Fungal Toenails

Yellow toenails, thick toenails and discolored toenails all point to the same thing – fungus. It’s an embarrassing condition, but it’s also pretty common.  We urge patients to give us a call at the first sign of a fungal infection, because it can lead to permanent damage and can spread to other parts of the body if left untreated.  If you didn’t call at the first sign and it progressed, don’t be embarrassed – I promise that we’ve seen worse!

The risk factors for fungal toenails are actually behavioral. Most types of fungus — whether it’s growing on your lawn, your food or your foot – thrive in moist environments.  So if you spend a lot of time at public pools, at the gym or showering at the fitness center, there’s a good chance you will get one of these delightful little fungi at some point. Or if you sweat a lot. Or wear air-tight shoes, which trap moisture. Or especially if you sweat a lot and wear air-tight shoes.  Foot fungi love that!

Fungal infections can also result from pedicures if the utensils are not properly sterilized.

The symptoms are fairly easy to recognize, with the most obvious sign being discoloration that starts as a yellowish or white spot just under the tip of the nail and darkens as it progresses throughout the nail. Other symptoms include nails that are thickened, brittle, distorted, crumbling at the edges or detached.

We can often diagnose the problem usually just by the appearance, but it will take testing a piece of the nail to pinpoint the exact type of fungal infection.  So we may have to lightly scrape or clip the nail for testing.

The treatment will depend on the type and severity of the infection. Options for treatment include prescribing an anti-fungal medication, which help your toe grow a new healthy nail; applying topical medications; or using an antifungal lacquer, a type of nail polish that can clear up fungal infections.  Please bring a list of other medications you are on to your appointment, as some antifungals used to treat this condition should not be used if you’re on certain types of medications.

A new treatment option that we have recently implemented is using a medical grade laser to provide clearing of the nails. This new option is virtually painless and does not carry the risks involved with taking the oral antifungal medications. The laser that Dr. Futch uses is one of the only lasers that is FDA approved for treating fungal toenails. Although as with the oral antifungals the results are not instantaneous, the long-term outcomes are quite remarkable.

Over-the-counter creams do not eliminate most fungal infections, so we recommend you come in for an appointment rather than trying to treat this condition yourself. It typically won’t go away, and it’s likely to return and spread to other toes and maybe even other body parts if left untreated.

In more advanced or persistent cases, we might need to remove the nail, but only as a last resort. We’ll use a local anesthetic so you won’t feel any pain, and a new toenail will most likely grow in its place.  Either way, no toenail is better than a painful toenail.

Fungal toenails can be a more serious condition for patients with diabetes or immune disorders. Call us right away if you have one of these conditions and a fungal toenail.