I strongly recommend the dermatologists at Adventist. It’s an easy short ride on the 292 bus for you, too – catch it going east, and get off at the first stop after it turns south on Dunhua, then walk about a block west. Can’t remember his name but one of the dermatologists is a youngish guy.
Ask him about where to get chlorhexidine gluconate solution. It’s a little hard to find here, but there are at least two brands available over-the-counter at the bigger pharmacies (real ones, not the cosmetics shops like Cosmed). 合泰大藥局 the one at about No. 26 Hengyang Road, about two blocks from 228 Peace Park, carries it. Wash your feet with the stuff, then apply a regular antifungal ointment over it. Their phone number is 02-2389-9977. (Note: this isn’t Shanghai Union Pharmacy, it’s the one a couple of doors down from it. Inexplicably, Shanghai Union doesn’t carry the stuff.)
The thing is that not do I not have NHI but I do not have resident certificate either. According to Adventist it would be quite expensive
If you were not a citizen of the Republic of China (Taiwan), or a foreigner without the resident certificate , your medical bill will be charged as the standard fee schedule in the International Priority Care Center (IPCC).
How do I ensure that a small local clinic will actually be qualified and be able to do proper assessment and recommendations? I am very afraid of getting a doctor that would push TMC, getting scammed, and worse getting the wrong treatment which would make things worse.
Would it be possible to get a Dermatology clinic recommended by anyone here?
I think this is a valid concern, and it’s one of the other reasons I avoid clinics - there are too many options and I’ve noticed a higher tendency to overprescribe. One of the advantages of TMUH is that you can see what most of the doctors specialize in (in English). Most other hospitals don’t have this (NTUH used to, but their English website seems to have gone to shit about 2 years ago, not that it was too great to start with).
I don’t think TCM is much of an issue in hospitals here unless you specifically go to the TCM department (which most hospitals have). A lot of doctors have trained in the west and prescribe (or overprescribe) Western medicines. Getting “scammed” shouldn’t be either, with the possible exception of being charged more at local clinics when you don’t have NHI as I mentioned above. But at hospitals, no.
I wouldn’t worry too much about getting the wrong treatment or choosing the wrong doctor - it’s just athlete’s foot, not a brain tumor. You don’t need the best dermatologist in Taiwan - just a vaguely competent one who’s going to prescribe you an antifungal cream or tablet and charge you NT$500-600.
Another reason to choose a hospital over a clinic is that I think clinics are limited to prescribing 3 days of medicine (might be more lax with a cream, though), whereas hospitals can do 30 days of medication without NHI (or at least that’s what I was told by a neurologist - I believe the limit is higher for NHI patients).
And on the off chance you get a dermatologist who’s never seen a foot before and recommends amputation, just go see another one - it’s only a few hundred TWD.
The Topidin and terbinafine will be about $250 for two week’s worth. The clinic/hospital will only give you a week’s worth for that. Even with NHI, it’s often cheaper to just buy what you need yourself.
Is it standard nowadays to take a systemic antifungal for a topical infection like athlete’s foot? I was surprised by this suggestion - seems a bit extreme for a first treatment option.
I don’t doubt that it would work, I’d just be concerned about it disrupting the normal microflora and resistance etc. (which is one reason why topical medicines are usually preferred as a first option where possible, as opposed to dosing the entire body to kill something on the foot).
No, it absolutely isn’t. Even aside from the potential liver and kidney damage, development of resistant strains is an even worse problem with fungi than it is with bacteria, and there are a lot fewer classes of antifungals than antibiotics, and they’re a lot harder to develop.
No problems here. Liver and kidneys in top working order and I never got athlete’s foot again.
Just be careful with topidin on the foreskin. It will soften the skin enough that it can rip a bit during sex. It takes a couple of weeks to toughen back up if you use it more than a few days.
I want to clarify because there is a lot of posts regarding just do self-treatment. I have been washing my feet two times per day and applying cream containing clotrimazole (From Canesten) two times per day also. I am working from home so I do not need to walk around with socks and shoes (I also mop the floor every second day to ensure that it is clean and not to re infect). The wound has continue to spread and I am also getting worried that my mild diabetic issues might have made the situation worse. I can barely stand on my fee anymore due to the multiple small cracks that hurt like a hell and my feet at its wounded area is mostly dark red. The only option I have left is to ensure that I am treating it right by getting a doctor to evaluate the situation because I am truly getting afraid that it might evolve into permanent damage. However, since I do not have a NHI or ARC I have been reluctant to go but I think I do not have much options left.
In this case with the diabetic issues as well, I really think a hospital would be your best bet - they have the resources to do microbial cultures if necessary (I guess cellulitis or something might be a concern?). Plus endocrinologists if you want to check anything about the diabetes.
The lack of NHI/ARC shouldn’t be an issue. Good luck getting it sorted!
Clinics are good for most stuff. However, if OP has had the problem for a month, he should go to a hospital where they can prescribe stronger stuff…and more of it.
I’d recommend going to Zhongshiao Hospital -halfway between Zhongshiao Fuxing and Zhongshiao Tunghua- or any other city government hospital, like Renai. Those are cheaper.
Taipei City Hospital Renai
02 2709 3600
And yes, the cost is really not an issue. A Japanese friend broke a molar here in Taiwan. Took her to my dentist. He spent like half an hour with her. I asked the secretary if they took credit cards. They had a good laugh about it. To make the long story short, it was 600 ntd out of pocket, with a bag of medicines, and they took a long time because he spoke Japanese and got along.
