Fungal toenails are difficult to treat. And unfortunately, there is no one single cure all for fungal infections. What might work for one person, might do absolutely nothing for someone else.
What is fungus and why does gets into your toenails
Fungi are spore-producing organisms that grow. There are many different types of fungi.
Mold is a type of fungus. Yes! That black stuff that grows on your shower walls. That icky stuff that ends up on your food that you throw out. That is fungus.
And when it starts growing on your body, that can lead to bigger and bigger problems.
Fungal spores are everywhere – across the entire planet. They exist from the North Pole to the South Pole. They grow best in warm, dark, and damp areas. If something damages your toenail and moisture starts to get under the nail, fungi can start to grow there. They grow slowly, so it may take a year or so for you to see it. By then, the fungus in pretty much rooted in there.
Do Fungal toenails need to be treated?
Absolutely! Fungal infections of the toenails are capable of causing many problems – the simplest being cosmetic. However, fungi can cause more serious problems if left untreated, such as:
- Fungal infections of the toenails can make your nails so thick that they hurt.
- Fungal infections can spread from one toenail to another, as well as to other parts of the body, like the skin on your feet, called Athlete’s foot, your scalp, under your arms, and your genital area.
- In people with immune problems, fungal infections can spread to your mouth or lungs.
- Fungal infections can cause cracks between your toes which can be places serious infections can start, especially in diabetics.
- Fungal infections can lead to bacterial infections under or surrounding the nail, which may need oral antibiotics or surgical removal of the nail.
How are fungal toenails treated?
There are three main types of treatment for fungal toenails:
- Topical antifungal medication
- Oral antifungal medication
- Surgical treatment – such as nail removal or laser treatment
Each treatment has its pros and cons. Some treatments might not be appropriate for everybody. For example, topical medications might not be strong enough to treat the problem, oral medications might not be right for someone with a liver condition. Laser treatment can be expensive and is usually not covered by insurance.
Why are fungal toenails so difficult to treat?
Fungal infections on the skin are not that hard to treat and usually respond well to antifungal creams. The fungi are usually on the surface of the skin and skin grows rather quickly – in fact, all the skin on your body gets completely replaced every 28 days or so.
Toenails, on the other hand, are a completely different matter. Fungi can hide deep under the nail where it is difficult to get at. Topical medications have to be able to penetrate completely through the nail. Oral medications have to get inside the nail as well. Even lasers have a very difficult time penetrating thick fungal toenails. In addition to all that, toenails grow very slowly. It takes anywhere from 6 months to one year (sometimes longer) to grow a completely new nail.
Sometimes the only option is to remove as much of the diseased nail as possible to allow the medications to attack all the fungal spores.
Treat the fungus before it becomes hard to treat
The best thing is to treat the fungus before it becomes so hard to treat – earlier is better.
Definitely don’t wait until your nails are all infected or so thick that you are having pain. And definitely take care of all fungal infections quickly if you have a medical problem such as diabetes, poor circulation, or are immunosuppressed.
When you come in for your appointment, we will examine your feet closely and let you know which options would be best for you and will prescribe the best treatment for your needs.
To schedule an appointment, visit our website or call our office. We also have a 24 hour answering service available for emergencies.
By: Dr. David Schlam
Hollowbrook Foot Specialists
Wappingers Falls, NY