Dr. Berg's Foot Facts

Posts for category: Fungus toenails

Here is what you'll learn during this webinar:

  • should my nails be treated?
  • what works and what doesn't
  • will laser therapy work for me?
  • what is a comprehensive treatment program for fungal nails and why does it matter

Should the nails be treated?

First we need to establish a diagnosis of fungus. Everyone who comes into the office with thickened toenails thinks they have fungus. While its true fungus is the most common cause of thickened and discolored toenails, other conditions can create changes in the nails that mimic fungus. Psoriasis and eczema are two of these conditions. In addition, trauma is one of the most common causes of nail changes I see in the office. When I see discolored nails I often learn a patient has participated in sports.

What works and what doesn't?

If I'm not certain of a fungal nail diagnosis, I'll send the nails to a lab to get tested. Once a diagnosis of fungus is made, treatment can begin.

Historically treatment for fungus focused on topical medications. These have been used for many years and there are many kinds. Some of them thin the nails and some treat fungus. Unfortunately, topical medications have a low success rate. Patients who have had success with topicals have needed to treat them daily for a long period of time.

Newer topicals have shown higher success rates. Topical medications as a whole are about 20%-40% successful. The success rate depends on the degree of fungal involvement of the nail and length of time it's treated.

Oral medications were developed in the 1960s. Unfortunately, some of the more successful medications had very serious liver side effects. Later oral medications became much safer. The success rate of these medications can reach up to 70%. However, not everyone is a candidate for systemic (oral) medications. Some people have a medical condition which makes taking these medications dangerous. Many others want to avoid taking them for personal reasons.  

Finally, laser therapy was introduced. Laser therapy has been around for many years. In 2010, a pulsed laser was developed. This resulted in the ability to apply therapy longer and without discomfort to the patient. This laser has been more effective in getting rid of toenail fungus.

Will laser therapy work for me?

To determine what will work for a specific person it's important to consider:

  • how long they've had the fungus
  • how much of the nail is involved - the less nail involvement, the better the results. In younger patients with less involvement we can achieve greater success.
  • how committed is the patient to getting rid of the fungus? Fungal nails are one of the most difficult conditions to treat and it takes a commitment on the part of the podiatrist and the patient it order to achieve success.

What is a comprehensive fungal nail treatment program?

A comprehensive program includes all of the therapies combined:

  • topicals (skin and nails) - we treat the skin and the nail with topicals because the skin feeds the toenail.
  • laser
  • oral medications
  • shoe therapy

Why treat shoes?

There's one difference between your fingernails (which typically don't get fungus) and your toenails and that's shoes. An ultraviolet light is very effective in getting rid of fungus in the shoes and preventing it from further infecting the toenails.

Laser treatments

The comprehensive program includes 3 laser treatments and they can be delivered weekly or monthly depending on the level of involvement in the nails. The topicals are used throughout the time of treatment. A short course of oral medications are also delivered during that time.

Together these modalities can offer a success rate of up to 80%-90%.

Toenails grow out slowly

Toenails only grow out 1 mm/month. We'll look at your nails 4-6 months after completing treatment to see how much resolution we've achieved. At that point we'll determine if further treatment is needed.

In summary, fungus of the toenails is tough to get rid of. It's disfiguring, can be uncomfortable, and unsightly. It takes a comprehensive program to get rid of it.

Questions from the audience

Q: How many laser treatments will I receive and what will it cost?

A: The patient will receive 3 laser treatments. The cost of treatment is $625. That includes the initial course of topical medications and the ultraviolet light shoe sanitizer.

Q: Will I have to pay the full amount up front?

A: The program is paid for in advance. We dispense the topical medications and the ultraviolet light and have the patient use this for a couple of weeks. We also provide a nail file to thin the nails to allow the topicals to penetrate the nails before we begin laser treatment. The patient then returns to the clinic to receive the laser treatments. The laser treatments are usually done every week, but can be spaced farther apart if there is less involvement of the nails.

Q: How do I know if I'm a good candidate for laser treatment?

A: I'm very honest about what I think the chances are for success. When a patient has extremely thickened toenails from the end of the nail back to the cuticle in all the nails and a long history of fungus it's much tougher to resolve the problem. It can require more than one round of treatment. I'm cautious in recommending laser or any other approach in that case. When there is less nail involvement, maybe only part of the great toenails and some of the other toenails then we have more predictability regarding success.

Q: How soon can I expect to see results?

A: The nails only grow 1 mm/month. When we first started treating with laser I had patients back too frequently and too soon because I too wanted results. Now I tell my patients they need to wait. The therapies don't eradicate the fungus already on the nail. Instead after several weeks and months we'll see the new nail coming out clear of fungus. Eventually the portion of the nail with fungus will grow out and be trimmed off. That takes at least 4-6 months.

Call us today at 206-368-7000 if you need appointmen for your fungal toenails. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

By Dr. Rion Berg
October 23, 2019
Category: Fungus toenails

autumn leavesYou know the old adage--out of sight, out of mind. While this phrase dates back to the 13th century it's even more relevant today since so much of our lives are lived at warp speed. We have to continually remind ourselves to take care of the big and little things in life or they can easily fall off our radar.

The same is true for our feet. Unless we're experiencing pain or discomfort we typically won't take action when it comes to going to the doctor. Toenail fungus is one of those things that we forget about once we shelved our sandals and tucked our feet into socks and boots for the winter.

And it's too bad really. Because fall is the best time to start killing toenail fungus.

Why?

It takes a good 9 months for your nails to completely grow out. If you get started now, you'll have beautiful nails this summer.

How do I know its toenail fungus?

Not all discolored or ugly nails are fungal nails. Trauma from wearing tight shoes or running can also cause toenails to change color. To ensure its fungus we'll take a sample of your nail and send it to a special lab.

How do I get rid of toenail fungus?

I'm glad you asked. While there is a bunch of hype out there about using everything from Vicks to Vitamin E, onychomycosis (the scientific name for nail fungus) is quite difficult to eliminate.

Why?

Nail fungus doesn't just live on the top of your nails where topicals are most effective, but beneath the nail in the nail bed and in your skin surrounding your nails.

We've found that using a combination of laser treatment, topicals, a short course of oral medication, and an ultraviolet shoe sanitizer provides the most effective treatment for killing toenail fungus. The PinPoint laser penetrates the nail bed to destroy the fungus. Topical medications destroy the fungus on the top of the nail and on the skin surrounding the nail. Oral medications treat the fungus systemically. And the shoe sanitizer kills fungus in the shoes.

How long does the treatment take?

You'll receive three laser treatments over three months. The treatment involves passing a laser beam over the infected nails and surrounding skin. The doctor will repeat this several times until enough energy has reached the nail bed. Your nail will feel warm during the treatment. A single treatment session takes about 30 minutes. Healthy new growth will be visible in as little as 4 months but will take up to 9 months for your nails to completely grow out.

What will it cost?

Because laser treatment for fungal nails is not covered by insurance, we make it as affordable as possible. Your first visit is covered by insurance. At that visit you'll have plenty of time to talk to Dr. Berg to determine if this treatment is right for you.

What are our patients are saying?

"Although I did have to take the oral medication for toenail fungus, it was a lesser amount than is typically taken. That plus the laser did the trick!"

- Jay N.

"This office is efficient and caring.  The treatment for toenail fungus includes 3 laser treatments and a topical to apply twice daily.  This is a long process but so far is working well."

-Sandy P.

If you or a loved one has toenail fungus, call us today at 206-368-7000 for an appointment. You can also request an appointment online.

For information about other foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

By Dr. Rion Berg
March 25, 2019
Category: Fungus toenails
Tags: Untagged

Every day I have patients who call my office wanting treatment for fungal nails. In addition to being unsightly, the fungus can spread to others and nails can become painful, thick, difficult to cut, and ingrown. In addition, there's an increases risk for ulcers in patients with diabetes.

For these reasons it's important to take the necessary precautions to prevent a fungal nail infection. These recommendations will also help reduce the chance of spreading the infection to your other toenails and other people and is best practice when you get toenail fungus treatment.

  • Don't use the same nail trimmer or file on healthy nails and infected ones (be sure to keep your nail implements for your own use to prevent spread to other family members).

  • Wear socks made of wicking material to draw moisture from the skin (an excellent sock is the Copper Anti-bacterial Antifungal Low Cut Socks; these are wicking and anti-microbial. If you're a hiker a sock liner from Fox River will keep the moisture away from your feet.

  • Change your socks when they are damp from sweat or your feet get wet.

  • Wear clean, dry socks every day and apply over-the-counter antifungal powder inside socks to keep feet dry.

  • Wear shoes with good support and a wide toe area (in addition shoes should fit well and leave about a thumbs length from your toes to the tip of your shoes. Tight shoes can cause your unaffected toenails to lift making it easier for the fungal infection to develop in them).

  • Avoid walking barefoot in public areas, such as locker rooms (always wear flip flops to prevent spread of the infection to others).

  • Be sure your nail salon is properly cleaning their instruments. To be totally safe do your own pedicure.

  • Wear a different pair of shoes every day to let them dry out between wearings.

  • Use a UV shoe sanitizer like Sterishoe Essential to kill the fungus in your shoes and keep down your fungal load.

Other factors that can increase your risk for fungal nails are:

  • Trauma to the nail—either direct (eg. stubbing injury) or repetitive microtrauma (eg. running in a tight shoe)—can cause damage to the nail plate allowing fungus to get in.

  • Aging – as people age they are more likely to have trauma to the nail and more opportunity for exposure to fungus.

  • Diabetes, HIV, and medications which decrease the strength of the immune system increases the risk of developing a fungal toenail infection.

If you have fungal nails and would like to learn more about how the Foot and Ankle Center of Lake City treats them, visit our Seattle Fungal Toenail Center.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

By Dr. Rion Berg
November 13, 2018
Category: Fungus toenails

Have you wondered if you need treatment for your fungal toenails? A recent article in Health Day News, a health information news site by US News and World Report, gives some great information for people with fungal toenails but misses the mark because it doesn't discuss the importance of treatment.

The article includes the following recommendations from the American Academy of Physicians (AAP). I've added my comments in parentheses. These recommendations will help reduce the chance of spreading the infection to your other toenails and other people and is best practice when you get your toenail fungus treated.

  • Cut nails short and file down thick areas.

  • Don't use the same nail trimmer or file on healthy nails and infected ones (be sure to keep your nail implements for your own use to prevent spread to other family members).

  • If you go to a nail salon, bring your own nail file and trimmer (you should always let the nail salon know you have fungal nails when you make your appointment; some salons won't allow people with fungal nails to be seen).

  • Wear socks made of wicking material to draw moisture from the skin (an excellent sock is the Copper Anti-bacterial Antifungal Low Cut Socks; these are wicking and anti-microbial. If you're a hiker a sock liner from Fox River will keep the moisture away from your feet.

  • Change your socks when they are damp from sweat or your feet get wet.

  • Wear clean, dry socks every day and apply over-the-counter antifungal powder inside socks to keep feet dry.

  • Wear shoes with good support and a wide toe area (in addition shoes should fit well and leave about a thumbs length from your toes to the tip of your shoes. Tight shoes can cause your unaffected toenails to lift making it easier for the fungal infection to develop in them).

  • Avoid walking barefoot in public areas, such as locker rooms (always wear flip flops to prevent spread of the infection to others).

  • (Wear a different pair of shoes every day to let them dry out between wearings).

  • (Use a UV shoe sanitizer like Sterishoe Essential to kill the fungus in your shoes and keep down your fungal load).

It's important to get your fungal toenails treated for these reasons:

  • Toenail fungus can cause nails to thicken and distort making them difficult to cut.

  • Toenail fungus can be painful. This won't occur when your fungal nail infection first starts, but can happen over time.

  • Toenail fungus and diabetes are a dangerous combination. If you have both of these conditions your chance of developing an ulcer is 3X greater than if you didn't have diabetes.

  • Toenail fungus can spread in families. While many of the recommendations above will help prevent you from spreading the condition to others, getting it treated will help ensure it.

Don't wait to get your toenail fungus treated. Call us today at 206-368-7000 for an appointment. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+

 

 

What's the best approach for treating fungal toenails? First let's look at the history of how fungus of the toenails has been treated. For many years the only available treatment was topical medication. And while somewhat helpful these medications had to be applied daily for up to a year. With all that effort, only 20% of patients saw clearing of their fungal nails.

In the 1960s and 70s the pharmaceutical industry developed an oral medication. Initially these medications were harmful to the liver. Eventually they developed a medication called oral Lamisil which had fewer side effects. The patient took one pill a day for three months and with that the success rate was about 75%. To be safe patients got their liver enzymes tested after one month.

However, even with testing the liver many patients were still hesitant to take the oral medication. Also, fungus would reoccur in some patients (as with any fungal nail treatment). Something that was non-invasive that had the potential to work better was needed. That's why laser treatment was developed. When we first started using laser in 2012 we found a success rate of 60%-70%.

After we added in topical medication for the skin and nails and put in place a program where patients used a UV light sanitizer in their shoes our success rate went up to 75%. Finally this year we added a one month course of oral medication and grouped our laser treatments closer together. Then our success rate went up to 80%-90%.

If you're looking to get rid of your fungal toenails in time for the 2019 sandal season, now is the best time to start. With treatment your clear nails will still need to grow out which can take nine months or longer.

Call us today at 206-368-7000 for evaluation. You can also request an appointment online. We'll test your nails to make sure you have fungus before we start treatment.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+