Toenail Fungus: Onychomycosis

Nail Fungus is treated painlessly with a special laser
Nail Fungus is treated painlessly with a special laser.

The dark, moist surroundings created by shoes and stockings make the feet especially susceptible to a fungal infection. Various types of fungi are present everywhere in the environment and most fungi are harmless until they penetrate the skin.


A fungus can invade through minor cuts or after injury. Repeated irritation to the toes may cause the nail to separate from the bed. Fungal infections of the nail plate, also known as onychomycosis and nail matrix, are the most common nail disease.


We take a cutting-edge approach to your nail problems. Whether the solution is as simple as an over-the-counter drug or taking advantage of laser technology, we care about your feet.

What are the symptoms of Toenail Fungus?


The first sign of a potential fungal nail infection is when the nail becomes thickened and turns black, yellow or green in color. After that stage, the nail often becomes brittle, with pieces breaking off from the toe.


Through time, the skin underneath and around the nail becomes inflamed. You may also notice white or yellow patches on the nail bed, scaly skin next to the nail, and an unpleasant smell. It may be painful secondary to the thickness of the nail and from the lifting of the nail plate off the nail bed.


What causes a Toenail Fungal Infection?

Toenail Fungus - University Foot and Ankle Institute


As we age, blood circulation is diminished, the fungus has had many years to grow, and nails grow slower and thicken, giving way to possible infection.  Nail fungus tends to affect men more often than women.


Other risk factors include:

  • Excessive perspiration

  • A humid environment

  • Poorly-ventilated socks and shoes

  • Going barefoot in public pools, gyms and shower rooms

  • Athlete’s foot

  • Diabetes 

Toenail Fungus treatment options


Treatment for nail fungus presents challenges because the infection lives inside the nail and is difficult to reach. It may take a year for new nail growth to replace the infect old growth. University Foot and Ankle Institute offers following treatments for nail fungus:



The first line of defense is typically topical medication. This can be administered as a cream, gel or nail polish. Your doctor may write you a prescription, though some topical toenail anti-fungal agents can be purchased over the counter.



Oral antifungal pills may be used for moderate-to-severe or hard-to-treat fungal nail infections. These medicines have shown the most success at approximately 75% clinical cure. However, oral medicine may cause possible drug interactions, allergy, and/or systemic effects for some patients.


Nail Removal

For severe nail infections, your doctor may recommend removing the infected nail during an office visit. Performed with a numbing injection, your doctor will loosen the skin around the nail and separate the nail from the skin by using a tool under the nail. If only part of the nail is diseased, only the diseased part is removed.


Q-Clear™ laser treatment

The new advent of a fungal nail laser has changed the treatment options.


Q-clear™laser treatment effectively resolves underlying fungal infections while preserving delicate surrounding tissue. The mid-infrared laser wavelength penetrates the toenail and eliminates the destructive fungus at the root the infection. Clear growth will begin to appear as the revitalized nail grows out.


The treatment takes approximately 15 minutes for both feet and patients report a mild, warming sensation as laser treats the nail. There is no down time following the treatment and patients can immediately return to normal activity. Laser treatment takes one visit, with an occasional touch-up.


There are reports of cure rates from 77% to 95% in the literature after one treatment with the laser. In many cases, patients who did not obtain a cure went on to full resolution with a second treatment. We have found that laser therapy is a very safe and effective method of treating onychomycosis.


In addition to applying the heat-based laser treatments, our physicians apply nail lacquer for optimal results.

University Foot and Ankle Institute, the best choice for Onychomycosis treatment


Our doctors take a cutting-edge approach to your nail problems. Whether the solution is as simple as an over-the-counter drug or taking advantage of laser technology, we care about your feet.

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