin, and we know that this is a risk factor for cross contamination to the toenails.
She tried everything!
Over the 20 years she tried all sorts of things to try and rectify it. Her doctor took nail clippings for testing and gave her something to use on it but it didn’t work. She also tried all sorts of over-the-counter remedies, all to no avail.
When she came to see me, she was at her wits end about these nails; frustrated that she was unable to wear her sandals without feeling self-conscious. Of course, as soon as Potty Purple Pod saw them, I knew I could help!
You can see from the pictures that multiple toe-nails were affected. I knew that the chance of topical treatment alone (that is putting something on the nail) was likely be inadequate to clear them. We would need systemic treatment (which is taking a course of tablets) as well to get the best results for her.
What am I thinking about when I see these cases?
Taking any form of systemic treatment (or to put it in English taking antifungal ‘terbinafine’ tablets, one a day for three months) is not for the faint hearted. As with all medications, it has potential side effects. Typically with terbinafine it affects people’s taste buds, making food taste metallic. Sometimes it can give them a gastrointestinal upset, or worst case scenario it can cause liver problems so often a doctor will want to conduct a liver function test before they will prescribe it.
For all these reasons, before I even suggest these tablets to any of my patients, I find out how important it is to them to get rid of their nail fungus. This lady was desperate to be free of hers and motivated to do whatever it took to achieve that outcome.
So, how are we going to fight this pesky Nail fungus?
Alright, let’s discuss how we can tackle nail fungus!
First off, we started with a 5 minute fungus test. This helped me confirm that the issue was indeed a fungal nail infection and not something else like psoriasis of the nail, which can look quite similar. What’s great about this test is that it only takes 5 minutes (yes the clue is in the name), so we get results right away and can proceed with the best treatment plan.
During a follow-up appointment, I used a dermatoscope to closely examine the progress of the treatment. In this particular case, my next step involved writing to the patient’s GP to request a prescription for terbinafine tablets. It’s worth noting that terbinafine is currently only available with a prescription and can’t be purchased over the counter.
Now, some people worry that terbinafine can cause liver problems, but the truth is that it’s actually quite safe. Don’t just take my word for it though – Dr Ivan Bristow explains here .
Follow up is important
I saw my client every couple of months for follow-up and was able to track the progress of improvement of the nails. I’m really grateful she’s consented to me sharing the pictures with you so that you can see the transformation for yourselves.
By June the following summer, 8 months after starting treatment, the nail fully regrown, is fungus free, and my patient was delighted! She also reported that she had none of the possible side effects while she was taking the Terbinafine tablets for those 3 months, so double happy!
To manage it, she will need to continue to periodically apply antifungal cream on her skin as fungus is notorious for coming back. Nipping it in the bud with the cream prevents it getting re-established on the skin, so it is an important routine to get into for after-care. Want to know how to apply antifungal cream effectively and keep fungus at bay? watch this short video.
Want to book to see me in person or via video? You can book online here
Until next time,