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Injuries and Medical Advice

Dr. J Attacks Fungal Toenails

Climbers are prone to toenail fungus because we continually cram our feet into tight, sweaty shoes where it can run amok.

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I have a really bad case of toenail fungus brought on by 30 years of too-tight climbing shoes. Any advice on nuking fungus?

JJ/Carbondale, Colorado

Does your partner pull awaywhen your feet touch in bed? I feel sad for you. You can’t tell someone you have a fungus and expect sympathy. They will cringe
and possibly don some form of latex.

I don’t often see toe fungus in my office, but rather at the crag when a climber is trying to get that crustacean into a shoe.

The most common culprit is a group of fungi known as dermatophytes. Climbers are prone to the disease more so than the normal population because we continually
cram our feet into tight, sweaty shoes where the fungus can run amok. Typically, the nail will thicken and become crusty. It may change color and stink
like the breath of a Balinese dog.

Being the vain society we are, we have an array of tonics and tinctures to return you to the love shack with the lights on.

There are options such as laser therapy for the financially cavalier, or cheaper alternatives such as smearing the toenail with Vicks VapoRub (I shit you
not, it’s proven to be quite effective). Other modalities include medications (with the usual side effects that may kill you), nail paint and aggressive
debridement in combination with all of the above.

Unfortunately, very few people actually recover at all. Not because even the most hippie of treatments—like thyme oil—won’t work, but because
the fungus is as recalcitrant as an African warlord. No matter what treatment you employ, none are quick—six to 12 months is a best-case scenario.

Patients rarely see the program to its end and the fungus, nestled into a defensive anatomical hidey-hole, lives on.

This article was published in Rock and Ice No. 212 (September 2013).