There is some "fairly" good info in this thread...
Vick's "sometimes" works due to its eucalyptus origin, which is similar to "Tea Tree Oil" which has a natural anti-fungal action. But...They only work on mild cases, and only work about 25-30% of the time. You also have to use it for months, until the nail grows out clear, just like any other topical med.
Listerine "may" work, but again, you have to use it for 6-9 months...
I think the alcohol is just lightening the nail and not actually killing the fungus, but if it works, great!
Penlac (Ciclopyrox) is a prescription topical that also has some success (better with mild cases.
Jublia (Efinaconazole) seems to work better than Penlac, but it's more expensive and I've had difficulty getting insurance companies to cover the cost.
Both of these meds have to be used for 6-9 months. The biggest mistake patients make is to stop using the meds once the nail "starts to look better".
Terbinafine (the oral medicine) probably works the best, with a 70-75% success rate. Yes, it can be hard on the liver (like cholesterol medicine), so I do an initial liver panel to make sure there are no problems, and then repeat the labs a month later. If there are no changes, you stay on the meds for 3-4 months and then let the nail grow out...
Now, as to lasers... I used to use a laser. It was expensive to buy and expensive for the patient. Insurance did not cover the charges (I don't believe they do now)...
The literature states a 50-60% success rate. So, it's better than the topical, but not as good as the oral meds.
All that being said, the severity of the diseased nail makes a HUGE difference in what modality to chose.
Pts with mild disease respond better to topical meds than those with severe disease.
The pills work better on the really bad nails...
Hope this helps... Please send me your insurance info for the consult...
