How to get rid of your crusty toenails for good... as leading researchers reveal simple 'game-changing' new treatment
Crusty fungal toenail infection patients could soon get a ‘game-changer’ treatment on the NHS that can banish the unsightly and hard-to-treat condition for good. The common problem leads to thickened or damaged toenails – with no effective treatment and many patients living with the uncomfortable fungal infection for decades.
However, British researchers believe they have finally found an answer. The treatment, which involves fitting the affected toenail with an artificial casing containing a potent anti-fungal drug, could be available on the NHS within five years.
The researchers will soon begin recruiting patients to test the process but they say early results indicate it is highly effective.
‘This could be a game-changer for millions of people across the globe,’ says Professor Stuart Jones, a pharmacology expert at King’s College London.
‘Lab tests have shown the concentration delivered by the device to nails in a single treatment is all that’s required. One dose, that’s it.’
Known as onychomycosis, the condition is the most common fungal nail infection, thought to affect around one in ten adults globally and up to half of over-70s.
The most typical symptoms are crusty, yellow toenails, which can become brittle and crumbly. The surrounding skin will often turn swollen and painful.
It can often be triggered by nail trauma, such as through playing sports, warm and moist environments and older age.
Onychomycosis is caused by a number of types of fungi, which are becoming more common and harder to treat. Earlier this year, the World Health Organisation warned invasive fungal diseases were ‘growing increasingly resistant to treatment’ and issued its first ever alert over the ‘critical lack’ of measures to stop the infections spreading.
Onychomycosis is caused by a number of types of fungi, which are becoming more common and harder to treat
Caught early, onychomycosis can be effectively combated. GPs often prescribe either oral anti-fungal tablets or an anti-fungal nail lacquer, which contains the drug amorolfine. The key early symptoms include discolouration, subtle changes in texture and the nail bed slightly separating from the skin underneath.
However, even at this stage, success is not guaranteed due to the fact the fungal infection is often drug-resistant.
As a result, onychomycosis can continue to return even after extensive treatment. Moreover, experts say that many patients put off seeking treatment because they are embarrassed by the state of their nails.
Professor Jones says: ‘It can take years for patients to come forward because this is a slow- growing infection that is difficult to identify until it has become severe. Many people suffer with onychomycosis for years, if not decades.’
However, researchers at King’s College London believe they have a solution. Dubbed OnchyMed, the device is an artificial nail that contains a special gel, made up of water and sodium hydrogen sulphide.
This compound is highly effective at destroying the fungus that leads to onychomycosis. However, when exposed to air, sodium hydrogen sulphide turns into a gas, making it exceedingly difficult to apply to the toenails.
But by keeping it contained within a casing, placed around the infected nail, experts believe this will ensure it passes into the nail, killing the fungus.
The OnchyMed is designed to be worn for just 24 hours on each affected toe – with researchers saying it is painless and tests so far show it has no side effects. Lab trials have revealed that even the most drug-resistant nail fungus infections can be killed, meaning it should be effective against the vast majority of cases in the UK.
Professor Jones says: ‘This is the first time hydrogen sulphide has ever been used as a medical treatment. It is complex to deliver but our artificial nail manages to control delivery into the nail plate.
‘As a highly potent antifungal, it works better than other treatments – it’s very small and can pass into the nail plate quickly but does not enter the bloodstream.
‘It could be re-applied if you have a very stubborn infection and it can also be used on multiple nails at the same time.’
The first human trial of the OnchyMed will launch early next year by Guy’s and St Thomas’ NHS Foundation Trust in London. This will involve 60 patients who will be monitored for 18 months. If successful, a larger trial is likely to involve a further 150 patients.
Professor Jones says: ‘We’re really keen to see it available on prescription in the UK within five years. We hope this product will become a market leader.
‘Any product that can change the game will benefit millions.’
Guy’s and St Thomas’ dermatology department will shortly begin advertising the trial online for anyone interested in participating. Further details can also be found by emailing onychofree@kcl.ac.uk
