Fungal Toenails

Fungal toenail infections usually don’t cause physical pain. But that doesn’t mean they can’t be extremely distressing and frustrating all the same.

The good news is that treatment for this condition has come a very long way, even in just the last few years! If you’ve been living with the condition for a long time, or even tried antifungal treatments that ultimately failed, there’s a new and much more effective option available: combination therapy using laser technology.

With much better cure rates and greater safety and convenience when compared to traditional oral antifungal treatments, it’s set a new standard—and an option we’re glad to offer to our patients.

But first …

What Are Fungal Toenails?

Fungal toenails are an infection caused by dermatophytes. This is a group of fungi that survive by ingesting a protein called keratin, which is abundant in skin, hair, and nails. (This same group of fungi also cause athlete’s foot, as well as other related skin infections.) If you have a fungal toenail infection, your nail may appear:
  • Thickened
  • Discolored (usually yellowish, brownish, or grayish)
  • Distorted, warped, or ragged in shape
  • Crumbly and brittle
Fungal toenails are usually not painful, but they sometimes lead to ingrown toenails—which very much are. Furthermore, infections can be dangerous for people with diabetes, as well as others with compromised immune systems.

How Did I Get Fungal Nails?

So how did you get in this mess? The short answer is that you came into contact with the fungi, and they found a way under the nail. It doesn’t take a large opening for them to do this—small cuts or separations in the nail you may not even be able to notice is all they need. Some common situations that can lead to fungal toenails include:
  • Having athlete’s foot. This condition is also caused by dermatophyte fungi, and they can easily spread from your foot to your nails (and back again) via your socks and shoes.
  • Going barefoot in public, especially around showers, locker rooms, pool decks, saunas, and other “sweaty” environments.
  • Wearing damp, sweaty shoes and socks.
  • Having dry, brittle nails and/or skin.
  • Simply being an older adult. As we age, toenails grow more slowly and circulation declines, providing more opportunity for fungi to set in.
  • Having conditions that compromise circulation or immune system function, such as diabetes.
  • Getting a pedicure at a spa or salon that does not properly sterilize their tools.

Can I Treat Fungal Toenails on My Own?

Unfortunately, the answer to this question is usually (although not always) no.

The nail offers substantial protection for the fungi underneath, meaning that topical antifungal powders and sprays usually can’t get to the micro-organisms they’re supposed to kill. For home treatments with topical ointments to have any chance of succeeding, you’ll need to thin out the nail at least weekly and apply the antifungal every day. Even then, it may take a year or longer to see results.

You can’t wait out a fungal toenail infection, either. The nail provides an effectively limitless supply of keratin, so fungal toenails will not go away on their own.

The Optimal Treatment Solution: Combination Therapy

In order to give you the absolute highest possible chance of eliminating the fungi and clearing your nails, we often recommend a combination therapy incorporating both laser therapy and oral medications. By attacking the fungi from both the “inside” and “outside” at the same time, truly outstanding results have been achieved.

This includes:

  • Laser therapy sessions. The treatment course usually includes three total monthly sessions, with each session lasting about 20 minutes.
  • “Pulse dosing” oral antifungal medications. We generally recommend that you take the medication for 7 days in a row, one week per month.

The fungal nail laser focuses a beam of light with a very carefully selected set of specifications. Essentially, the beam can pass through your nail and is completely painless and harmless to your body’s healthy cells. However, it is deadly to the types of fungi that cause fungal toenails.

After years of research, testing, and clinical use, no side effects have ever been observed with the laser system. It is safe, painless, and extremely convenient when compared to previous treatment protocols.

At the same time, “pulse dosing” the medication (as opposed to 12 weeks of daily use, as with traditional treatment) is not only a lot more convenient for our patients, but also safer and more comfortable for those who might be sensitive to the drug’s possible side effects.

Are There Other Treatment Options?

While combination therapy is often our top recommendation, it may not be right for everyone. We can provide treatment using laser alone, oral medications alone, or even a program of topical medications (although it takes much greater time and discipline than other methods).

Our goal is always to give you a range of possibilities and help you determine which approach is the most appropriate for your needs.

How Long Until I See Results?

No matter which treatment option you choose, it will take time to achieve full clearing of the nail.

The reason is that, even though you may kill all of the fungus, the damaged toenail they leave behind will still be there, waiting to grow out and be replaced by clear nail.

That said, with laser, most people do begin to see significant, noticeable clearing of their toenails after just one or two treatments. Full results depend on how quickly your toenails grow, although it can take up to a year.

Will the Fungus Stay Away?

An infection, unfortunately, can always return if you are not careful. It will be important to take precautionary, preventative measures after treatment to keep your feet safe. You will want to:

  • Avoid walking barefoot in public places like showers and locker rooms.
  • Rotate pairs of shoes every day, and always change socks and shoes if they become damp.
  • Use antifungal powders and sprays on your feet and in your shoes.
  • Keep your hands and feet clean.
  • Treat any ongoing fungal skin rashes, like athlete’s foot as quickly as possible.
  • Avoid wearing nail polish and artificial nails.
  • Avoid tight or restrictive shoes.

Do these things, and you’ll have a great chance of keeping your fungal toenail infection away for good.

Don’t continue to be embarrassed by unsightly fungal nails. To schedule an appointment with Dr. Foster, please give us a call at (816) 246-4222 today. Or simply fill out our contact form online to have one of our staff members reach out to you.

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