dystophic toenailSeattle athletes and non-athletes alike frequently come into our office with deformed or thickened toenails. We refer to these as dystrophic toenails. Nails may become distorted by too much keratin in the nail plate and nail bed, causing the nail to lift off the underlying skin.

Dystrophic toenails are commonly caused by a fungal infection of the toenail, called onychomycosis.  Other potential causes include psoriasis and trauma - either direct injury or chronic, repetitive microtrauma.

Onychomycosis is typically caused by dermatophytes (which also causes athlete’s foot), and less commonly yeasts or molds. People may have an increased risk of contracting toenail fungus if they wear tight shoes, have had trauma to the nail bed, have exposure to fungus in gym showers and locker rooms, or are not attentive to foot hygiene.  Patients who are older, immunocompromised, or have an underlying medical condition such as diabetes also have higher incidences of onychomycosis.


Onychomycosis can usually be diagnosed upon examination but sometimes requires laboratory confirmation with a nail sample.

Treatment of Dystrophic, Fungal Toenails in North Seattle

Fungal nails are often treated with over-the-counter topical medication, natural and home remedies, oral medications, and lasers. Topical medications can slow fungus growth but are usually not effective in eliminating fungus without other treatments. Oral medications such as Lamisil are considered up to 75% effective, but there is a tendency to have a recurrence of infection. Additionally, patients who take such medications must be monitored, as there is a slight risk of damage to the liver.

Laser treatment for fungal nails is a more recent entry into the fungal nail treatment landscape. By itself, laser treatment is about 60% effective. With the addition of a newer topical called Tolcylen, a short course of oral medications, and the use of a UV shoe sanitizer our podiatry office has seen patient satisfaction in the elimination of fungus increase to 80-90%.  Learn more about the Foot and Ankle Center's Comprehensive Laser Treatment Program here.

While dystrophic toenails can be present with fungal nails, in the past we had little to help our patients improve nail appearance. Fortunately, Tolcylen can also help improve the appearance of dystrophic toenails. 

Need Treatment for Dystrophic Toenails in Seattle, Washington? Request an Appointment Now

Dystrophic or misshapen toenails are caused by several different conditions. Learn how we can help you get to the root of the problem.  Complete the contact form on this page or call our office at 206-368-7000 to schedule an appointment with Dr. Berg.

Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.

North Seattle Foot & Ankle Specialist Dr. Rion Berg offers compassionate podiatry care for all foot and ankle problems to those living in Seattle Washington and the surrounding areas. Call us today at 206-368-7000 for an immediate appointment or request an appointment online.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.