Terbinafine tablets for fungal nails in child - risks? Anyone used?

[NailTreatment]

Hi, my 10yo has had really stubborn fungal toenails (8 of them!) for the last 6 months or so. We have been seeing a private podiatrist who recommended urea past treatment and Amoralfine nail lacquer. We have been doing those diligently (as well as Lamisil) and a couple of the nails have cleared up but 4 are really stubborn still.

The podiatrist cuts out a lot of the soft nail when we see them but has now said that terbinafine tablets might be the best option to sort it out.

The thing is there is a small risk to liver function and DC would need blood tests when taking it. I'm keen to continue as we are as the GP said they would not give it to their child which has really put me off, but also if we're in the same boat in another 6 months should I consider it? Otherwise it won't just 'go away' on its own.

Would like to know if anyone's been in the same boat?

The blurb on Terbinafine says "There are many non-prescription and prescription only topical preparations available, but toenail fungus is very hard to eradicate using creams and lotions. The fungal spores grow under an infected nail which makes it extremely difficult to treat as topically applied medicines cannot penetrate or get under the nail easily."

DC doesn't really understand why it needs risky treatment as the fungal nails themselves aren't a risk to their health, but I don't want them to go on forever.

I spoke to a gp about this recently after a nurse prescriber had given it to me. I am a retired nurse myself and had my doubts about taking it so I asked him if he would ever take it personally and he said that having worked in wards of people with liver failure he would never risk it just for fungal nails.
I persevered with a podiatrist cutting and cleaning etc and the infection is now gone. Took about ten months.

Eek. I'm risk-averse but at the same time I'd hate him to have this his whole life. It's tiring treating it (the urea paste needs soaking off, scraping and replacing with plasters every night - we do this for a fortnight at a time) and then the Curanail is weekly but we try and put athlete's foot cream on too. Plus washing DC's socks in a separate hot wash!

I'm aware that HCPs will see all the negative side effects and not necessarily the successful treatments but it does make me pause!

Sorry no advice on the tablets but have you looked at Clearanail? It's a machine that drills tiny holes in the nail so topical treatments can get through. You can look at their website for podiatrists that offer it. I recommend combining it with Neem oil.. smells AWFUL but really works!

I tried the creams etc and the drilling in to the nail - which was awful. I'm so squeamish.

What worked in the end was laser treatment with a Lunula laser.
I did all the separate washing of socks, kept nails short and used an antifungal cream in between treatments too.

It's gone and hasn't come back.

Yeah I don't think my 10yo would be up for drilling! But I'd never heard of it so I'll ask!

I know this is an old thread but I’m having the exact same issue with my 10yo DD and also reluctant about the medication that has been suggested. Did you manage to clear it?

Sorry to say, no not at all, and I hadn't realised it's been going on for so long

We're just putting up with it and using Curasil still but could do with going to the podiatrist again for a cutback and advice, but suspect they'll just keep pushing the tablets. DC is still not keen on the idea.

Thanks for the reply and sorry to hear it’s still ongoing. We’re not going the medication route either.

What worked for me was Gehwohl ingrown toenail fluid. I bought it for an ingrown toenail intending to tackle the fungus once the ingrown nail had been dealt with. Really surprised that it not only softened the ingrown nail enough for me to cut it back into shape but also had the unexpected effect of eradicating the fungus. Still using it once a week to keep nails healthy and soft.

I took terbinafine for my fungal nails, it was the only thing that got rid of it in the end. No liver issues

Following

I was on it for over a year. Had to have regular LFT, sadly it didn’t work for me and the fungal infections remains. I never had any issues on it though.

Sorry to hear that. Why are they so stubborn?!

Speak to your GP and get Potassium Permanganate prescribed, an old remedy but it worked for DH. Yes, it's a traditional old fashioned treatment, but worth a try to avoid the nasty side effects. Sometimes a small hammer works better than a sledge hammer. of modern drugs. Nothing ventured...

Thanks - what are the benefits of that over amoralfine?