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Fungal Nail Treatment

What is Toenail Fungus?

Fungus that lives in our everyday environment can sometimes infect the nail, causing changes to nail color, thickness, and texture. Toenail fungus is common in all ages and may be the result of previous trauma to the nail. It is also often associated with fungal infection of the skin (athlete's foot). The clinical term for fungal infection of the nail is onychomycosis. Tinea pedis is fungal infection of the skin of the feet.

Severe toenail fungus can be painful and cause long-lasting or permanent damage to the nails. If you are immunosuppressed, it can increase your risk of bacterial infection or other more complicated issues. Toenail fungus spreads easily so it is important to treat it as early as possible.


Symptoms of toenail fungus

  • Yellow, white, or brown discoloration

  • Thickening of the nail - may be difficult to cut

  • Brittle or crumbly with increased breakage

  • Lifting of the nail with debris or new nail forming underneath

  • Change in shape or increase in ingrowns

Risk Factors for Toenail Fungus

  • Advanced age

  • Sweating heavily - especially when wearing non-breathable footwear

  • History of athlete's foot

  • Walking barefoot in communal spaces

  • Diabetes

  • Any condition that compromises the immune system

Diagnosis and Treatment

​Although fungal nails are often easily identified during an exam, a piece of nail may be sent for biopsy for confirmation. This also allows for identification of the type of fungus infecting the nail.

Once fungal infection is confirmed, there are several treatment options. Unfortunately, fungal toenails can be very challenging to treat and there is no one perfect method. 

Treatment options include:

  • Topical nail polishes and creams - These products are available both over the counter and by prescription. They need to be applied daily for several months.

  • Oral antifungal medication - Oral medication will work faster than topicals however there are possible side effects. Labs are performed at the beginning and during treatment to ensure no negative changes. The typical prescription is one pill daily for 90 days.

  • Laser treatment - Laser treatment can be very effective for some patients, especially with multiple sessions. It is quick, usually painless, and has no side effects. However it is not covered by most insurance plans.

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