Rats! There's a fungus among us 2015.11.04

Oh, the irony. Twenty years ago I write a column making fun of toenail fungus. A dozen years later I have my own odd-looking toenails—and one fingernail.

Actually, I was just making fun of the medication used to cure the condition. I could still do that today, and add my own experience—an odd greasy, black paste that’s supposed to be a cure from Eastern medicine. Oh, and there’s also those who suggest soaking toes in good old-fashioned apple cider vinegar. And don’t forget tea tree oil. Sounds like another column.

Dec. 6, 1995

Rats! There’s a fungus among us

It’s difficult to get a good night’s sleep when those giant toenail fungus ads appear in the big daily papers. Toenail fungus. A blight on America.

I know it’s an important issue because, according to my Michigan newspaper guide, that ad in a Detroit daily paper costs at least $30,000 every time it runs. Maybe they cut a deal. Probably the publisher of the Free Press has a serious case of onychomycosis, himself.

I’ve never personally known anyone who needs to “Kick Toenail Fungus” as the ad suggests. At least I don’t think I have. I know, who’s going to talk about it? Why would anyone confess to rotten toenails?

In the ad, you can see a pair of bare, shapely legs emerging from the side. The right foot is wearing what appears to be an old hunting boot. The left foot is kicking off a stinky old boot. No wonder there’s a problem. You’re asking for trouble when you walk around naked but for a pair of boots.

More disturbing than the haunting specter of toenail fungus are the effects of the cure. This big ad is for a drug called Sporanox®. It’s created by Janssen Pharmaceutia, a world leader in anti-fungal research, a company that will soon be writing me a nasty letter.

More than half of the ad is about the contraindications of Sporanox®. In other words, it gives a hundred reasons why you might want to live with toenail rot.

It’s all right there in frightening black and white:

Human pharmocokinetics data indicate that oral ketoconazole potently inhibits the metabolism of cisapride resulting in an eight-fold increase in the mean AUC of cisapride. Data suggest that coadministration of oral ketoconazole and cisapride can result in prolongation of QT interval on the ECG.

And that’s just the potential human havoc. Look what happened to rats.

“They overdosed me on the stuff,” one senior rat lab rodent was quoted as saying, “and look at me now. I’ve got unsightly tumors in my soft tissues.”

Uncaring researchers tried to gloss it over by saying it might be caused by hypercholesterolemia, a condition common to rats but not to dogs and humans.

Fortunately, rats’ fertility rate was unaffected even at doses up to five times the recommended level. Some rats died at the 20x overdose level, but their toenails looked just spiffy.

I still can’t figure out just what this toenail fungus problem is all about. The advertisement mentions thick, hard, yellowish and/or brittle toenails. There’s a small photo of an actual case of fungated toenail that suggests the despicable incidence of toenail biting, and a poor job of it at that. Very uneven nibbles. Bloody on the edges.

A genetic defect? A chemical imbalance? Those are popular causes for ailments these days and onychomycosis may be no exception. If the benefits outweigh the potential risks, as the ad says, then go forth boldly with Sporanox®.

But here’s my prescription: Let the old boots dry out. Buy a new pair of shoes. Change your socks at least once a week. Don’t walk naked through rat labs. And by all means, avoid public rest rooms.