Nail Fungus


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Onychomycosis or nail fungus is a fungal infection of the toenails.  The fungal infection can be within the nail plate itself, the skin under the nail or the growth plate (nail matrix).
Fungal infections of the nails can make the nails appear unsightly due to discoloration and thickening of the nails.  The nails may become yellow and brittle.  Thick nails can become painful or ingrown.

Onychomycosis can take what seems like a long time to cure especially when the nail fungus has penetrated the growth plate of the nail.  Treatment is aimed at clearing fungus from the growth plate or nail matrix so that new nail, free of fungus is produced and eventually grows out clear.  If the growth plate is damaged, then the nail can be cleared of fungus but may not look completely normal due to damage to the matrix.

The effectiveness of topical medications can be limited due to lack of ability of topical medication to penetrate through the nail plate to the nail bed and growth plate.

Oral medications have been a mainstay of treatment for years but due to the relatively high dosages needed and long length of treatment time there is concern for potential liver toxicity. Patients on a number of such medications need obtain liver function testing to ensure that no problems are occurring.  Additionally, patients taking certain medications such as cholesterol medications need be aware of potential interactions.

Lasers have been introduced as a means of eradicating nail fungus in a painless, drugless way.  A laser is a device that emits monochromatic light, that is, light of a specific frequency.  This is opposed to polychromatic light such as sunlight which contains a broad spectrum of frequencies.  Additionally, lasers emit light that is coherent, that is, the wavelengths of light are parallel and highly focused.

White light is a combination of multiple wavelengths.  When such light is focused on a prism, the light is “broken up” into its component wavelengths.

Monochromatic light is light that contains only one wavelength.

The spectrum of visible light  contains wavelengths from 390 to 700 nm.  Wavelengths of light that are longer than 700 nm or shorter that 390 nm are not visible to humans.

It has been shown that specific wavelengths of light have certain biologic effects.  Research on treatment of nail fungus has shown that focuses wavelengths at 980 nm to about 1300 nm appear to be effective for treatment.  The ability to supply such specific wavelengths, highly focused and at sufficient power and penetration are the factors that allow nail fungus to be treated not only in the nail plate but the nail bed and nail matrix  (growth plate).

Once lasers have been used to treat the nails, the nails then need grow back out.  Nails, like hair, are in a state of steady growth with toenails growing at about 1/8 inch per month.

  1. It is important that the nails grow out as completely fungus free as possible to prevent reinfection.
  2. The organisms that cause nail fungus are found just about everywhere so reinfection during the process of new nail growth need be prevented.  Certain prescription topical agents are effective in this process.
  3. There is no rule that one must rely only on one method to clear fungal nails.  Sometimes a combination of methods are more successful.   For example, combining laser treatment with topicals or even a very low dose of a safe oral agent can enhance success.  
  4. It is important to see a doctor who is experienced in the diagnosis and treatment of nail fungus and who can custom tailor a treatment plan that is successful.  Remember that there is not one miracle cure or one time treatment for this condition so be aware of some of the cure claims on the internet.

For more information on Toenail Fungus Treatment in the San Antonio, TX area, call Ed Davis, DPM, FACFAS. at (210) 490-3668 today!

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South Texas Podiatrist
109 Gallery Circle, Suite 119
Stone Oak

San Antonio, TX 78258
Phone: 210-490-3668
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