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Fungal toenails A fungus that
grows under the toenail often causes thick, discolored, and brittle
toenails. The fungus grows
under the toenail, often killing the nail, causing it to become thick
and discolored.
How the fungus seeds under the toenail is not
known. Many believe the cause
to be related to a genetic predisposition. It has never been proven that poor hygiene nor locker
rooms have any correlation to developing a fungally infected toenail.
Treatment options for fungally infected toenails involve
either an oral medication taken for 3-5 months, removal of the toenail,
or application of a topical liquid applied every day for up to a
year. Leaving the condition
alone is not likely to cause long term problems, with the exception of
potential recurrent fungal skin infections (athlete’s foot) or for
patients who are diabetic and/or have poor circulation. The oral medications
(Lamisil/Sporonox) are usually 75-80% effective at getting rid of the
fungus. They do, however,
require periodic labwork, as they are metabolized by the liver and can,
in rare cases, cause liver toxicity.
Period labwork (blood drawn) is performed to ensure this does
not occur. Certain insurance
restrictions may prohibit use of the antifungal medications.
Removal of the nail is performed in the office under
a local anesthetic. Allowing
the nail to grow back will often result in recurrence of the
fungus. Killing the root of the
nail to where the nail will not regrow is an effective option. The area under the nail will heal
with regular skin. There are no
long-term effects of having toenails permanently removed and nail
removal does not cause any problems with shoes.
The final option is daily application of a topical
medication, Penlac. This
medication is applied every day for up to a year and has a success rate
of 20-30%. The advantage of
this option is that it does not require the labwork necessary with the
oral medication.
Please call the office to schedule an appointment should you want to
discuss treatment options for any discoloration of your toenails.
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Please call the
office with any concerns regarding insurance coverage.
Some insurance plans require a referral prior to
being seen by a specialist (podiatrist).
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