Download If prevention doesn`t work, laser treatment best way to clear toenail

Note: This column was originally published in the June/July 2014 edition of Willamette Living
Magazine.
If prevention doesn’t work, laser treatment best way to clear toenail fungus
By Dr. John Murphy
Many people are reluctant to talk about their toenail fungus. Not only is it
unsightly, but it also may be painful. About 40 million Americans suffer
from this condition, medically known as Onychomycosis.
Fungal nails often become thickened, yellowed and crumbly. Unsightly at
the very least – and often progressively painful as the nail thickens. This is
NOT a hygiene problem. We all have normal skin flora of both fungal and
bacterial organisms. Problems develop when the population count goes up,
or our defense system fails.
John Murphy, DPM
Factors that may predispose you to infection are as follows:
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Chronic Athlete’s foot with cross contamination to toenail
Injury to toenail
Warm moist environments where fungus thrives
Contaminated shoes
Elderly, diabetic, and immuno-compromised patients
I emphasize to my patients the importance of an overall care program for skin, toenails and
shoes. You must pay attention to all three to have success in your treatment of the toenail fungus.
Here are my recommendations:
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Use antifungal medication directly on toenail for 8-12 months. Two of my favorites are
Fungoid Tincture and Tineacide. Be patient as toenail growth is slow, thus change comes
slowly.
Apply anti-fungal cream to skin of feet daily.
Spray shoes at end of day with anti-fungal spray or powder.
Change out of moist or sweaty socks; fungus thrives in dark moist environments.
In addition, many nail polishes trap moisture and may contribute to the problem. Use nail polish
that does not contain formaldehyde. Remedy Nails is one example of this type of product. Stay
diligent with your care of skin and shoes even after the nail infection clears. This will help
prevent recurrence.
If the above methods don’t work, I would suggest seeing your provider about medications or
laser treatment.
Prescriptions and Laser Treatment
While I do suggest antifungal medication to my patients, I also have to caution them that the
topical treatments are not very effective as a stand-alone treatment. Topical antifungals have
been effective in only 8 percent of cases because it is difficult for the topical medicine to
penetrate underneath the toe nail where the bacteria are embedded.
Prescription oral antifungal medications, such as Lamisil, have been slightly more effective, but
the pills may interact with other medications and can have side effects.
Laser treatment is by far the most effective method to eliminate toenail fungus. Clinical studies
reveal that it has a 65-85 percent success rate. This technology has proven to be more effective
because the laser can penetrate beneath the toenail, killing the fungus and allowing a new
healthier nail to grow out in six months. However, preventive care must be continued to help
stem reoccurrence.
Laser treatment is painless, safe, requires no anesthesia, and takes place in about a 30-minute
single office visit. Because toenail fungus is very contagious, this procedure requires that all 10
toenails be treated to prevent spreading. The type of laser I have been using since 2009 employs
a near infrared beam that destroys the fungal pathogens.
As with Lasik eye surgery, laser toe nail treatments are not covered by insurance. However, it
can be covered through flexible healthcare savings accounts, and it beats the cost of repeated
topical and oral medications that can become equally expensive.
So, if you can’t avoid toenail fungus, take heart. There are treatments that can return your
toenails to a clear, clean look.
John Murphy, DPM, is a podiatrist at The Corvallis Clinic. He can be reached at 541-754-1276.
If you want more information on toe nail fungus laser treatments, go to
www.corvallisclinic.com/healthblog/toenail-fungus and click Yes, I want to know more about
laser treatments.