Nail Fungus

Are your toenails becoming discolored? Are they becoming thickened? You may have toenail fungus.

Medically, this condition is known as onychomycosis (ah nee ko my cose is).

Toenail Fungus Causes

Toenail Fungus occurs when a fungus gets under a nail and begins to grow. It can develop following trauma to a toe. Exposure to the fungus could occur at a swimming pool or in a locker room. Fungi grow best in dark, warm, moist conditions so the environment inside shoes is often ideal for fungus growth.

For some individuals, there is a hereditary predisposition to developing nail fungus. If you have diabetes, you are more likely to have this problem. Some people with nail fungus complain of pain because the thickened nails press against the toe box of their shoes. Also, ingrown nails are more likely if you have a nail fungus. For some people, there is no pain, but they find the presence of the fungus unsettling. Many people with toenail fungus also have a chronic athlete’s foot infection as well.

Toenail Fungus Treatments

Once you develop a toenail fungus, it tends to spread from the tip of the nail to the base of the nail and also to your other toes. Is there a solution to this unsightly problem? Fortunately, there are treatments available that often eliminate this problem entirely.

Oral Medications — Taking anti-fungal medication by mouth is the most effective treatment currently available. The medication enters the nail through the growth plate at the base of each nail. As new nail grows, the old infected nail is trimmed away at the tip of the toe. The medication is usually taken for a few months. However, it can take up to one year for new, uninfected nail to grow in place of the old infected nail. Oral medications are effective approximately 65-70% of the time. You cannot take these medications if you have any problems with your liver. Before beginning treatment, a blood test needs to be done to make certain your liver is healthy. During the course of the treatment, Dr Helms or Dr Bowers will see you in the office periodically to assess your response and adjust the treatment if needed.
Topical Medications — Many topical medications are available to treat nail fungus. Unfortunately, the fungus lives inside and underneath the nail and it is very difficult for a topical medication to penetrate the nail and kill the fungus. The most effective topical agents are those that utilize an agent that helps the medicine penetrate the nail. The medications are applied daily and the top of the nail must be filed down frequently. One year of treatment leads to success rates of less than 50%. However, for individuals who cannot take the oral medication, this is often a good alternative.
Nail Removal — Another option is the removal of the entire nail. This allows for complete removal of the area of infection. This can be very effective if only one or two nails are involved. There is very little recovery time required and all normal activities can usually be resumed the next day. Drawbacks include the potential for the nail to regrow a little thicker than normal or for an ingrown nail to occur as the nail regrows. If a nail has become deformed from nail fungus, a permanent removal of the nail is often the best solution. Following a permanent nail removal, new skin grows where the nail used to be.
Laser Treatment — A new treatment holds promise for eliminating nail fungus. Studies are underway using lasers to kill the infection. Initial reports indicate this treatment is effective close to 80% of the time. We are following this closely and will make this treatment available to our patients once we are convinced it is effective and it is approved by the FDA.

We Can Help

If you think you have toenail fungus, please give our office a call. Dr Helms or Dr Bowers will help you decide on the best treatment for you.