Many of my patients ask me how they got toenail fungus and I tell them “there’s a fungus among us!” By that I mean it’s everywhere in our environment. Common sources of infection include swimming pools, public showers, gyms, and nail spas; however, you can even get from traveling barefoot at a hotel, and sharing nail clippers, nail files, or nail polish. It’s not only found in public places, it can be lurking in your home too. When a patient with toenail fungus tells me they walk around the house in bare feet, I tell them, “no shoes, no socks, no way!” Toenail fungus is very contagious and they can put their significant other, or family members, at risk if the proper precautions are not taken. Who wants that? Once the little yellow fungus monsters (Dermatophytes) invade the nail bed, they want to stay for life! In the majority of cases, toenail fungus is rarely cured; it’s managed.
Anyone who has this condition wishes there was a fast remedy, but there is no quick fix with conventional remedies like over-the-counter topical creams, prescription lacquers, or oral medications. Each of these remedies is a long, tedious process that works less than half the time. Buyers beware because many ads are misleading. Efficacy rates are not always accurate, risks are sometimes understated, and treatment costs can be high.
Laser technology has helped millions of people pitch their glasses. Now, breakthrough laser treatments for toenail fungus are allowing people to pitch their socks for open-toe shoes and sandals, and to go barefoot without embarrassment. Treatment is not a cure for everyone but podiatrists across the country are having outstanding success.
There are a variety of lasers on the market to treat toenail fungus. Some are FDA approved, others are not. They function in a similar manner but have different energy strengths, pulse durations, spot sizes, and treatment parameters. Tiny pulses of laser energy are applied to the toenail and surrounding tissue to eradicate the fungus. Treatments are relatively pain-free. Patients feel a mild pinch as the toenail heats up with a warm sensation that dissipates within seconds when the laser is applied to the next toe. Pain injections are not administered and, in the majority of cases, medications are not necessary or prescribed. Consequently, there are no risks or side effects. Other therapies are sometimes used in conjunction with laser treatment such as topical fungal creams, vitamins, nail soaking products, and ultraviolet shoe sterilizers. Depending on the type of laser used, the numbers of treatments range from one to three and treatment times vary between 15 to 60 minutes. Treatment intervals are usually scheduled four to eight weeks apart. Patients are able to return to work or resume normal activity immediately following treatment, and can continue to have pedicures afterward. Patients must be compliant while the new nail clears and often apply antifungal cream for a year.
Follow-up care or maintenance is sometimes required depending on the severity of the condition. Treatments are shown to be between 60 to 80 percent effective. The new nail begins to clear within three months but can take as long as one year to become fully visible.