The Struggle for Beautiful Toenails: A Research Project
Stephanie Specht
ENG 102
Ryan Jones
12/21/2014
Stephanie Specht
ENG 102
Ryan Jones
12/21/2014
The Struggle for Beautiful Toenails
Fungal nails, or onychomycosis, is a growing epidemic with many ways to treat and hopefully cure this disease. Onychomycosis is the cause of 50% of nail problems (British 1). Nails are thickened, painful, and yellow. Patients are unable to trim these nails at home with over the counter nail clippers. Nail salons will turn down patients whose nails have fungal infection or will not be able to properly trim them down leading to other nail problems, such as ingrown toenails. Nails fall apart easily because the fungus breaks down quickly. Onychomycosis is a common disease, and although many people don't focus on it or have not complained about it, one doctor says 70% of the patient's coming in to his office has fungal infections. (Washington Post). Treatments are difficult as most treatments treat the cosmetic portion of the fungus and not the actual problem, which leads to the growth of the fungus reoccurring.
There are many ways to treat fungal nails but none more effective and less harmful than laser fungal therapy. The first option to treat fungus is by topical medication. Topical fungicides have a low success rate. They have to be applied twice daily for an entire year, which causes patient's to become non-compliant. Most topical treatments are over the counter, and therefore insurance does not pay for them and they are paid for in cash by patients. Fungus can be treated by oral medication as well. Oral medication has proven to be harmful to the liver. Many patients forget to take the pill daily. Lastly, fungus can be treated b laser fungal therapy. Laser therapy has the highest success rate. Laser therapy has the least side effects. Patients have no choice but to be compliant because they go in to the doctor office and have the procedure done and there is no continued daily care.
Topical medication like Penlac and Formula 3 have a low success rate in getting rid of fungus completely. Penlac is said to have less than 12% success in treating fungus. Patients are non-compliant due to having to paint this on twice daily every day for an entire year. Patients get discouraged when the fungus does not disappear immediately.
"Due to the lack of comparative studies with Ciclopirox (Penlac, CNL-8) for the treatment of onychomycosis, it is difficult to measure its effectiveness versus other indicated products. An oral antifungal, if tolerated, may lead to higher success rates in the treatment of onychomycosis." (Oregon 13)
Oral medication has a better success rate than topical; however, it does have some nasty side effects. There has been an increased amount of liver failure in patients who take anti-fungal medications such as Lamisil, also known as Terbinafine. Patients become non-compliant over time when they either forget to take the pill or choose to skip a day. Patients are required to get liver function panel testing done every two months while on the medication. These tests can be costly for those patients without insurance and the oral medication can be costly as well. Patients are frightened and less likely to take a medication if it requires blood work to be done first. Typically the longest you can take this medication is a few months, however, Lamisil requires 12 months in order to get rid of the fungus.
Laser fungal therapy has proven to be a very successful treatment for fungal nails. Laser therapy was given a 90-95% success rate at a podiatry office in Washington State. Laser therapy is virtually painless with the only complaint of getting too warm. The laser treats the fungal nail and as the laser beams are going across the toenail it will get warm, when this happens the aesthetician moves on to the next toenail as to not create discomfort for the patient. Warmth is the least of patient's worries when compared to lived damage. The laser is done in a matter of a few minutes and there are no side effects or daily treatment. Most offices require the patient to come back into the office and have it done once monthly for three months and then the fungus will easily disappear. List most treatments it does take 12 months for a new nail to fully grow so patients will notice a growth of new nail but the nail will not be completely fungal free for 12 months. Unfortunately there are not many public trials of the use of the laser therapy machine yet, but the studies that have been conducted are said to be "promising and optimistic," (MedicineNet)
There are many treatment options for fungal nails, although the most successful and likeable option is laser fungal therapy. More offices should use this because it is a good source of money. Insurances do not cover laser therapy so patients will be cash pay, which is a lot of money going straight to the doctor. With other forms of therapy such as topical and oral, patients are paying money to pharmacies, which could be going to the office. Patients are willing to pay more money for a higher success rate of treatment and something with little to no side effects. Patients are happy because they do not have pain and do not have to do daily treatment. Patient's compliance is increased. Patients are happy with a painless, side effect free procedure. Patient's can visually see a difference after one treatment, as compared to other types of treatments where they would have to wait several months. Overall, it comes down to quality treatment. Patients want quality, successful treatment and doctors should want that for their patients.
Insurances do not cover... It might be clearer to say 'Insurance policies do not.."
But that is nitpicking; I don't see much room for improvement, because this whole essay is so well-written and well-structured!
I checked a few times to see if you just pasted this from an online article. I mean that as a compliment! It is so professionally and clearly explained. Example: I like your decision to use the word 'nasty', because it makes this so much more interesting.
Well, what can I possibly suggest...? I guess I would like to suggest that, if this is a proposal for a research project, you should spend some time to propose what you suggest doing. Is this simply a piece of expository writing to explain the topic? If so, it is great as it is. But if the purpose is to suggest a research project, then it's great to explain what research method you would like to use and what benefits can be enjoyed as a result of answering the research question.
: )
