TOENAIL FUNGUS

[toenail50]

Both my toenails are coloured. It has been like that for more than 10 yrs. One of the toenails have turned from brownish to blackish. It is very embrassing.

I have tried Lamisil tablets, Lamisil cream, soaked in apple cider vinegar, pour listerine over the toe and all without success.

If I want to get specialist treatment in Malaysia, what kind of specialist should I be looking for? Skin specialist maybe?
Pls help.

[Vanessa Lacuesta]

Hi,

Since your nail condition has not been given proper diagnosis ,you may discuss with your physician a nail biopsy. Nail biopsy is done to determine the cause of the condition. Based on the results of the biopsy, your physician may opt for nail surgery as a method of treatment.

For patient who underwent nail surgery indications include chronic infections like fungal infections , nail tumors (which I believe is not applicable in your case) and in some trauma and unknown causes. (http://www.ncbi.nlm.nih.gov/pubmed/8982419)

Here is a url which may give you an overview of the process involved in nail surgery. Discuss this with your physician when you seek consult.

http://www.bassetlaw-pct.nhs.uk/services/foothealth/nail_surgery.htm

[toenail50]

Thanks doc for taking time to address my condition.

I have no other medical conditions beside this toenail. My thinning hair maybe the other one. But I have no diabetes, my skin is ok. No injuries to the feet before and do not varicose veins. No lesions too.

Only the toenails are discoloured. Do you think removing both the toenails can solve the problem? How long would it take for the new nails to grow? Any possibilities it wont grow again?

Thanks again.

[Vanessa Lacuesta]

Hi,

This has been present for a long time. Based on its chronicity and the presentation, this may be a case of a fungal infection. Fungal infections involving the nails may require oral medications and may take at least 6 weeks to treat. Another differential is a vascular problem.

Have you had  any trauma or injury to  the area before?

Are there any bruising, discoloration or varicose veins in the extremities?

Have you been diagnosed with diabetes?

Any other underlying illnesses?

A dermatologist or  a skin doctor who specializes on nail disorders is the best person to seek consult with. He/she may refer you to an internist if other further tests are indicated.

Are there any other lesions, discolorations or scaling in the body?

[jeanie208]

I too have toenail fungus on both big toes & for many years. Have had one of them removed just to have it grow back the same after 2 removals. From my understanding one must use both an oral med along with a topical med if it is truly toenail fungus. I suffer from multiple skin cancers & have had 6 surgeries in 6 weeks with about a year more to go as I also have RA & thus a lousy healing & immune system. Not to scare you but upon researching sking cancer online I read that toenail bruising with no apparent trauma can be a sign of skin cancer so in my opinion if you do not have a primary care physician to give you a referral I would see either/or both a podiatrist 1st, then a dermatologist. Hope this helps. I understand & sympathize/empathize with you. Hope all goes well. Let me know. There are people who care & Lord knows we all need all the help, compassion & support that we can get. You may contact me via email jeanie.***@****. I live in the Chicago area & am 58 years old. These are supposedly the beginning of the "golden years"! Golden years my buttt! I also have quite a sense of humor. It helps one get through life. They say money can't buy happiness but I say it sure as heck can't hurt. I'm on SS Disability myself. God Bless. Jeanie