toenail fungus

[Ben Crowell]

I just noticed that I have toenail fungus on one toe. I have two backpacking trips coming up: a short one, then a week's gap, then the JMT. I'm guessing that the fungus will require taking lamisil orally, which is Rx only and may require monitoring of liver function. Is there any point in trying to get a doctor's appointment before my trips, or should I just wait? I'm guessing that it would not cause physical problems that would interfere with the JMT hike, but most likely I'll have my feet getting damp a lot, which could cause it to spread to other toes. I hear that topical treatments aren't generally effective by themselves, but I'm wondering if treatment could stop it from spreading. Is the topical treatment something that could be practical to bring on the JMT? Is it a good idea to try to file off the irregular puffed up part of the nail?

[Trudi Short]

The call is free, I'd go to the doc if an appointment was available. Probably the sooner you start treating it, the better.

That said, I've gotten rid of small bit of infection on my big toenail by clipping and filing away as much bad nail as possible then using gentian violet solution on it. It'll stain everything it touches a bright purple. Available over-the-counter at drug stores, 1 oz. bottle. Just be careful not to open a wound in your toe with the filing and clipping; a tissue infection could really make your hikes miserable.

[Rick Horne]

Never had the problem, but have heard of a fairly new laser treatment

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Ask your podiatrist about it.

[Ben Crowell]

"Never had the problem, but have heard of a fairly new laser treatment

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Ask your podiatrist about it."
Thanks for the suggestion, Rick! But I believe it may be expensive and not covered by insurance.

[John Nausieda]

Many people use hydrogen peroxide . Some use it mixed with vinegar.

[John S.]

Are you hiking the entire JMT over several weeks? I guess if it were me, I'd not want to have to worry about Lamisil pills while hiking (depending on how bad it is). I'd go see the doc before, get prescrip if he agrees it's fungus, get information on prevention, but wait to fill it until after I was back (if doc agrees you could wait). Let the doc know your plans of filling script after trips, if that is what you decide. As you probably know the pill treatment is 3 months.

What I would do for the trip though is use Lamisil cream every day to prevent skin involvement. I take it on all my hikes and use it daily.

There's nothing wrong with filing off bad nail, but be careful not to damage the skin and cause bacterial infection. In some cases the bad nail can be removed somewhat easily and then topicals can work. Without debridement of bad nail, topicals frequently won't work, in my opinion.

Maybe Doc Hurd (family practice I think) will respond.

[Joe Geib]

Wait until after the trip. It's a 90-day Rx, and you really don't see results until after 60 days or so, and probably won't get "discharged" until 6 months. Also, knowing that sanitary conditions on the trip will be less than ideal, you might not be helping things much.

Oh, and they make you do the "liver functions" test beforehand, but it wasn't really monitored over the course of the Rx. I also think that a side effect my be stomach issues; you probably don't want any of that on the trail either.

Wait.

[Ben Crowell]

Thanks, all, for the advice!

-Ben

[obx hiker]

Vicks Vaporub will slow it to a standstill……
( seriously Vicks Vaporub who'd a thunk but look it up…. (google vicks vapor rub and toenail fungus )here's one of many links http://www.ehow.com/how_5277195_cure-vicks-vapor-rub-mentholatum.html) can cure it but it takes months and months and just too iffy. Still ought to be a manageable addition to a trail kit since the amount to spread on one toenail twice a day ……… well a dropper bottle ought to keep you supplied from re-supply to re-supply or a couple of weeks.

The lamisil will get it for sure but agree why stress the system with a serious medication on a long hike.

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