Wednesday, February 23, 2011

New Toe Fungus Therapy

Courtesy of Wall Street Journal

A growing number of doctors are offering an expensive laser procedure they say zaps away a common fungus that causes ugly, discolored nails. Published data on laser treatment for nail fungus is scant, but early results suggest it is a reasonable option for people who don't want the side effects of oral medications.

Onychomycosis, or fungal infection of nails—most often on the toes—affects about 12% of Americans, according to the American Academy of Dermatology. Some people are genetically prone to it. Others, including swimmers and other athletes, may be more likely to get it because they go barefoot in public areas or because their feet are often damp, scientists say. In its mild forms, nail fungus is merely a cosmetic problem, but over time it can cause toenails to grow abnormally and become painful when walking. Toenail laser treatment offers a new alternative to oral medication, which carries a risk of liver damage, and a nail lacquer, which has poor efficacy.

The cost of zapping nail fungus with a laser can range $750 to $1,500 for a treatment course. It isn't generally covered by insurance. Whether you choose oral medications or lasers, it can easily take a year for nails to clear entirely. So far only one company's laser has received Food and Drug Administration clearance, which is a streamlined review process for medical devices, for toenail fungus: PinPointe USA Inc., of Chico, Calif., received clearance in October to market its laser for "the temporary increase of clear nail" in patients, according to the FDA clearance letter. Depending on the severity of the problem and the laser used, patients may need one to four treatments. How the lasers work varies and how they affect toenail fungus isn't fully understood in all cases.

If you are willing to risk side effects, the best tested—and likely most effective—treatment for toenail fungus remains oral medications such as Novartis AG's Lamisil. According to Lamisil's FDA-approved prescribing information, 3.3% of patients in clinical trials had abnormal levels of liver enzymes, a possible warning sign of liver damage, compared with 1.4% of people taking a placebo. In rare cases, people have needed liver transplants or died from liver failure after taking Lamisil. To prevent fungus recurrence, you must follow a scrupulous hygiene program, including anti-fungal spray for feet and shoes, not going barefoot, keeping feet clean and dry and changing socks daily, doctors say.

Bonnie - systemic yeast imbalance and candidiasis also proliferate toe fungi. These should be ruled out.

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