Toenail Fungus (Onychomycosis)

Watch the video above to learn about Toenail Fungus (Onychomycosis), and how I approach treating this with my patients. There's also more information below. As always, when you're ready, fill out the form on this page to request a consultation.
Dr. Stewart can do everything and anything, including my toenail fungus. — Nick
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Onychomycosis is the term used to describe fungal infection of the toenails. There are 4 commonly described types of toenail fungus including distal subungual, proximal subungual, white superficial, and Candidal.

Symptoms

  1. Yellow nails
  2. Thickened nails
  3. Misshapen or dystrophic nails
  4. Whitening or scaling of the nails
  5. Brittle nails
  6. Hard nails that are especially difficult to cut
  7. Painful nails
  8. In certain circumstances, fungal nails can cause infection of the underlying nail bed and this is characterized by redness, swelling, pain, warmth, drainage, odor, bleeding, and loss of function
  9. Fungal nails can also cause ingrown nails characterized by pain along the border of the toenail

Diagnosis

Diagnosis is typically made by clinical exam of the nails by Dr. Stewart. Diagnostic studies including KOH, PAS stain, and fungal cultures are frequently utilized to confirm the diagnosis.  Click here to make an appointment

Treatment

  1. Lasers utilize heat energy to destroy the fungus embedded in the nail and are approximately 85-90% effective in treating toenail fungus. There are no known side-effects of lasers and there are no known contra-indications to treatment
  2. Most topical medications are approximately 10% effective in treating toenail fungus. Dr. Stewart describes these medications as management tools to control the fungal load and to make the nails easier to cut
  3. Lamisil (Terbinafine) is an oral mediction used to treat toenail fungus. It is approximately 50-70% effective and it is taken over the course of 3 months. Patients undergo blood tests to test for liver dysfunction as this is a possible side effect of the medication. The medication is contra-indicated with certain medical conditions and cannot be taken in conjunction with certain medications
  4. Nail debridement (reduction in thickness and length) performed by Dr. Stewart is recommended for painful and thickened toenails. Patients should not attempt to cut thickened or hard nails on their own without professional assistance or guidance to prevent injury and infection to the toenail and surrounding tissue
  5. Patients treated with laser or Lamisil should be started on anti-fungal creams indefinitely to prevent recurrence of the toenail fungus in the event of a cure

Laser therapy to remove toenail fungus? It really works and it’s worth every penny! – Terri Weller

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