Fungus Toenail

Sandal season is coming and the appearance of our feet becomes a concern.  Onychomycosis is a fungal infection of the nails.  The nails may appear discolored, thickened, deformed and often are loose with debri under the nail.  This condition can be more than cosmetic, resulting in pain on pressure when in shoes.  Diabetics, as well as people with nerve and/or circulation issues, could be at risk for secondary sores and infections.

Onychomycosis is extremely common in our society.  We are not meant to be walking around with closed shoes.  A dark, moist environment is perfect for the fungal spores to reproduce.  These fungal spores are common on most ground surfaces.  The most common mechanism of obtaining fungal nails is through repeated exposure to the fungal spores under optimal conditions for the fungus to reproduce.  Fungal nails can also occur after a trauma to the nail.  Any weakening of the nail makes it easier for fungus to enter.

So how do we prevent onychomycosis?  At East Avenue podiatry we advise our patients to drive her feet very well after showering or bathing.  We also advised patient to change their socks during the day if they are prone to sweating.  Applying a powder to the feet before putting on socks can also be helpful.  Wearing flip-flops in public showers can also lower the risk of exposure.  For patients that appear to be very prone, it is advisable to apply a topical antifungal medicine once or twice a week as prevention.  At the end of the day, allowing your feet to “air out” is a good policy.

Treatments include topical medications, oral medications and laser therapy.  The topical medications tend to only be successful in very mild cases.  The oral medications are successful in approximately 65 to 70% of the cases, but require bloodwork to monitor the liver enzymes.  A new laser therapy is now approved for treatment of onychomycosis.  However, it usually is not covered by insurance.  Success rates appear to be in the same range as the oral medication.  The reoccurrence rate does appear to be high for people who do successfully clear the fungus from their nails.

A visit to the podiatrist for a proper evaluation of the toenails is helpful to determine the proper course of action.  East Avenue podiatry looks forward to helping you maintain happy and healthy feet.