South Florida Sun-Sentinel (Sunday)
Thick, hard toenails often caused by fungal infection
Q: The nails on my big toes are so thick even large nail cutters do not open wide enough to trim them.
I’ve tried vinegar or smearing on Vicks VapoRub with the hope that they would soften the nails enough to file them. Neither worked. What can you suggest?
A: Thick, hard toenails are often caused by an underlying fungal infection. There are lots of remedies, both prescription and over the counter, but they can take many months to work. The same is true for remedies such as amber Listerine and vinegar soaks, or applications of Vicks VapoRub.
Once the fungus is eradicated, you may need to use a foot bath to soften nails enough to trim them. An hour or two of soaking may be required.
If all else fails, a podiatrist can trim nails and offer other nail fungus treatments.
Q: What can you tell me about Voltaren Gel? I know that people can now buy this pain reliever without a prescription for joint pain. My dermatologist says it can also treat precancerous actinic keratoses that result from too much sun exposure. Why don’t people know about this?
A: Topical diclofenac (Voltaren Arthritis Pain Gel) was approved for over-the-counter use a year ago. The Food and Drug Administration considers it appropriate for relieving osteoarthritis pain in joints such as knees and hands (but not for spine, hips or shoulders).
We were intrigued by your dermatologist’s statement. Actinic keratoses are rough patches on the skin that are considered premalignant. These cells differ from normal skin.
A German study found that three months of treatment with diclofenac and hyaluronic acid (Solaraze) normalized metabolism and improved immune response (Frontiers in Oncology, July 3, 2019). However, the study treatment contained 3% diclofenac rather than the 1% available in over-thecounter Voltaren Arthritis Pain Gel.
Q: Help me! I can’t eat bananas, pineapple (unless it’s in a jar with its own juice), grapes, oranges, and watermelon just to name a few. My throat swells and itches extremely badly when I eat any fruit, except for pomegranate. That’s one fruit I can eat and not have one single symptom from it. I have to carry an EpiPen around with me just in case. What is it that I’m allergic to, exactly?
A: Doctors sometimes
refer to your condition as “oral allergy syndrome” or OAS for short. Many fruits contain proteins similar to plant pollens that can trigger severe allergic reactions.
OAS can start as an itch in the mouth or a little tingle on the tongue or in the throat. The reaction can progress to life-threatening breathing problems.
Foods that can trigger oral allergy syndrome include berries, banana, watermelon, honeydew, apple, apricot, kiwi, orange, peach, pear, plum, grapes, mango and pineapple. Cooking or processing such foods can break down the proteins that cause the reaction. That may explain why canned pineapple does not trigger your allergy.
You are wise to carry an epinephrine injector with you at all times. You never know when some food you eat could contain a protein that might trigger a severe allergic reaction.