Common Disorders
Fungal Toenails, Yellowed or Deformed Toenails
The most common cause of yellowed, thick and /or deformed toenails is a fungal infection of the toenail. The fungus that infects the nail, most commonly, is the same fungus that causes athletes foot. It tends to be slowly progressive, damaging the nail to a greater and greater degree over time. The infection usually starts at the tip of the nail and works its way back. It usually is not painful and often not noticed until it has gotten well established. A single toenail or any number of nails can be affected. It can also occur on just one foot. Over time, the nail becomes thickened, crumbly, and distorted in appearance. Sweaty feet contribute to the initial infection process and contribute to its spread. The fungus prefers an environment that is moist, dark, and warm, which is why it affects the toenails much more often than fingernails. It does not spread through the blood stream. The infection limits itself to the nails and skin. It is often found in association with areas of dry scaly skin on the bottom of the foot or between the toes. The dry scaling skin is frequently found to be chronic athletes' foot. It is not highly contagious, and family members are almost as likely to contract it from some other source as they are from the family member who has the infection. Keeping common showering areas clean is recommended, and sharing shoes should be avoided.
Diagnosis
Not all thicken or yellowed toenails are caused by a fungal infection. Injury to a toenail can cause the toenail to grow in a thickened or malformed fashion. This can be due to an established fungal infection or may be due to the damage caused to the nail root when it was injured. In these instances, treatment with anti-fungal medications will not correct the malformed nail. Other causes of thickened toenails are small bone spurs that can form under the toenail and psoriasis. Taking a scraping of the toenail and culturing it makes the diagnosis.
Treatment
It is best to treat the condition as soon as it is noticed. In early cases, over the counter medications may be sufficient. It is also important to treat any concomitant athlete’s foot that may be present. In more advanced cases, a prescription medication may be needed. There are effective topical and oral medications available for the treatment of fungal toenails. If sweating feet are a problem, changing shoes and socks during the day is recommended. There are some topical medications available that help to reduce the sweating of the feet. On occasion, your doctor may recommend removing the toenail.
Laser Nail Treatment for Fungal Nails
The FootLaser is a major leap forward in medical technology, providing the safest and most cost effective treatment of toenail fungus (onychomycosis).
This breakthrough procedure offers patients successful results with a single treatment, no down time and no oral medication.
HOW DOES IT WORK?
The Laser kills fungus that lives in and under the nail. A laser passes through the nail without damaging it or the surrounding skin. Although the existing nail will not become clear immediately upon treatment, the new nail growth will appear normal, as the fungus will no longer be present.
HOW SUCCESSFUL IS THE TREATMENT?
Clinical studies which began in November 2007 have demonstrated a success rate of 88%. These studies also report no adverse effects or injuries associated with this treatment.
 HOW MANY TREATMENTS ARE REQUIRED?
Typically, the patient requires one treatment only.
IS THE PROCEDURE PAINFUL?
Intermittently, patients may experience a sensation of heat or a pin prick. The level of discomfort is not so significant as to require local anesthetic.
IS THERE A RECOVERY PERIOD?
One of the advantages of this breakthrough procedure is that there is no down time. Patients walk in, walk out, and have no physical limitations following treatment.
HOW LONG DOES THE PROCEDURE TAKE?
The laser procedure usually takes approximately 30 minutes.
CAN THE FUNGUS GROW BACK?
The fungus is killed after one treatment; however, as this fungus is commonly found in one's environment, the doctor will strongly recommend post-procedure care that will greatly reduce the possibility of reinfection.
 CAN I USE NAIL POLISH AFTER THE PROCEDURE?
Polish can be applied 4 weeks following treatment. It is important to remove all polish and nail decoration the day prior to treatment.
IS THIS COVERED BY MY INSURANCE?
Insurance plans consider this procedure aesthetic/cosmetic and therefore do not provide coverage. If you have a Health Savings Account, Medical IRA or other Flexible Medical Spending Accounts, you can pay for the procedure with these funds. Otherwise, payment can be made with cash, credit, debit card or Credit Care.
HOW MUCH DOES THE PROCEDURE COST?
The treatment typically costs about $1200. This cost is comparable to that of taking oral anti-fungal agents for 6 months along with liver function tests which are indicated with these medications.
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