A question specifically for those who have lengthy experience with battling between-the-toes foot fungus. And by lengthy experience I mean, you’ve suffered with it on & off for many years despite taking known precautions: keep the area as dry as possible, change socks, wash socks, avoid public floors, wash between toes regularly, etc.
Do you have a UL kit and system which has proven effective over the long term?
My past kit and system recently failed me and I’m experimenting with changing it. My prevention UL kit and routine used to be:
1. Have two small towels, one for left foot, one for right foot. This prevents cross-foot contamination.
2. Wash carefully with soap between toes each evening at camp with the towel specific for that foot.
3. Apply a couple of drops of tea-tree oil mix with a base oil, using a small bit of single-use cotton swab.
4. Keep the towels as washed and dried as possible during the day, and packed separately.
My kit has been a tiny dropper with the oil, a collection of cotton swabs, and two small dedicated foot towels. Why tea tree oil? I read that it can combat foot fungus. I got a case nonetheless.
I have never carried any medication before. I’ve dealt with outbreaks after returning home.
Do you know if anti-fungal medication can be used full time, even when there isn’t an apparent occurrence, and if so, can you cite a quality study to back it up?
This Mayo Clinic article: https://www.mayoclinic.org/drugs-supplements/betamethasone-and-clotrimazole-topical-route/precautions/drg-20061704
states, regarding clotramazole:
“Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems.”
However, this Harvard Health article: https://www.health.harvard.edu/diseases-and-conditions/staying-one-step-ahead-of-toenail-fungus
states: “Whether you’re trying to clear up a fungal infection or hoping to avoid getting one, the following can help…Use antifungal foot powder daily.”
But perhaps they are referring to another type of medication. Or perhaps it is poor writing in the Harvard article – maybe they wrote “use powder daily” to refer back only to “trying to clear up an infection” and not also “hoping to avoid one.”
I don’t know if over-use of any of them can be harmful, or lead to antimicrobial-resistant fungi. I can’t find any quality study online which states it definitively, one way or the other. I searched pubmed to no avail.
The change I’m considering is to carry Miconazole nitrate 2% powder in a container of some kind (I don’t know how best to ultralight carry powder) and to apply it each evening after washing and drying. I have briefly experimented with applying a foot balm such as Badger Foot Balm between the toes every morning, with the idea that it will keep moisture at bay. Some say they’ve had success with this. In my experience so far, I don’t like the results. It leaves the toes a bit gooey and moist at the end of the day, and borderline itchy – an awful sign for an outbreak. However I can’t definitively rule it out yet.
My feet freeze at night, so I generally put a bit of Miconazole powder into the toe of my socks also. Then I awake at 3am with warm feet and I can’t stand the feel of wearing socks so I take them off and fling them.
My current thought is to not do anything for the morning except keep them dry. And obviously, frequent breaks during the day to dry out the toes. Using any kind of powder during the day, such as talc or corn, hasn’t worked well for me. Moisture clumps it up.
At home, the most effective medications for me, in order, have been:
1. Terbinafine Hydrochloride cream 1%
2. Miconazole nitrate 2% powder or spray
3. Tolnaftate 1% powder or spray
Clotrimazole cream 1% – I haven’t used this enough to know
Regarding Terbinafine – online studies show this to be the most effective for many people. It certainly has been for me. Remarkably, the directions say “Use for one week.” So this makes me question if a dab of this is safe to use full time in the backcountry, purely as a preventative. And I’m considering a long trail, so it could be for weeks or months.
Experienced sufferers know that the slight itchiness which occurs the day or two prior to a full outbreak heralds, in my experience, a full blown case. Which, for me, is usually like a head cold: do what you want, but it’s going to run its course. For me, the cracks run so darn deep, it looks like they go almost to the bone, and then the bleeding begins. This makes me really nervous about stepping into mud puddles and such. My neighbor ended up in the hospital with a severe kind of blood poisoning which began in his foot. The doctors said he picked it up in a puddle after having a cut in his foot.
Thanks for reading!
Mark

