Toenail Fungus and Treatment Overview

Fungi, including yeasts and molds, are typically the causes of nail infections, and most are caused by a group of fungi called dermatophytes. The most common fungi that cause nail infection disease in animals and humans are Trichophyton rubrum, Trichophyton mentagrophytes, and Candida albicans. These fungi can live in the layer of dead skin around your nails, in the space under your nail, and in the nail itself.

Fungal nail infections often result from damage to the nail plate or the surrounding area. A skin infections or athlete’s foot invades the nail, causing the infection. Up to 30 percent of patients with fungal nail infections also have fungal skin infection. Hot, sweaty feet in fully enclosed shoes provide the ideal warm, damp environment for fungi to thrive.
Factors that increase the risk of nail infections are:

• nail damage (e.g.: activities that cause trauma to the nail)

• medical conditions such as diabetes, psoriasis, or weakened immune system

• smoking

• general poor health

• using shared washing facilities without slippers

Medical conditions like diabetes and poor circulation can create the potential for worsening conditions such as secondary bacterial infections. The fungus can thrive when the foot is contained in a warm, damp shoe for a long time. Poor foot hygiene, walking on contaminated floors and the use of badly sterilized nail cutting and filing equipment are other ways the feet can be exposed to the fungus.

Nail infections can cause permanent deformity of the nails, which can interfere with being able to wear shoes, walking, sports, and other activities. Infected nails often show one or more of the following signs:

• Yellow streaks in the skin under the nail, or nail bed, and on the underside of the nail

• Buildup of bits and pieces of skin and nail fragments under the nail

• Discolored and thickened nail that may separate from the skin under the nail

• Brittle, broken, and thickened nails

• White spots or streaks on the nail surface

• Soft and powdery nail surface, which appears as the infection worsens

• White spots or streaks on the nail surface

• Distorted shaped Toenails

• Dull toenails without luster or shine

• Dark colored toenails due to fungus debris building under the nail

• Splitting of the nails

• Tenderness of the toe with or without pain

• Damaged, crumbly, and brown or gray nail surface, with no separation of the nail from the underlying skin

The PinPointe Foot Laser kills fungus that lives in and under the nail. The laser light passes through the nail without causing damage to the nail or the surrounding skin. At the time of the procedure, the toenail will not become instantly clear— it takes time to grow out.

The process begins with physical examination. If nail fungus infection is confirmed, treatment options will be discussed. The physician will explain the procedure that is to be performed and any follow-up visits that may be required.

Most patients feel no pain. Some may feel a warming sensation or a slight pinprick.
No, there is no downtime/recovery required. You can proceed with regular activity after the treatment.

No, there is no downtime/recovery required. You can proceed with regular activity after the treatment.

The procedure typically takes about 30 minutes.

The infection improves after one treatment. However, there is a chance of reinfection because the fungus is present everywhere in the environment. We will give you guidance to help reduce a recurrence of the infection.

Credit card, debit card or cash. If you have Flexible Medical Spending Accounts (Medical FSA), you can also pay for the laser fungus treatment with these funds.

This procedure is considered aesthetic and therefore health insurance does not provide coverage. However you can use your HSA, Medical IRA, or Flexible Spending Account to cover the procedure.

Leading scientists and medical professionals working together for 20 years (with funding provided by the National Institutes of Health) developed the technology used in the patented PinPointe Foot Laser.

Clinical studies began in November 2007.

Yes, the device has received FDA clearance.

1. Make sure you remove all the nail polish and nail decorations the day before your treatment
2. Wear comfortable clothes that can easily be rolled up
3. Bring a clean pair of socks to change into after your laser nail treatment appointment
4. Thin all affected nails down as much as you can

In most cases, only one treatment is needed. Thick or severely infected nails can require additional treatments to clear up. If more than one treatment is necessary, patients who purchased our post-treatment-care products package will be given a discount for their next treatment (good for up to 12 months from the date of the original treatment).

Nail fungus is caused by an infection; the nail has to come in contact with the fungi. To prevent this infection it’s essential to:
• Know what athlete’s foot (tinea pedis) looks like and treat it early and effectively.
• Take care around public areas, changing rooms and swimming pools. Wear flip flops and dry your feet well.
• Let your feet breathe. Don’t wear the same shoes every day.
• Keep your toenails clean and trimmed.
• Wear cotton or natural fiber socks and leather or breathable uppers in shoes.
• For those at risk, use an antifungal daily.
• Use separate nail clippers for your fingernails and toenails. Toenails are more likely to have fungus and that will help prevent transferring toenail fungus from your feet to your fingernails.
• In wet and moist areas, don’t walk barefoot to prevent collecting fungi that is likely to be present on the floor.
• Don’t share shoes with other people. This will help prevent transferring fungi to each other.
• Before wearing socks, spray or powder your feet and inside of your shoes. This will help to keep your feet and shoes dry, and eliminate buildup of fungus.
• The regular nail polish and artificial nails can trap unwanted moisture and exacerbate an existing infection. We recommend using special anti-fungal nail polish to help avoid toenail fungus infection.
• Wear waterproof boots and gloves to avoid prolong moisture exposure to your nails.
• Wear wide shoes with ample space for your toes. This will help to prevent moisture and trauma to your toenail (common reasons for toenail fungus).
• Avoid foot injury and micro-trauma to your toenail (ex: playing soccer)
• If you already have toe nail fungus don’t use the same nail clipper for healthy and unhealthy nails. Seek appropriate medical solution at an early stage.
• Only attend nail salons that have adequate levels of hygiene.

Even if you treated your toenail fungus, your shoes are likely to have fungus in them. Shoes provide warm, moist and dark environment in which the fungus can thrive. Therefore, your old shoes may get you re-infected. The best way to avoid recurrence of toenail fungus is to throw away old shoes and clean the rest of your shoes diligently with antifungal products. You can also sterilize your shoes with special U.V. light devices.
After washing shoes carefully, let them dry in the sun. Next, use an anti-fungal foot spray and spray it inside the shoes. You can next use anti-fungal powder inside the shoes. Spray the shoes again to kill toenail fungus that managed to survive. Keep your shoes as dry as possible to prevent future spores and fungus growth.

Nail fungus is the cause of 50% of all nail problems.

Toenails are easier to be infected than fingernails. Here are the typical types of nail fungus:

• Distal Subungual Onychomycosis
  This is the most common type of nail fungus infection.
  It is usually caused by T. Rubrum, that invades the nail bed from the tips of nails and spreads through the nail backwards to the cuticle. This fungus can be limited to one side of the nail bed or it may progress and spread throughout the entire nail. Early stages of the infection is characterized by nail color change, most commonly into dark green or a yellow color. Later stage of the infection will result in thickened toenails that can cause pain.
• White superficial nail fungus
  Common nail fungus infection that accounts about 10% of the diagnosed onychomycosis cases. This nail fungus infection works directly on the nail matrix, forming white patches on the nail surface. This type of nail fungus is usually painless.
• Candidal onychomycosis
  This is a rare nail fungal infection, which is caused by yeast (Candida albicans). The fungus invades the fingernails, rather than toenails. Candidal onychomycosis can also be a sign of a compromised immune system.
• Proximal subungual onychomycosis
  The least common infection of nail fungus. This nail fungus is seldom found in the healthy people, but is common with people who are immunocompromised, such as those infected with HIV, cancer, or diabetes. Therefore patients with this nail fungus injection should take it as a warning sign of a more serious underlying disease.
  If you suspect that you are infected with any type of nail fungus above, visit our clinic for a free consultation and laser nail fungus treatment.

Toenail Fungus Laser treatment usually costs the patients less than expensive prescription medications and other treatments that they have tried in the past. Toenail laser treatment is a great alternative to oral medication that carries a risk of liver damage. These medicines are costly, and cost often exceeds $1000.
We offer several payment plan options, please call us for details.

Yes. Toenail Fungus, or Onychomycosis, infection is highly contagious. Nail fungus can be easily spread and infect healthy toenails or fingernails. People with nail fungus are also likely to spread this disease to others. Since nail fungus is an infectious disease there is also a chance of re-infection. Therefore patients who have eliminated toenail fungus should still be careful and follow some basic precautions to prevent fungus recurrence. We recommend using anti fungal spray for feet and shoes, keeping feet clean and dry, and changing socks daily.

Yes. You can apply nail polish on your toenails immediately after the procedure. To avoid re-infection use newly purchased nail polish. We suggest using anti-fungal nail polish, but it’s not a must. If you wish to have a manicure- we recommend bringing your own tools to prevent reinfection from other customers who share the same tools in the nail salon.

Do you notice small white dots on your fingernails? Possible reasons for the white dots on the nails:
• Trauma – this is the most common reason.
• Nutritional Deficiency – white dots are often a symptom of calcium or zinc deficiency.
• Allergy – Allergies to nail polish or artificial nail glue are a common cause for white spots.
• Fungal infection – White spots are a symptom of a common fungal nail infection called “White Superficial Fungal Infection.” You should visit a doctor to treat this condition.
• Sign of another underlying disease – If all of your nails show white spots, this could be related to another more serious condition such as anemia, cardiac disease, or diabetes. Pay attention to the changes of your nails and to consult your doctor as needed.

Nails are horn-like tissues covering our fingers and toes. Nail plate is the proximal part of the nail (closer to our body). Finger nails and toe nails are composed of Keratin (just like our hair) and attached to the skin.
The Nail bed is located under the Nail plate. The nail plate is the area responsible for nail growth and regeneration. The plate is slightly red because of the blood vessels under it. The nail shape depends on bone under it (finger or toe bone).
Interesting facts about nails:
-Toenails grow faster during summer seasons and in hot climates
-Toe nails grow about 4mm per month, almost as fast as hair. Nail growth rate varies by age, climate, gender, diet, physical activity, and genetics.

A Podiatrist, also known as a Foot Doctor is a doctor who specializes in foot and ankle conditions and problems. Podiatrists treat nail deformities, toenail fungus, sport injuries, foot ligaments, tendons and muscles and diabetic foot conditions including foot neuropathy.