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Fungal Nail Treatment

Discussion in 'General Issues and Discussion Forum' started by declanpod, Oct 14, 2014.

  1. declanpod

    declanpod Welcome New Poster


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    Hi All,

    I am just looking feedback on what fellow pods use as a first line fungal nail treatment and then if this doesn't work what is the next treatment option? There are lots of treatments ie nail lacquers, creams etc. I am a recent graduate and I am looking for some advice on what to offer as fungal nail treatment which will produce good results.
    Any help will be greatly appreciated.

    Declan
     
  2. Quiros

    Quiros Member

    Ha salido Naloc gel va bien, no lleva antibioticos. Indicado para onicomicosis y psoriasis,
     
  3. LeonW

    LeonW Active Member

    Best is pills lamisil . Active ingredient is terbinafine. Very strong but it works.
    If u dont want to take poison then u can try laser treatment it is meant to be very good.
    Or apply tea tree oil.
     
  4. Pyearsley1

    Pyearsley1 Member

    Forgive me if Im wrong, but I thought the wonders and efficacy of Tea Tree Oil was dispelled some time ago?
    From what I remember, it shows some antifungal properties, but thats it. No evidence to support its use in treating fungal nails.
     
  5. JaY

    JaY Active Member

    I read an article the other day (beats me if I can remember the title or even the journal at the moment!) that the new philosophy about treating OM is to "control" it rather than "cure" it. There is about a 15% recurrence rate if you do manage to cure it too...
     
  6. Stormpod83

    Stormpod83 Welcome New Poster

    I find that while the tea tree oil may not be as effective as some other treatments, the compliance is more likely for erdlerly patients. If they are coming for regular treatments and the infected nail can be cut back, then tea tree oil seems to "control" the O/M in a lot of cases. I tell patients all treatment options and then they can decide what suits them best economically and what treatment they are most likely to comply with.
     
  7. blinda

    blinda MVP

    No clinical studies have revealed superiority of TTO (Tea Tree Oil) over existing licensed pharmacological treatments for onychomycosis.

    Regardless of the unproven efficacy of TTO, my concern is that practitioners are continuing to recommend the use of TTO without first explaining the risks, i.e. the nature of oxidation.

    Amongst the active ingredients in TTO are the terpenoids; terpinolene, ascardiol and a-terpinene which are thought to be responsible for the much publicised `antimicrobial activity` of TTO. The oxidation process of these terpenoids leads to the formation of peroxides, epoxides and endoperoxides. In turn, the potency of these act as triggers for contact allergy which increases with further oxidation of the oil upon repeated exposure to light, moisture, heat and air. So much so that, oxidated TTO has a sensitizing capacity multiple times stronger than a newly opened fresh bottle of TTO, after just a few days if opened daily, thus rendering the oil as a severe irritant.

    Terpenoids have been documented as known sensitizers for allergic contact dermatitis for many years and the incidence of reactions to oxidized TTO is recorded as being relevant enough to warrant warnings on TTO products. Put simply, the EU stated that `even small amounts of the undiluted oil could be unsafe and unstable after clinical trials found users risked rashes and allergies as it is a severe irritant to the skin and degraded rapidly if exposed to air, light and heat`.

    The unproven efficacy along with the amount of patients that I have personally seen presenting with allergy induced Paronychia , is enough for me to discourage its use.
     
  8. Simon Ross

    Simon Ross Active Member

    Taken from top bloke Ivan Bristow's lecture:

    Tea tree oil does kill fungus and is natural, but tea tree oil is an irritant to 5% of patients (dermatitis). A trial had to be stopped because of it. More effective to use an anti-fungal than tea tree oil! In a trial the adverse event rate must be <0.01% for an anti-fungal (or it is thrown out), tea tree oil is 5%. They think that the irritation is tinea (when in fact it is eczema) so they put more TTO on it (thinking its fungus), making it worse. A lot of irritant dermatitis is caused by TTO.

    As Ivan said, if a complaint was made to the HCPC, if you had recommended TTO and not an anti-fungal, you would be on very dodgy ground.
     
  9. blinda

    blinda MVP

    Indeed. That`s why all the frequently cited TTO `trials` are in vitro....Many substances destroy fungus, but you wouldn`t necessarily wanna put them on compromised skin/nail.

    I will be sorry to miss Ivan`s gig at Bournemouth, which includes the splendid Julia Schofield. Ian Reilly and I are performing a duet at the same time. :drinks
     
  10. Michdeg

    Michdeg Welcome New Poster

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