Rolando Melendez conservative treatment for onychomycosis (nail fungus)

1. Onychomycosis
Goal #1: Eliminate the fungal infection
1. Topical treatment:
 OTC creams: 15% success rate
 Formula 3: 30% success rate (with money back guarantee)
2. Oral treatment: Lamisil (Terbinafine): 80% success rate
 3 month treatment course
 Requires blood work before treatment is begun
 Liver damage is only seen in patients with prior liver disease, lupus
erythematosus, or people who drink large quantities of alcohol

“In two multicenter trials of terbinafine 496 patients aged 18 to 75 years
used the drug for a 3 month treatment period for toenail infection and a
6-month mycological cure rate was 80% for toenail infection…There
was a 0.5% of asymptomatic changes in liver enzymes that cleared after
cessation of therapy” Double blind, randomised study of continuous terbinafine compared with intermittent
itraconazole in treatment of toenail onychomycosis BMJ 1999; 318
3. Oral + Topical Treatment: 85% success rate
4. Laser treatment: 90% success rate
Goal #2: Prevent recurrence
1. Treat the skin fungus: prevent spread of the fungus from the skin to the nail
 Sweaty feet: Loprox gel 0.77%
 Dry feet: Ketoconazole cream 2%
2. Keep nails short to decrease bulk of the fungus
3. Treat the shoes: avoid transmission of fungus from the shoes to the nail
 Lysol spray once a week
4. Keep feet dry
 Apply antiperspirant spray on feet daily for 2 weeks then once a week