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Houston podiatrist discusses toenail fungusA fungal infection of the toenails, called onychomycosis, is a very common infection. It makes the toenails thicker, yellow in color, and you see a dry powdery substance coming from beneath them. Well, how do fungal infections start?

Fungus is a natural flora on our feet and in our shoes, this is especially true in warm and humid climates. Plus, our shoes are dark and moist from our feet perspiring. That makes them even more attractive to fungus developing. 

Fungus is an opportunist. That means if a situation occurs that allows a fungus to infect, it will do so. The most common of these situations is trauma. If you have a tendency of getting athlete's foot, which is a fungal infection of the skin, that can also spread to the toenails. That's why it's so important to treat and control an athlete's foot infection. Usually over the counter creams work to do this. If not, you should come to the office and get it checked. 

A fungal infection of your toenails are not usually painful, but they can be because of how the nail thickens and deforms. Even if there's no pain, you should get the nail treated. If the infection is unclear, I take a sample of the nail and send it to the lab. There, they're able to break down the toenail and examine it to see if there is fungus. Our treatment will be guided by these results. 

When it comes to treatment, there are several options. If you go down the foot care aisle of the pharmacy, you'll see an abundance of topical treatments for fungal toenails. Unfortunately, none of these are effective. There are other topical treatments available by prescription. These are more effective than the over the counter products, but they're still limited by how well they penetrate the nail. I found that these are effective about 50 to 60% of the time. You can expect to treat the nail with this medication for at least six months. 

The next treatment is with an oral medication. This treatment it's been available for over 25 years and is now a generic medication. It's about 85% effective. It's more effective than the topical medications, because it doesn't have to penetrate the toenail to be effective. Any medication is metabolized by your liver or your kidneys. We know this medication is metabolized by your liver. Because of this, I like to see a recent blood test to make sure the liver is happy and healthy. You take the medication daily three months. 

The third way to treat the toenail infection is with a laser. I'll admit I'm biased with this one. I had a laser in my office and I wasn't happy with the results that it gave me. I know there are other practitioners that have had better experience using the laser to clear fungal toenails. To its benefit, it involves one to three sessions and no medication has to be used along with it. 

No matter how you choose to treat a fungal infection in your toenail, it'll take the same amount of time for your nail to clear. It takes about nine months for the great toenail to grow in and about six months for the lesser nails. 

If you want the appearance of the nail to improve quickly, there's a cosmetic solution we use called Keryflex. Keryflex is a cosmetic nail system that gives you a nice appearing nail while your natural nail is recovering. It's made from a keratin resin, the same material that your toenail is made from. That makes it flexible and porous. 

This is important. 

The flexibility of the Keryflex will prevent it from digging into your toe and preventing it from forming into an ingrown toenail. Because it's porous. It won't suffocate and damage the new nail growing beneath it. Keryflex is used in our office for both women and men who wish to have nice looking nails, while their nail is recovering from their fungal infection. 

Up to this point, we've been focused on treating the fungus on your feet and beneath your toenail. We also need to address the fungus that grows in your shoes. After all, what good is treating the fungus on your feet. If you just stick them into shoes, filled with fungus. You'll just be reinfecting yourself. For this, I recommend an anti-fungal spray designed for the shoes.