Toenail & Foot Fungus, Fundamentally

Have you noticed a yellow discoloration in one or more of your toenails? Is the toenail thicker and harder to trim than usual? Perhaps white marks have appeared under the nail plate, and you’re detecting an unpleasant odor. Well, chances are you have the ever-annoying Toenail Fungus.

Let’s take a closer look at your feet. Do you detect any scaly, dry, circular patches on your soles or in between your toes? Do they itch? That’s probably Tinea Pedis, or Athlete’s Foot if you’re scratching between the toes.

Take heart because you’re not alone here. Both these fungal infections are common and often occur at the same time. I’ll bet that at this point you’re asking how you got your feet into this mess! Simply put, placing them in a damp environment is most probably the culprit. For example, walking bare-footed in swimming pools, locker rooms and gym showers is notorious for causing fungal infections. Sounds like you? Not changing socks daily doesn’t help the matter, either. (Probably doesn’t sound like you!) Really, though, it can happen to anyone. I should mention, however, that diabetic and HIV patients are particularly at risk.

Okay, so now you need to be certain. I recommend seeing a podiatrist since left untreated, fungal infections can spread to other toenails, different parts of your feet and even your fingernails. Also, the longer you wait the harder they are to treat. To check for toenail fungus, I would take a small sample of the nail and send it to a lab for analysis. For Tinea Pedis, well, I can detect that by eye.

If we’re dealing with Tinea Pedis, treatment combines the daily use of both an anti-fungal cream and powder. Simply apply the cream to the bottom and top of the foot and the powder in between the toes each day for the prescribed amount of time. Products such as Clotrimazole, Ketoconazole and Nystatin have had much success in eliminating the problem. Just remember to keep your feet dry. There, that was easy.

If the condition is toenail fungus, treatment is much more involved and frankly, not as easy. I always present my patients with 3 approaches they can take. The first is to apply an anti-fungal solution to the nail, just as you would nail polish. We’re talking a 9-month course here and in my opinion, there’s only a 25-30% chance that the fungus will go away with this treatment alone.

The second approach is laser therapy. 8-10 treatments have shown me adequate results about 50-60% of the time. It also lightens the discoloration of the nail. By the way, this is usually the treatment of choice for patients who don’t wish to use medications.

The third type of treatment is the most popular and most effective because it gets to the root of the problem which is, in reality, the root of the nail. It involves taking one Lamisil pill per day for 3 months. I’ve seen good results with this anti-fungal medication about 75% of the time. As with all medications, there are possible side effects. Although it is FDA approved, it can cause liver damage or even failure. So, I wouldn’t prescribed it to patients with a history of liver disease or other immunocompromised conditions.

My recommendation? Let’s combine all 3 treatments and get rid of your toenail fungus as soon as possible – and for good. In fact, it will increase your chances of healing to 80-90%. Sounds like a solid plan of action to me, and it’s sure to get you back on your toes!

Ankur Bahri, DPM
DeLoor Podiatry Associates

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