Nail fungus, or onychomycosis, is a condition resulting in the growth of either fungus or mold in the nail bed. As the growth progresses, the nail will become discolored and thick, then progressing to degrade the nail itself by making it flaky and brittle. Over time, if left untreated, it is even possible to lose the nail as the fungus separates it from the nail bed. Normally, despite the aesthetic problem that nail fungus creates, symptoms are minimal and pain is rare. Fungus is difficult to treat because it is hard to physically get to it, thus making results varied and prolonged. As a result of this there are three treatments available, and all have their pros and cons.
The first is topical cream; you want to look for butenafine, ciclopiroxolamine, or amorolfine in the cream, and despite years of use there is not any evidence one works remarkably better than another. Topical creams are inexpensive in the scheme of fungus treatment, however the downside to them is that one must be near perfect about applying it properly everyday for the treatment to be effective. For truly noticeable results, some patients have had to apply the cream for a year.
The second is oral medication, terbinafine, or the generic name Lamisil. Due to the medication being taken orally, it has a much better chance of getting to and affecting the fungal infection. Oral medications have a better cure rate than topical creams, however the side effects of this drug can be quite severe, and as a result doctors are very stringent about prescribing it. Terbinafine is frequently linked to liver damage, and the side effect can progress quite aggressively. Tests will be routinely be run in order to check whether or not a patient has a higher risk of this side effect occurring. Before they begin the drug regiment, during the period, and after a patient will be subject to liver testing in order to ensure their safety.
The third, and newest form of treatment, is laser treatment. Lasers had been used previously in other fields of medicine however within the last ten years they have been migrating into podiatry to treat toenail fungus. The biggest downside of laser treatment right now is the price, despite most offices like ours offering reduced rates should you need a follow up laser. Most places will charge upwards of $1,000 for treatment, depending on how many toes and other practice specific factors. Up until very recently the biggest problem with lasers was the size of the beam emitted from the machine, it was approximately 1mm in diameter. This made treatment long (as the doctor needs to move the laser beam over the entirety of the nail) and ineffective (as the laser needs to kill ALL of the fungus or else the chance it will grow back is high). Thanks to a company called Cutera there is a new laser out that has a 5mm diameter, and has made the treatment far more effective. For more details on this process please visit our page on Laser treatment specifically, here.
Toenail fungus is a fairly common issue with a not so simple treatment, however good results are a reality when in the hands of a talented podiatrist. At Agoura-Los Robles Podiatry Centers, we will ask you to come in for an initial appointment at either our Thousand Oaks or Agoura Hills office, and if you are eligible for laser treatment we will get an appointment made for you so you can get on the road to a quick recovery.