Excilor - fungal nail treatment

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Just wondered if anyone has used Excilor as a treatment for onychomycosis and what the outcomes were.

I was a given a leaflet on this product at the SCP Conference in November and although the information provided sounds promising, wondered what the real-life experiences were.

Many Thanks
Katie

 

Hi Katie,

Taken from the Excilor website; http://www.excilor.com/CorporateEN/faq.html

As the tin says; it doesn`t actually `treat` OM as it does not contain either a fungicide (destroying the dermatophyte) nor a fungistatic (preventing spore reproduction) ingredient. It claims to make it difficult for dermatophytes to thrive by altering the pH of the nail apparatus. Personally, I would question how this device could penetrate to subungal level where the fungus is active. But that`s just me.

A quick search does not reveal any trials, nor even case studies, for the effectiveness of what is essentially a vinegar (it has its uses, I know) and solvent compound for OM.

Hope that helps!
Bel

 

I prefer my vinegar on chips!

Katie and Bel
It begs the question as to why the SCP allows products like this to be given out at conference, or advertised in their journal, considering that we are supposed to pursue an evidence based practise.

CM

 

That`s what I said to my gynaecologist.

Indeed. Not as if they need the support of any ol`trade to fund the conference, considering the high attendance fees.

 

I was sent these by email today. So, the 2 `studies` only recruited participants with SWOM and/or light distolateral OM, cos that`s really difficult to treat, isn`t it? Any thoughts?

 

hello there,

i also have received a leaflet on this product...OM is one common complaint that pts seem to struggle with sticking to the advice and compliance is fairly low. having thought about it (for all of about 5 mins!) after reading the vinegar thing...i wondered if anyone had thought of trying soaking the nail/s in vinegar and then applying an antifungal product straight after? i havnt tried it myself...just throwing a thought out there at this point

what else do you guys use to treat OM? do you always take a clipping? what products work in your opinion/experience and do you give other advice eg footwear, nail varnish, diet etc?

poppet

 

Within my UK private practice I offer four treatment options for nail mycosis:-
1) A penetrating nail oil including Clotrimazole - Gehwol protective nail and skin oil, available from Canonbury Products. Cheap and cheerful, daily application of a single drop.
2) An extensive nail reduction when extreme dystrophy and NOT penetrating beneath the cuticle, using burrs with wet drill to remove all accessible detritus down to the nail bed, with follow-up of Lamisil gel under occlusion for 1 week, then Lamisil spray daily for a few weeks (terbinafine).
3) When multiple nails are involved or it has spread beneath the cuticles (inaccessible to topical treatments), then I refer for a 3 month prescription of oral terbinafine. Perhaps this is unsuitable, if concerns over liver function.
4) As a longer-term fall-back, an older broader-spectrum anti-fungal and anti-yeast nail paint called Phytex (acid based). This can build-up discolouration over a period - cleanse with nail polish remover.

In all cases, client expectations must be set appropriately. This is a race between the body's ability to grow new nail and the fungus (90%) / yeast (10%) ability to consume the nail. A thick, slow growing or damaged nail or nail bed is always going to struggle to clear the infection. Replacement of a whole toe nail can take 6 - 12 months, so treatment is for the medium - long term.

I also arrange a periodic 2-3 month review, when the treatment may be changed or combined. I also use digital photography to monitor the initial situation and progress - a great motivational aid!
Gary Denby, Foot Wise Podiatry. www.footwisepodiatry.co.uk