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Treating Nail Fungus

Arlene Santantonio is one of 25 million Americans plagued with nail fungus. When home remedies failed to work, such as soaking her feet in Clorox and vinegar, she turned to podiatrist, Fred Buxbaum.


Two months ago, Santantonio began using Penlac, the first topically applied nail lacquer approved by the Food and Drug Administration to kill fingernail and toenail fungus.


"It's like nail polish," she tells CBS 2's Paul Moniz. "It smells like nail polish."


Every day, Arlene brushes on the lacquer, which must be used alone, not under nail polish.


As Dr. Buxbaum drills away diseased nail, he sees improvement.


"If you look at the tip, there is still fungus," he describes. "But the base is clean."


The lacquer can take 48 weeks to work, much longer than the 3 months needed for the pills.


But some patients can't take the pills either because of interactions with existing drugs they're taking or side effects, such as stomach upset and, in rare cases, liver damage.


"[The lacquer] doesn't work quite as well as the pill does," Dr. Buxbaum says. "But it's very safe. It doesn't interact with medication and we've been quite successful with it."


In controlled studies, effectiveness of the lacquer ranged from 29 to 36 percent versus 60 to 70 percent with the pills.


But the lacquer's side effects are quite mild, ranging from a localized rash to temporary tingling or burning.


Prompt treatment of toenail fungus is important because it can spread to surrounding nails.


Because the prescription nail lacquer helps only one in three patients, you may still have to take the pills.


Some specialists believe combining the two treatments may increase effectiveness.


If you don't have insurance, treating fungus is expensive business: one bottle of the lacquer costs $85.


Arlene is not cured yet but she's on her way to showing off her feet once again. As for how long her treatment will take, she's keeping her toes crossed.


"It's up to my toes really, it's not up to me!" she says.

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