Fungal Toenails

Fungal toenail infections can be extremely embarrassing and distressing, especially for those who like to relax by the pool or wear their sandals in the summer. The thick, yellow, even warped nails aren’t exactly easy to hide.

But despite the embarrassment, fungal nails are also a lot more common than you might think. In fact, it’s estimated that about 10 percent of all adults have at least one.

And thanks to recent advances in treatment—namely laser treatments—this pesky condition is safer and easier to treat than ever.

More on that in a bit. First, let’s talk about the condition itself.

What Are Fungal Toenails?

Fungal toenails are an infection caused by dermatophytes, 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.

Common symptoms of fungal toenail infections include nails that appear thickened, discolored, distorted, crumbly, brittle, or ragged. If the nail is especially warped, it can also start to cause painful ingrown toenails.

Fungal toenails are usually not painful, but infections can be dangerous for people with diabetes, as well as others with compromised immune systems. They can also spread to other toes, other parts of your body (where they could cause skin rashes), and even other people.

How Did Fungi Get Under My Nail?

So how did you get in this mess?

Fungal toenails are a relatively common complication of ingrown toenails, but it doesn’t take an opening nearly that large for the fungi to sneak under the nail.

The fungi might enter the space under your nail via a small gap or cut—sometimes too small for you to even notice. And once they are there, they won’t go away on their own. The nail provides an essentially infinite supply of keratin, as well as protection against most topical medications.

If you already have athlete’s foot, your risk of developing a fungal toenail infection is much higher. However, you can also pick up an infection from other sources. In particular, exposing your feet to hot, wet, and/or dark environments where the fungi are likely to congregate put your feet at risk. Common factors include:

  • Going barefoot in public, especially showers, locker rooms, pool decks, saunas, and other “sweaty” environments.
  • Wearing damp, sweaty shoes and socks.
  • Having dry, brittle nails and/or skin.
  • Already having a fungal infection (such as athlete’s foot or ringworm)
  • 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.

How Do I Get Rid of Fungal Toenails?

There are a couple of methods we can employ to get rid of your fungal toenails, although the best option by far for most patients is laser therapy. Dr. Joel D. Foster, DPM is proud to offer this exciting, FDA-approved therapy to his patients.

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 with previous treatment protocols.

One session with the laser can typically be completed in less than 30 minutes, though this depends on how many toes need treatment, as well as the severity of the infection. On average, 3 total sessions are required, although some people may require an extra session.

Besides laser therapy, more traditional methods may be considered:

  • Oral antifungals. This was the “tried-and-true” treatment method before laser therapy came along. You’ll need to take a daily pill for about 12 weeks. Cure rates are respectable (60 to 80 percent) though not as high as laser. A small percentage of people can develop serious side effects, including liver damage.
  • Topical medications. Topicals are the overall least effective option, due to the long treatment time (up to 1 year or longer) and need to thin the nail on a weekly basis. However, they can be effective—if you are patient and disciplined!

Combination Therapy from Dr. Foster

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 as directed. As stated above, 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.

“Pulse dosing” the medication 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.

That said, 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 the 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

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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