Fungal Toenails, Yellowed or Deformed Toenails

What causes nail discoloration?

The most common cause of nail discoloration is fungus. Fungal infections of the toenails can leave the nail thick and brittle and can make the nail appear yellow, brown, or white. Often times, fungal infections can come about from the skin. Patients that have Athletes foot (tinea pedis) can spread the infection from their skin to their nails easily. The infection in the nails typically starts at the edge of the nail and eventually spreads its way to the entire nail. Generally speaking, fungal infections do not cause pain and may go unnoticed at the early stages. If pain is present, it’s usually due to the pressure of the thick nail. Other causes of nail discoloration could be mold, bacterial infection, yeast, trauma to the nail matrix, psoriasis, or cancer.

How are fungal nails diagnosed?

Fungal nails are diagnosed by clinical presentation as well as biopsy. In performing a biopsy, a small sample of the nail as well as some of the soft tissue underneath the nail is taken and sent to a lab for microscopic examination. The lab is able to determine the cause of the discoloration. In finding the cause, we are then able to find the appropriate treatment regimen.

How are fungal nails treated?

There are 3 main ways to treat fungal nails. One is topical medications such as creams, gels, and laquers. Keep in mind, these medications are most effective when the nail is kept its shortest and thinnest.  The effectiveness of topical medications is per patient and results vary widely. The second method of treatment is oral medications. Oral medications, however, can have detrimental effects on the liver. Therefore, your doctor will typically have you get blood work to check the function of your liver before and half way through the course of the medication. Lastly, and the newest form of treatment is laser therapy. Laser therapy is the least invasive and typically has the best results, especially when combined with a topical medication. Lasers are typically done 3 weeks apart and a minimum of 4 sessions are needed.

It is important when doing any of these treatments to maintain your entire lifestyle to be fungal free. This means spraying your shoes daily to get rid of any fungal spores that may reside, as well as maintaining the skin on the bottoms of your feet with an anti-fungal cream, along with cleaning your bathtub with bleach. The nail typically takes 8-12 months to grow out, so it will be the new growing nail that will be fungal free once treated. Vitamin supplements can help facilitate nail growth such as biotin. If your feet sweat a lot, this can lead to a moist environment, perfect for breeding fungus. In this case, an antiperspirant is necessary to maintain a dry environment.

What to do if you notice discolorations of your nails?

Have it checked out immediately. The sooner you begin treatment, the more effective it will be. The quicker you start treatment, the more you can prevent it from spreading to your other nails, as well as other people you are living with. It’s also important to have it checked out to rule out any malignancy. If you notice discolorations of your nails, call us at Advanced Podiatry at 813-875-0555. We have the latest laser technology and we will find the most effective treatment catered to your needs.

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