Nail fungus (onychomycosis) is a common nail infection that causes toenails to yellow or discolour. As the infection advances, nails become thick, brittle and separate from the nailbed. Nails may become painful.
While it can be difficult and a long-term goal, we can successfully treat nail fungus using a range of treatment options at our Melbourne clinic.
Toenail fungus treatment options
- Topical toenail fungus treatments
- Oral antifungal medications
- Laser toenail fungus treatment, using the PIQO 4, a Nd:YAG 1064nm laser, that has been cleared by the FDA to be both a safe and effective method of toenail fungus treatment
Contact us to arrange a consultation with one of our cosmetic dermatology specialists to discuss your toenail fungus treatments.
How we treat toenail fungus
There are many fungal strains that affect the toenails and nailbed. Nail fungal infections can be difficult to treat, even with the most effective treatments. Antifungal medications are used either topically or orally (or both), while also treating the affected nails with lasers.
The laser heats up the nail and the surrounding skin where the fungus is embedded, though this doesn’t cause pain. Multiple treatments are required depending on how the fungus has spread. Between treatments, topical antifungal ointment is applied at home.
For more extensive infections, we use the Deep FX laser. The laser applies thermal energy through the nail and nailbed so the topical solutions are able to penetrate the affected area. The Deep FX treatment is performed by Dr Rich, as it is a specialist laser that requires care in its application.
Contact us to arrange a consultation with one of our cosmetic dermatology specialists at our Melbourne clinic to discuss your toenail fungus treatments.
Laser toenail fungus removal
We often use the laser for toenail fungus removal because it’s very effective. Laser treatments for toenail fungus takes about 30 minutes, but several sessions are required, usually at four-weekly intervals.
We tend to see results within 6-12 months, as nails grow very slowly. Clear, uninfected nail will start to appear gradually. During laser toenail fungus removal treatments, you can expect a warm sensation on your toes, but no pain. Most people experience at least some improvement in their toenail fungus after laser treatments, but ongoing care at home is also important.
About fingernail and toenail fungus
All nail fungus starts to appear as a white or yellow smudge under a nail – toenails or fingernails. The same fungus that causes tinea (athlete’s foot) between toes can also cause nail infections, but tinea is not the only culprit – toenail fungus can be any fungus or mould. Fungus seeps deep into the nail bed, causing nails to change colour or become crumbly or brittle. Nail fungus may only affect one nail, or it might affect many. It doesn’t usually affect all nails on a hand or foot.
Mild fungal infections may not require treatment, but anyone with thick, brittle, discoloured nails requires treatment. Nail fungus is hardy, so seeking treatment early and using self-care at home is important.
Symptoms of nail fungus
- Thickening nails
- Crumbling, brittle nails
- Nails change shape and become irregular and distorted
- Nail is dull without shine
- Nails become discoloured
- Infection may cause nails to separate from the nailbed (onycholysis)
- Nails may smell
- Nails may be painful
About fungus that causes infections in nails
Fungi live without light and enjoy warm, moist environments. Fungi love shower floors, which is why flip flops are recommended in public showers.
Fungi can enter your skin via any small opening, including the tiniest of gaps between the toenail and nailbed. If your hands are often wet and warm there is no die-off period, so the fungi multiply without hindrance.
Toenail fungus versus fingernail fungus
We see more toenail fungus than fingernail fungus for several reasons. The main factor is that feet are constantly wrapped up in dark socks and shoes, and are often sweaty. Your immune system doesn’t have access to the crevices in our toenails, so it’s harder for the body to fight fungus.
Why do some people get toenail fungus more than others?
There are a few factors we know that increase the risk of toenail fungus. One important factor is decreased blood flow, which occurs as we age. Nails also grow slower and fungus has a longer brewing time. Sweat can also contribute since it keeps your feet damp.
If you work in a humid environment with your hands in water frequently (bartending, cleaning), or wear socks that don’t breathe or wick away moisture, you’re also at risk.
Being around other people with nail fungus increases your risk of contracting nail fungus. We know that people with a family history of nail fungus are more likely to have it, which is proximity to other family members with nail fungus. Wet communal areas harbour fungi, like swimming pools, change rooms and gyms, but the family shower can also be a breeding ground.
If you already have tinea, athlete’s foot, or toenail fungus, you are more likely to see the infection spread to the nail bed. Psoriasis can also increase the risks of developing toenail fungus, along with diabetes, poor circulation and poor immunity. We see more toenail fungus in children with Down’s syndrome.
Toenail fungus treatments – pharmacy treatments
Pharmacies often advertising toenail fungus treatments. You see those huge posters of infected toenails in the windows. Pharmacy treatments are usually the first port of call for consumers, but they don’t necessarily do the trick.
Prescription drugs and laser treatments are the next, more advanced option.
Toenail fungus treatments – medication
You may start you off with oral antifungal drugs. The new nail can grow free from infection, which over time grows in place of the infected nail. The treatment doesn’t appear to be working for at least 6-12 months, as the nail grows out. You take the antifungal medication for a few months and then wait and see.
People over age 65 don’t tend to respond as well to antifungal medication, but we often combine treatments to knock the infection out. There may be side-effects from antifungal drugs, such as a rash or liver issues, so we do regular blood tests. Some people can’t take antifungals.
Toenail fungus treatments – medicated nail polish
There is a nail polish treatment, ciclopirox (Penlac) painted onto infected nails and surrounding skin each day for a week. The polish is rubbed off with alcohol and the process starts again, potentially for a year.
Toenail fungus treatments – medicated nail cream
Antifungal cream may be prescribed, rubbed into the nail and nailbed after soaking in water to enhance penetration of the cream.
Toenail fungus treatments – surgical removal of the nail
In some cases, nail infections may very deep and painful, requiring removal of the entire nail. Once the infection is treated, the new nail can grow unimpeded and uninfected. Medication topically or orally may be used in conjunction with surgical removal of the nail.
Helping yourself at home
- When you notice any white spots on the nails, file them off and immediately use an antifungal cream
- Make sure you treat athlete’s foot or any other easily-treated fungal or bacterial infections
- Keep your feet and toes clean and dry
- Urea can be used to thin nails out to provide access to anti-fungal creams
- Keep your nails short and your hands dry
- Wear socks that wick moisture away from feet (such as wool)
- Change socks regularly when sweating
- Wear open-toed shoes
- Throw out old shoes that could be harbouring fungus or give them a good antifungal rinse (with rubber gloves on!)
- Wear rubber gloves if you have your hands in water a lot
- Keep the skin around your nails intact – don’t pick, bite or cut
- Always wear shoes in public places, especially wet public areas
- Make sure anywhere you get your nails done is using excellent hygiene practices
- Avoid constant use of false nails or nail polish that can trap fungus – give your nails time to breathe
*Results may vary from person to person