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Fungus Toenails 101

Posted by Michael Connor, DPM on February 27, 2014 ·

Onychomycosis, commonly known as Fungus toenails is one of the most common conditions I treat in my practice. Over the years, there have been many new procedures used to treat this difficult condition, all with varying results. I have had patients tell me they have been cured by using Vicks Vapor rub and Australian Tea Tree Oil only to see they never had a fungal infection at all!

For some of my patients it is strictly a cosmetic problem, while for others it will cause pain and disability resulting in difficulty in walking, infection and in some high-risk patients amputation from ulceration under the toenail.

It may seem obvious, but the first order of business is to confirm the condition is in fact a fungus! I have diagnosed one case of melanoma, which although rare, is possible. There are many other causes of a thickened and discolored nail ranging from excessive smoking, diabetes and poor circulation. Other causes are due to severe hammertoe conditions, trauma and certain activities such as running, downhill skiing and any sport where you are putting excessive pressure on the front of your foot.

A complete history and physical examination are essential to determine if there is a true fungus condition. Tests performed may include a nail biopsy where toenail clippings are sent to a lab for analysis.

If there is a mild fungus condition studies show that treating the fungus with topical medications can be beneficial. If the fungus is more involved, then treatment is more aggressive and can include taking oral medications for three months. Studies have shown that these medications are safe with side effects being very minimal. It can take up to a year to see if a fungus has completely cleared as that is the time it takes for the nail to grow from the base to the top.

An exciting new treatment is laser which is non-painful and usually a one-time treatment. I have used it more in conjunction with other treatments, as no one treatment is 100% successful.

After treating this tough condition for over twenty years I have several tips to help prevent fungus from developing or reoccurring. They include getting rid of older shoes, avoiding barefoot walking, locker rooms and keeping your feet dry. Studies now show that some people are more genetically predisposed to getting a fungal infection and once they have “cured” their fungus toenail they need to be careful not to get reinfected.

To summarize, the sooner you seek treatment, the sooner you will have success in getting rid of this pesky condition.

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